Millions of Americans suffer from chronic pain every day. A variety of pain conditions exist for which patients seek medical care. These issues comprise the vast majority of physician office complaints and visits. The frequency of such visits stems from an overall lack of successful long term treatment options. Couple this with the problem that many physicians don’t feel comfortable treating chronic pain and often leave their patient with partial care because of fear of addiction, diversion and government agency scrutiny.

This article is not meant to explain all types of pain and every option for all conditions, but rather give insight as to the different categories of treatment strategies a patient can pursue if one has chronic pain. For purposes of discussion I will break down the options into the following categories: Pharmaceuticals, surgical, interventional non-surgical, telemedicine, holistic/alternative. A well balanced treatment plan will likely encompass a nice mix of the above.

Most physicians and patients are quite aware of pharmaceuticals to treat pain. When one thinks of chronic pain they often associate it with the need for medicine such as narcotics. This is part of the reason pain management gets a bad name because of this association. Needless to say, a complete discussion of all medicines available to treat chronic pain is well beyond the scope of this article. There are, however, a variety of pharmaceutical options for physicians to trial on patients with pain. Non-narcotics such as acetaminophen and nsaids are first line options. Medications that act similar to narcotics but with less risk of dependence include tramadol. Narcotics work directly on the pain receptors in the body and many are available to choose from for moderate to severe chronic pain. Newer "centrally acting" medications are effective in modulating the brains sensation of pain and are often used in conjunction with narcotics to treat chronic pain. These include a variety of anti-seizure medications, anti-depressants and other uniquely acting drugs.

Surgical intervention is appropriate for some patients with chronic pain. Unfortunately the results in regards to pain relief are often disappointing. This tends to be particularly significant in patients with back problems. Surgery is often effective in helping stabilization in function but not relief of pain. A good example is a patient with chronic back pain from a bulging disc. This causes the patient pain and overtime neurologic problems such as numbness and weakness. Surgery would be a viable option to prevent progression of the weakness but a decrease in pain level is often disappointing. On the other hand patients with severe joint disease such as arthritis can get significant pain relief after a joint replacement.

Non-surgical interventions are becoming more readily available. These include injections of chemicals directly to the source of pain by trained physicians. Often there is the use of x-ray, CT or ultrasound to guide the injection to the proper location. Other treatment options include the use of radio frequencies to dampen the "bad" response of damaged nerves. New techniques are emerging to provide a nice adjunct to patients with medications and avoid or prolong surgery.

Online pain management is an emerging field of medicine using a newer technology called telemedicine. This allows patients to provide these treatment options to their patients in a more convenient format. There is a shortage of pain specialists and this technology allows patients and doctors to connect via phone or video conferencing often without having to travel or make frequent in-office visits. Close follow up is afforded to the patient with the ability for the pain management specialist to track the patient’s response to medication or other options as described above.

Finally there are holistic or alternative treatments for pain. These include everything from chiropractic and acupuncture to herbs and supplements sold over the counter. These treatment options are less regulated but that does not mean ineffective. Medical literature does support the use of chiropractic and acupuncture for certain pain conditions. There are effective and safe over the counter creams which may help some. Patients do need to be careful with all products sold online or elsewhere that are not regulated by the FDA. These products may not be safe and or may interfere with other treatment options such as prescribed medication. Given the millions of Americans suffering with pain, it has become a big business. As in any business there are those out to make a quick buck and sell ineffective products. Needless to say, be careful and ask a professional before use.

As you can see, the limitation of pain treatment to narcotics is quite inaccurate but often the stigma associated with pain management. Although this discussion if very superficial it shows how there is a variety of treatment plans that can be implemented to any given person. A well balance approach will often lead to successful pain management.