13 ways to manage chronic pain

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According to the Centers for Disease Control and Prevention (CDC), around 20% of adults in the United States had chronic pain in 2016, while 8% had high-impact chronic pain.

The 2017 Global Burden of Disease Study estimates that pain and diseases related to pain are the leading cause of disability worldwide, and the amount of people living with chronic pain is increasing.

Chronic pain has associations with numerous physical and mental health conditions, including:

• depression
• sleep problems
• social isolation
• overuse of medication

Pain management refers to techniques to reduce and control the amount of pain a person experiences over the long term.

There are many ways to manage pain, and not all of them include taking medication.

Various physical methods can help relieve pain, including physical therapy, hot and cold therapy, massage, and acupuncture.

Hot and cold therapy

Hot and cold therapy is a common and safe technique to reduce pain.

Heat can help relax the muscles and dilate the blood vessels. It can also promote healing after an injury.

Cold therapy reduces blood flow and reduces inflammation that causes pain. It often involves applying an ice pack wrapped in a towel to the skin.

Massage

Massage is a type of soft-tissue manipulation. People may benefit from this technique when used with other pain management treatments, such as physical therapy and pain medication.

The benefits of massage include:

• relaxation
• increased flexibility
• reduced inflammation
• improved posture
• improved circulation
• reduced stiffness

A 2007 review on massage found that it may be effective for lower back pain. However, there is mixed evidence from examining its benefits for other chronic pain types.

Physical therapy

Physical therapy involves physical techniques to strengthen and stretch the muscles and joints. It can relieve pain throughout the body, while the specific methods will vary by body part.

Therapeutic exercise can have long-term benefits for chronic pain, including helping people cope.

Techniques may involve massage, exercise plans, and red light therapy.

Acupuncture

Acupuncture involves a practitioner applying thin needles to the skin at precise points in the body.

According to the National Center for Complementary and Integrative Health, evidence suggests this technique could help people manage certain pain conditions.

This includes short-term relief from pain in the lower back, neck, knee, and osteoarthritis. However, there is little evidence to suggest it is effective over the long term.

The proposed benefits of acupuncture are:

• pain relief
• reduced inflammation
• relaxation
• reduced muscle spasms

Acupuncture is generally safe when performed by trained practitioners using sterile needles.

Methods that combine psychology and the body can help many people manage chronic pain.

Cognitive behavior therapy

Psychological treatments for chronic pain include talking therapies, such as cognitive behavioral therapy (CBT).

Psychological treatments aim to reduce the negative impact that chronic pain can have on a person’s mental health.

A 2013 review on the effectiveness of psychological pain management techniques concludes that CBT is effective at reducing pain immediately after treatment compared with using no strategies.

The review also found that there was no evidence that CBT can reduce long-term pain. However, the technique was useful for reducing anxiety around pain and for improving quality of life.

Yoga

Yoga aims to relax, strengthen, and keep the body flexible through stretching, with specific poses focusing on particular body areas.

A 2010 study into yoga’s effects on chronic pain found that it did not decrease participants’ pain, but it did help them cope, and they were more in control of how their pain affected their everyday life.

However, other studies have found yoga to be effective in reducing pain.

Yoga is a safe and accessible pain management technique that people can try at home, using online videos, or in a class with an instructor.

Tai chi

Tai chi is an exercise therapy involving slow, continuous, fluid body movements combined with breathing and relaxation techniques. The method is also gentle on the joints and muscles.

Tai chi can improve strength and joint stability, and the concentration it requires can improve a person’s mood.

According to a 2016 review, there is some evidence that the technique could help with chronic pain. It states that people using tai chi experienced improvements in chronic pain from rheumatoid arthritis, lower back pain, and osteoporosis.

Dealing with chronic pain can be stressful for many reasons, such as not feeling in control regarding a person’s discomfort.

Relaxation techniques can help ease muscle tension, muscle spasms, aches, and pains. They can also release endorphins, which are the body’s natural painkillers.

A person can help reduce stress through relaxation, which can ease some of the burden of chronic pain while promoting better sleep.

Relaxation methods for chronic pain include:

• Deep breathing techniques: Slow and relaxed breathing methods, such as box breathing, help relieve tension.
• Progressive muscle relaxation: Involves tensing and relaxing each muscle group in turn, for 10 seconds each, from the head to the toes. Focus on breathing and avoid muscles that feel painful.
• Thinking calmly: Spend 5 minutes imagining a calming scene, such as a sunny afternoon in nature, surrounded by green trees and birdsong.
• Calming activities: Set aside time for relaxing activities such as having a warm bath, reading a book, or crafting.

There is a wide range of medications to relieve pain. Each class and type of drug work differently, while some may be more suitable for certain people than others.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of medications that reduce inflammation and pain. They are available in capsules, tablets, or as creams or gels for the skin.

However, NSAIDs may cause issues with the stomach and the cardiovascular system in some people. Talk with a doctor before beginning treatment with NSAIDs.

Opioids

Opioids can treat moderate-to-severe pain and are generally only appropriate for short periods, as they can be addictive.

CDC guidelines recommend people should only use opioids when the benefits outweigh the risks.

There is a lack of evidence that this treatment works for chronic pain, as people typically use opioids for short periods.

Antidepressants

Some antidepressants, such as amitriptyline, can help with pain relief.

Amitriptyline is an antidepressant that, at lower doses, people also use for chronic pain, such as diabetic neuropathy and fibromyalgia.

It can take 2–4 weeks for a person to feel the effects of the medication.

Side effects of amitriptyline can include:

• dizziness
• dry mouth
• fatigue
• headaches

Beta-blockers

Beta-blockers slow down the heart and stop hormones, such as adrenaline, from working. Some people use them to treat migraines.

A study shows that beta-blockers at low doses can temporarily improve chronic pain in females with fibromyalgia and temporomandibular syndrome.

However, beta-blockers may not be suitable for everyone. Consult with a doctor before using them for chronic pain.

Cannabis

Medicinal cannabis and cannabidiol (CBD) are increasingly common pain treatments.

A 2017 review states that cannabis may ease neuropathic pain, but not pain due to fibromyalgia, headaches, or rheumatoid arthritis.

In addition, cannabis for medicinal purposes may not be legal everywhere. High doses can trigger side effects, so it is best to check with a health professional before using cannabis CBD for pain relief.

Read more about CBD for chronic pain here.

There are a variety of ways to manage chronic pain, while many are accessible and easy to use.

Most pain management techniques aim to reduce chronic pain or improve a person’s coping strategies.

Some pain management approaches, such as acupuncture, physical therapy, and yoga, are best performed with a professional therapist to ensure that a person can safely practice them.

People should speak with their doctor before beginning any new medication. This is to make sure they are safe, do not worsen pain, and will not interact with any other drugs a person is taking.