Chronic pain is a complex disorder that is affected by a range of different factors, including lifestyle, mental health, socioeconomic status, and family influences1. As a result, it’s now common practice for healthcare providers to prescribe a combination of treatments to manage chronic pain – different types of pain medication; lifestyle adjustments; pain-relieving procedures; and psychological therapies1. Here are some of them:
Analgesics
Analgesics are medicines that relieve pain – in other words, painkillers2. You get different types of analgesics, with different chemical compositions2. The World Health Organization’s analgesic ladder acts as a guide to determine which painkillers should be prescribed3. For mild pain, it recommends non-opioids such as nonsteroidal anti-inflammatory drugs (NSAIDs) or paracetamol3. For moderate pain, a mild opioid – such as codeine – could be prescribed3. When the pain is very bad or lasting, strong opioids – such as morphine – may be preferable3. However, opioids carry the risk of addiction, misuse, and accidental overdose, so healthcare providers need to be extra careful when prescribing them4.
Adjuvants
These are also known as “co-analgesics”3. They consist of a wide range of medicines usually used to treat other conditions, but that may be prescribed alongside painkillers to help treat certain kinds of pain3. Adjuvants may include antidepressants, serotonin-norepinephrine reuptake inhibitors (SNRIs), anticonvulsants, topical anaesthetics, topical therapies, corticosteroids, bisphosphonates, and cannabinoids3. In some specific instances, adjuvants may even be prescribed as standalone pain treatments, for example, anticonvulsants and tricyclic antidepressants to manage pain caused by diabetic nerve damage3.
Cognitive behavioural therapy (CBT)
This is a type of psychological treatment that focuses on changing your thought patterns and coping strategies1. Several studies have shown that it can help manage chronic pain disorders, including fibromyalgia, chronic lower back pain, rheumatoid arthritis, and chronic musculoskeletal pain1. CBT has also been shown to help people with chronic pain regain control of their lives by learning to function again1.
Cognitive functional therapy (CFT)
This is another kind of psychological treatment that involves identifying and changing your personal behaviour patterns to alter your response to pain1. It’s less concerned with lowering your perception of pain and more focused on improving quality of life and ability to function1. The idea is that you learn to create a story out of your pain experience and, through telling it, identify behaviour, emotions or patterns that are holding you back in your journey to managing your pain1. Ultimately, the goal with CFT is to create a lifestyle change that has you exercising, moving more, and sleeping better1. If you need help with managing pain, speak to your healthcare provider to find the method that works best for you.
References
1. Hadley, G. & Novitch, M.B. CBT and CFT for Chronic Pain. Curr Pain Headache Rep. 25, 35 (2021).
2. American Psychological Association Staff. APA Dictionary of Psychology (2020). Available at: https://dictionary.apa.org/analgesic
3. Anekar, A. A. & Cascella, M. WHO Analgesic Ladder. In: StatPearls. Treasure Island (FL): StatPearls Publishing. (2021).
4. Sehgal, N., et al. Prescription opioid abuse in chronic pain: a review of opioid abuse predictors and strategies to curb opioid abuse. Pain physician, 15(3 Suppl), ES67–ES92 (2012).
