Pain Clinic

Although pain clinics differ in their focus and offerings, most involve a team of health care providers that can help you with a variety of strategies to manage your pain.

These health care providers are likely to include doctors of different specialties as well as non-physician providers specialized in the diagnosis and management of chronic pain. These providers may include psychologists, physical therapists, and complementary and alternative therapists. Together, they will put a pain management plan for you.

At a pain clinic, your therapy plan will be tailored to your specific needs, circumstances, and preferences. Depending on the cause of your pain, treatments may include one or more of the following:

Medications. In many cases, patients are prescribed treatment before receiving other forms of therapy. Medications for pain may include:

• Non-aspirin pain relievers. These drugs, such as acetaminophen (Tylenol), relieve minor pain and are sometimes combined with other drugs to provide greater pain relief.

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Available over the counter or by prescription, these drugs — including ibuprofen (Motrin) or naproxen (Aleve, Naprosyn) — are used to treat pain and inflammation.

• Corticosteroids. Available only by a prescription, these cortisone-like drugs are used for more severe inflammatory conditions.

• Opioid pain medications. These morphine-like drugs are often prescribed short term for acute pain or for cancer pain. Occasionally, doctors prescribe them for chronic, non-cancer pain.

• Antidepressants. Originally designed to treat depression, these drugs can be useful for relieving certain types of pain. Antidepressants may also promote sleep, which can be difficult when you are in pain.

• Often, medications alone aren’t enough to treat chronic pain. Other treatments may be more effective than medications, and medication may be more effective when combined with other treatments. Other available treatments offered by pain centers may include:

• Injections. Local anesthetics, sometimes combined with a corticosteroid, may be injected around nerve roots or into muscles and joints to relieve irritation, swelling, and muscle spasms.

• Nerve blocks. If a group of nerves, called a ganglion or plexus, causes pain to a specific organ or body region, injections with local anesthetics may be useful for blocking the pain in that area.

• Physical therapy. A physiatrist (doctor specializing in rehabilitation medicine) or physical therapist may prescribe a specially tailored exercise program to increase function and decrease pain. Other physical therapy options at pain clinics may include whirlpool therapy, ultrasound, and deep-muscle massage.

• Electrical stimulation. The most common form of electrical stimulation used in pain management is transcutaneous electrical nerve stimulation (TENS), a technique that uses a small, battery-operated device to stimulate nerve fibers through the skin. Other implants for pain control use medicine, heat or chemicals.

• Psychological support and counseling. Although pain is a physical sensation, many people in pain suffer emotionally with feelings of anger, sadness, and hopelessness. Dealing with unrelenting pain can affect your ability to hold a job, maintain a home, meet family obligations, and relate to friends and family members. Psychological support, along with medical treatment, can help you manage your condition.

• Surgery. Although sometimes surgery is clearly necessary to relieve a problem that is causing pain, it is often a treatment of last resort. If pain has not responded to any other treatment, surgery on certain nerves may offer relief and allow you to resume normal activities.