Drug therapy is just one aspect of a multi-modal approach to chronic pain management. Physical therapy (physiotherapy, acupuncture, Transcutaneous Electrical Nerve Stimulation (TENS), regional blocks (injection of drugs around nerves or other tissues) and psychological therapies (techniques which improve coping of pain) are also very important in a comprehensive chronic pain management program.
Before considering what medication to use, it is important to determine the type of pain. Pain can be described as nociceptive, neuropathic or mixed. Nociceptive pain is pain that occurs as a result of tissue damage or a painful stimulus, such as mechanical low back pain and degenerative or inflammatory joint pain. These pains may begin as purely nociceptive, but over time there may be changes within the nervous system that result in a neuropathic component to the pain. Neuropathic pain occurs as a result of damage to the nervous system, resulting in the nerve becoming oversensitive. Patients describe this pain as sharp, stabbing, lacinating, burning and electric-shock like.
Last date updated on July, 2014