Dr. Pamela Squire, MD, CCFP, DCAPM, ISAM, CPE, discusses treatment of chronic pain.
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How is Chronic Pain Treated?Dr. Pamela Squire, MD, CCFP, DCAPM, ISAM, CPE, discusses treatment of chronic pain.
Featuring Dr. Pamela Squire, MD, CCFP, DCAPM, ISAM, CPE
Duration: 2 minutes, 31 seconds
We treat chronic pain by looking at all of the different underlying factors that are playing a role in anybody's pain.
Some of the factors will be biological, related to tissue damage, some will be psychological factors relating to how people think about their pain and deal with their pain, and other factors will be related to society and how society helps them or doesn't help them live with their pain.
Most physicians will assess chronic pain by looking at the particular part of you that is in pain, deciding if they need any investigations, whether they should have consultations to help them understand why you're having chronic pain, and then try to look at the impact of chronic pain and decide if you're having problems with anxiety or depression and look at ways to manage that.
An important part of chronic pain management involves self-management. A lot of physicians are not necessarily familiar with how to instruct their patients. And, indeed, a lot of patients need to go outside their physician's office to find that.
A physician will refer a patient to either an individual physician with expertise in assessing and managing chronic pain or to a team that has the same kinds of expertise but involves interdisciplinary members.
Medications used to manage chronic pain involve a wide variety of classes. We'll use analgesics. Some of them are simple, like acetaminophen. Some of them involve stronger analgesics, like opioids.
We use a class of medications that work on the system that turns pain off. Those medications are the same medications that work for mood, so some of the antidepressants work exceptionally well for chronic pain, not all of them.
We also use anticonvulsants. Those are medications usually used to treat seizures, but they also help with nerve related chronic pain. Anti-inflammatories are medications used to treat chronic pain if the pain is mild to moderate or if there's an element of inflammation.
Another class of medications used to manage chronic pain are the cannabinoids. Marijuana is a plant that has 60 different cannabinoids, of which THC and CBD are cannabidiol, are two of the most active for pain management.
There are pharmaceutical companies that have manufactured medications that contain one or both of those compounds, and we often use them when we manage chronic pain.