How to Build a Treatment Plan for Managing Pain

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There are two lies that bedevil just about any person who suffers from chronic pain. The first is that there is nothing you can do about your pain except to live with it. The second is that there is a fast and easy “magic bullet” that will instantly make you pain free for the rest of your life.

The truth of the matter is that there are many safe and effective ways to manage pain, but probably no single therapy that will cure you of all your ills. It’s my opinion—and other pain specialists agree—that the best way to manage pain is to take a multimodal approach. In other words, you’ll get the best results by combining several therapies so that you are fighting pain in more than one way at a time.

Generally speaking, pain treatments fall into one of three categories. Let’s look at each and then review how to decide which therapies you should use.

Conventional Medical Pain Therapies

“Conventional medical therapy” is a formal way of saying “the stuff that doctors usually do to help treat pain”—namely, drug therapy and surgery.

Drug therapy. Let’s talk about medications first, because they are the most common way of controlling pain. There are many popular pain relievers on the market. These include over-the-counter options like aspirin, acetaminophen, and NSAIDs, as well as prescription narcotics such as morphine, oxycodone, and other opioids.

While drugs are often effective, they are not always safe due to the side effects they cause. This poses a dilemma for many people with chronic pain, because the pills that help reduce pain usually are not safe to take over the long term.

For example, you may find relief with a shot of morphine—but that isn’t really a feasible solution for every day of the rest of your life. Even drugs like ibuprofen or acetaminophen are associated with serious risks if you take too many of them, or take them over a long period of time.

The truth is that pills are not always the answer for people living with pain, and they must be used very carefully. This is especially true for opioid pain relievers, upon which users can become chemically dependent.

Surgery is another common conventional therapy. The decision to have surgery is a big one, but for many people with chronic pain, surgery is a good solution—although it may not provide complete pain relief. Talk to your doctor about the risks of surgery as well as the potential benefits, and proceed with caution.

Natural Pain Therapies

Natural therapies can help with managing pain, too, but they are less well studied by physicians. Examples of natural therapies include, but are not limited to:

  • Massage
  • Physical therapy
  • Chiropractic medicine
  • Vitamins
  • Herbal remedies
  • Pain diet
  • Exercise
  • Heat therapy and cold therapy (i.e., a heating pad on an aching back or an ice pack on a sore knee)

Complementary and Alternative Pain Therapies

Complementary and alternative medicine (also known as CAM) is being studied and even offered at some of the world’s most prestigious medical centers. CAM approaches to pain include, but are not limited to:

  • Acupuncture
  • Acupressure
  • Chinese herbal therapies
  • Reflexology
  • Biofeedback
  • Deep relaxation
  • Talk therapy
  • Meditation
  • Spiritual pursuits

How Should I Go About Building a Pain Treatment Plan?

To build your multimodal treatment plan, simply combine the conventional medicine (medication, surgery, physical and rehabilitative therapy) with natural and CAM approaches (anti-inflammatory diet, exercise, relaxation, massage, acupuncture, and so on) that work for you—keeping in mind that the benefits of any therapy you try should outweigh its risks.

Finding your ideal treatment mix will be a process of trial and error. The best thing to do is to test and try different approaches, keeping an open mind about all of them. Some things you will be able to do yourself (ice packs, heating pads, over-the-counter topical products, more sleep, a different mattress or pillow, a stretchy bandage to support a joint, quitting smoking or drinking, cutting sugar out of the diet, etc.), and others will require the help of a professional (chiropractic treatments or massage, for example).

Not everything will work as well as you want it to work—but now and then, something you did not think would work at all will provide major relief. I encourage you to educate yourself on as many treatment options as possible and not be shy about trying them. You have to be your own advocate!

Get Into the Right Mindset

One last point I want to make is about managing expectations. My experience has shown me that many people living with pain are often extremist in their thinking—either they want their pain to be totally cured, or they’ll just grit their teeth and endure it. Both are extreme points of view and not especially realistic. Therefore, it’s important to manage your expectations toward the middle.

Chances are good that your pain did not come over you all at once, and chances are good that your pain is not going to go away all at once. In fact, in your earliest stages of pain treatment, your goal should be “pain management.” Managing pain does not mean that your pain is totally gone (although that could happen); it means that your pain is lessened and under better control.

You’re playing a numbers game by trying to find several things that control your pain. For instance, let’s take a person with low back pain. She may find that getting more sleep reduces her pain about 10 percent. A heating pad helps another 10 percent, a new mattress helps 40 percent, and some exercises in the swimming pool help another 40 percent. That is a lot of little stuff—but it adds up to 100 percent relief.

If you find something that relieves even a small amount of your pain, keep doing it. Anything you can do to manage and control pain is good therapy.

Dr. Joseph Pergolizzi

Meet Dr. Joseph Pergolizzi

Dr. Joseph Pergolizzi is an internationally recognized expert in pain medicine who has spent much of his career studying what pain is, why it occurs, and how best to treat it. That experience has led him to believe strongly that there are often ways to relieve or manage pain which are overlooked or discounted, and that the most effective treatment approaches are always multi-modal.

More About Dr. Joseph Pergolizzi