Possible solutions for chronic pain include?

Answer 1

For many types of chronic pain there are new options:

• Exercise has been clinically-tested and found beneficial for both Arthritis and Back pain. A common response is: "But I can't MOVE without pain! How do you expect me to exercise?" Ans: That is why Pool Therapy was developed. Many million-dollar athletes owe their fast-recovery to aquatic therapy. Not swimming, usually a physical therapy specialist can design a program for you to do in the pool.

• Topical pain-relief medications - though so new they are essentially "secrets" - provide good relief applied directly on your painful knee, elbow, back or shoulder. Cochrane Reviews found 35 studies showed "good" pain-relief with the new topical NSAID medicines. And - there is a new, herbal over-the-counter option as well.

• For back pain - even the pain of degenerative disc disease - there is the new "pattern-recognition" approach that seems to offer fast-relief with less than half the pain pills when tested on 2,110 patients. (reported in 2009)

• New medications that help pain include: Cymbalta - an anti-depressant with pain-relief characteristics; Nucynta - a combination quasi-narcotic + anti-depressant (can be taken with other anti-depressants); Long-acting tramadol also works well.

Chronic narcotic pills are increasingly shown to be a poor choice for long-term pain-relief. Some evidence is that medicines like Vicodin cause your brain to "flip" after 2-3 months and actually cause an increased sensitivity to pain to develop.

Older options include:

• Fentanyl patches may help for a year or two. Then relief seems to taper-off;
• Spinal cord stimulator for back pain - moderately effective, but costly to maintain;
• Morphine pump - implanted in the spine. More pain-relief effect with less brain "fog";

You'll want to discuss these with your M.D. and perhaps a Physical Medicine and Rehabilitation specialist (pain specialist). Watch out there - the trend is to "drug you up" a bit by some.

Most of the time, It's a better idea to get 25-35 percent relief using one well-tolerated approach - like exercise. Then add another approach like the topical pain relief "secrets" I mentioned - to get another one-third or more relief. Combining several of these effective - but not 'Home-Run' - treatments often works better, than always looking to Hit it Out-of-the-Park.

Hope you get that. And Keep Moving - Exercise - Even just a little, but several times a day, does REALLY GOOD THINGS for your brain. (Don't mean to shout, but it IS that important)

Best,

drdanbullock (orthopedics)