Managing Chronic Pain: A Multidisciplinary Approach

Dr.Prabhat Sinha, 2 mins read

No one wants pain. And chronic pain? No one wants to talk about it either. It's dull aching and makes you even dull. But let's address that today.

Chronic pain, defined as persistent discomfort lasting over three months, affects approximately 19.3% of the Indian adult population. Notably, women are disproportionately impacted, with a prevalence rate of 25.2%. Another important segment of population affected are the elderly. Common causes include neuropathic pain, post surgical and post traumatic pain and cancer related pains.

A multidisciplinary approach-integrating physical, psychological, and medical therapies-offers the most effective and sustainable relief.

The myriad of options include-

Non-Pharmacological Methods:

Exercises and physiotherapy:

• Tailored movements enhance strength, joint mobility, and reduce stiffness, forming the cornerstone of chronic pain management. And when I say exercises, I mean it's much beyond the routine stretches and jogs, it includes yoga, Tai chi and hydrotherapy.
• Cognitive Behavioral Therapy (CBT): CBT assists patients in reconstructing maladaptive beliefs, addressing negative thought patterns, developing coping mechanisms, and reducing the emotional burden of pain
• Stress Reduction Techniques: Practices such as mindfulness, meditation, music therapy and deep breathing can lower pain perception and improve quality of life.
• Transcutaneous Electrical Nerve Stimulation (TENS), Acupuncture, This non-invasive therapy provides relief by stimulating nerves to interfere with pain signals.

Pharmacological Treatments:

• NSAIDS and non narcotic medications: Topical and oral drugs like diclofenac and Topical Lidocaine and capsaicin at high concentrations can reduce the pain signals especially accompanying with neuropathic pain
• Analgesic antidepressants and antiepileptic drugs: Medications like amitriptyline or duloxetine, gabapentin and pregabalin are effective for neuropathic pain and also help with sleep and mood
• Cannabinoids: Approved cannabinoids, including cannabis oil, offer relief in selected cases of neuropathic or cancer-related pain.
• Opioid Patches: Transdermal opioid patches (morphine, fentanyl) deliver steady relief for severe, persistent pain. But one needs to take them always under close supervision of your doctor, due to risk of misuse, abuse and addiction.
• Ketamine & Lignocaine Infusions: These are used in resistant cases, particularly for complex regional pain or neuropathy.

Invasive Procedures:

• Trigger Point Injections: These provide targeted relief from muscle-related pain, effective for conditions like fibromyalgia. Intra articular steroid Injections can be given for conditions like osteoarthritis and JIA.
• Nerve Blocks and Radio Frequency Ablation: Effective for localized, severe pain, offering both diagnostic and therapeutic benefits.
• Prolotherapy: Involves injecting irritants to stimulate tissue repair and healing.

Takeaway!

Lastly I would like to say, pain is dynamic and so is the science of medicine. Integrative treatments combining modern medicine with the physiological and psychological interventions is the holistic way of modern chronic pain management. And it can be effectively managed. You can become independent, pursue hobbies, and reclaim a fulfilling, active life. And most importantly all this without having to bear that dull, boring and nagging pain all day.

Pain should not and will not define the future. Only you can! Your decisions can! Meet your doctor now.