Trends in Chronic Pain Management

According to the American Chronic Pain Association, a simple definition of chronic pain is "pain that continues when it should not." Without knowing or being able to treat the underlying cause, health-care professionals must turn to other methods of treating this pain in order to provide some level of relief to their patients.

In addition to many well-known, established treatments, such as non-narcotic drugs (acetaminophen, aspirin, and ibuprofen, for example) and narcotic medications (such as morphine and methadone), several alternative methods are being used to treat chronic pain, with varying degrees of success.

One such treatment uses a transcutaneous electrical nerve stimulation (TENS) device, which delivers a small electrical current to the skin surrounding the painful area(s). While considered safe overall, the effectiveness of TENS in treating chronic pain is still under debate, but it has helped some patients. A product called Quell is electrode strip that, like a TENS unit, sends electrical signals that "stimulate dense nerve clusters triggering endogenous pain relief mechanisms in the body."

While not exactly a new technique, the use of marijuana for medical purposes such as pain relief remains in the spotlight as bills to legalize its use come before state legislatures off and on. Presently, over half of the states in the U.S. allow the use of medical marijuana, although it remains banned on the federal level. The long-term benefits of marijuana on chronic pain remain unknown due to the lack of scientific research.

Spinal cord stimulation (SCS) involves implanting a small device beneath the skin that creates small electrical impulses near the base of the spine. Sometimes called a "pain pacemaker," SCS devices can now work via remote control, which allows the patient to adjust the level of the electrical signals in response to increasing or decreasing pain.

Like the TENS device noted earlier, however, the effectiveness of spinal cord stimulation is still under study and implantation of these expensive devices requires extensive testing of individuals with specific types of pain to maximize the potential of success.

Not unlike an SCS device, a "pain pump" or "drug pump" is a device implanted beneath the skin but this unit actually delivers medication directly to the fluid surrounding the spinal cord. Use of a pain pump is not widespread because of the expense involved, but for certain patients, these devices have proven effective because the amount of medication needed is lower, which can reduce the negative side effects experienced with other drug-delivery techniques.

Unconventional treatments for chronic pain have grown significantly in the past two decades due to the growing acceptance of non-conventional medical methods, such as herbal supplements, yoga, meditation, etc. These various processes are collectively referred to as CAM, or complementary and alternative medicine. Briefly, a complementary technique will be used along with other pain-control treatments, while an alternative method is used in lieu of another type of treatment.

The list of CAM treatment types is long but includes massage therapy, acupuncture, hypnosis, magnetic therapy, tai chi, and herbal or dietary supplements, to name a few. While some of these processes and products might lack significant scientific research to prove their effectiveness, it is important to remember two things. First, some of the treatments now used in conventional medicine, such as chiropractic care and herbal supplements, existed outside of mainstream medicine for a long time. More importantly, many people suffering from chronic pain have found some degree of relief.