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When Your Pain Medication Isn't Working

What your next steps might be in treating your chronic pain.

Putting Your Mind to Work continued...

She's a psychologist who works with people in chronic pain to help them find new ways to think about it. The brain can be a powerful ally -- or enemy -- during chronic pain. That's because:

  • Your brain filters the pain signals coming from your body. Your thoughts and emotions play a role in this filtering. The brain can dampen the strength of these pain signals or ramp them up, Thorn tells WebMD.
  • Over time, the brain can become more sensitive to chronic pain. It may overreact to even less intense pain signals.

Cognitive-behavioral therapy (CBT), an approach that Thorn uses with patients, can address both issues, she says. CBT helps people:

Change their pain-related thoughts. "If the thought of a pain flare-up makes you say things to yourself like, 'I'll have to go to the ER for sure,' or, 'I can't stand this anymore, this is ruining my life,' it can really dig a hole for you," Thorn says.

Pain control involves noting negative self-talk and replacing these thoughts with factual, positive options, like focusing on the good parts of your life.

Change their behaviors. "When they have a pain flare-up, many people go to bed, pull the covers up, and withdraw. This makes them more susceptible to pain, and it can make them depressed," Thorn says. CBT can help people follow their usual routines even during flares.

A psychologist can also help you deal with your pain with a related technique: mindfulness. Instead of reacting when pain grabs your attention, mindfulness involves observing the pain with a neutral attitude. "When that reaction isn't there anymore, pain is easier to manage," Thorn says. "What people start to realize is that there's a lot of variability in their pain. If they really pay attention to their moment-to-moment experiences, they realize that sometimes they're pain-free."

Seeking Other Alternatives

Unconventional treatments may also succeed when medication doesn't provide the answer.

Lawrence Taw, MD, of the UCLA Center for East-West Medicine, often sees people with autoimmune diseases, some of which can cause chronic pain, such as lupus and MS.

Some people look to complementary medical approaches because medicines haven't worked. Others just want natural solutions. "I'd rather not think of this as a medical option of last resort. I think it's important to consider using these therapies earlier in the course of treatment, or in conjunction with mainstream medicine," Taw tells WebMD.

These providers tend to develop specific approaches for each person's needs, Taw says. Options may include:

  • Herbs and supplements. The herbs ginger and turmeric can reduce inflammation, for example. Always tell your doctor about any supplements you're taking, even if they're "natural," so that your doctor can watch for any problems and has a complete record of what you've tried.
  • Acupuncture and acupressure. Surveys have found that painful conditions -- including back and neck pain and headaches -- are some of the most common reasons why people use acupuncture. Acupressure is a related treatment that uses focused pressure to stimulate certain spots on the body instead of the thin needles used in acupuncture.
  • Topical treatments. These include menthol rubs, capsaicin cream (for joint pain), and arnica cream.

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