What is pain management?
Pain management is an interdisciplinary branch of medicine that aims to improve the quality of life of patients with chronic pain by reducing their suffering. It aims to relieve pain over the long term and can be practiced by a single physician or by a dedicated pain management team composed of different specialists. It may involve pharmacological or psychological treatments, or a combination of both.
Why is it done?
While many branches of medicine focus on diagnosing and treating injuries and pathology, as well as treating symptoms and pain during the healing process, pain management is necessary when pain persists after an injury or illness has healed. If the cause is unclear, the goal is to relieve pain. Typically, recipients of therapy are patients with chronic (long-term) pain. Types of pain that often need to be managed include chronic back pain and headaches.
What is involved?
There are many types of treatments for pain management, which can be divided into three categories:
- Physical treatments include: physical therapy, therapeutic exercise, application of heat and/or ice, acupuncture, electrotherapy and various interventional procedures, such as facet joint injections and spinal cord stimulation. Patients may find different methods that can alleviate their pain, such as therapeutic massage. Some treatments may have a psychological element, such as the placebo effect.
- Psychological treatments, such as cognitive behavioral therapy (CBT) and hypnosis, have been used to treat pain, but with inconsistent results regarding effectiveness. Some studies have shown a slight improvement in mood after CBT, but there is insufficient evidence to definitively state that it can relieve pain. Similarly, studies on the effects of hypnosis are limited, although there are signs of improvement. Some believe that the effectiveness of psychological treatments may be caused by the placebo effect.
- Pharmacological treatments involve the use of different types of medications, mainly analgesics and anti-inflammatory drugs. The type of medication depends on the site, severity and probable cause of the pain. For example, mild pain can be controlled with over-the-counter analgesics, while severe pain (after an injury or surgery, for example) can be treated with opioids. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, while antidepressants may be prescribed for conditions such as fibromyalgia.
Because of the multidisciplinary nature of this specialty, a dedicated pain management team may consist of physicians, nurses, physical therapists, psychologists, and other mental health therapists.