Effective pain management of chronic or musculoskeletal pain

    There are a number of reasons why you may suffer from pain. And, there are just as many methods to manage this pain. The management of pain, in fact, begins as soon as the health care provider examines the patient and ask some basic questions related to the pain, like:

    1. What does the pain feel like?
    2. What is the intensity of the pain?
    3. If patient can locate the pain, where is it located?
    4. Does anything alleviate the pain?
    5. Any precursors to the pain?

    There are many other questions that the health care provider would ask letting him/her understand the nature and cause of the pain better.

    Let’s take a look at some of the effect methods of pain management:

    Physical approach to pain management

    Medicinal approach with rehabilitation

    Medicine along with rehabilitation remains the most common method of pain management. Pharmacotherapy is often accompanied by physical techniques like electrotherapy, thermal agents, therapeutic exercising and behavioural therapy.


    TENS, Transcutaneous electrical nerve stimulation, is found to be useful in diabetic neuropathy, while it may be ineffective for lower back pain. Adequate evidence based research is required to establish the proper efficacy of TENS. TENS is usually advised for chronic musculoskeletal conditions where its effectiveness may be explained by the gate control theory of pain. In fact, Oncel M and team conducted a study to compare the efficacy of TENS against NSAID in patients with uncomplicated minor rib fractures. The study found that giving TENS therapy twice a day for 3 days was more effective than NSAID or placebo.


    Acupuncture has emerged as a popular method of pain management. This therapy involves the use of needles that are placed at specific points in the body to alleviate the pain. Studies suggest that acupuncture can be useful in join pain, thus, particularly useful in knee osteoarthritis.

    Light Therapy

    Light therapy is another method in use recently like low level laser therapy. However, studies have failed to establish the effectiveness of light therapy, especially in low back pain.

    Interventional Pain management

    There are several interventional pain management methods available. Interventional procedures are mainly used for chronic pain management facet joint injections, epidural steroid injections, neurolytic blocks, intrathecal drug delivery system implants and spinal cord stimulators.

    Methods like neuromodulation, pulsed radiofrequency, nerve ablation and direct introduction of medication are useful in targeting specific tissues, organs or systems which may be responsible for chronic pain.

    The intrathecal pump is used to deliver medications directly to the spinal fluid in small quantities, thus, minimising systemic side effects.

    A spinal cord stimulator is a medical device that can be implanted and produces electrical impulse applying them near the dorsal surface of the spinal cord giving a tingling (paraesthesia) sensation. This method modifies the way the patient perceives the pain.

    A surgical method known as cordotomy may be useful in a small number of patients like those with untreatable cancer.

    Psychological approach to pain management

    There are several methods available that utilize the psychological approach to pain management. Some of the methods are:

    Cognitive behavioural therapy

    This therapy helps patient in understanding the association between their physiology related to pain and muscles, emotions, thoughts, and behaviour. The major goal of this therapy is to instil a positive attitude in the patients, to encourage helpful thought patterns and promote healthy activities like regular workouts or jogging. It also helps in improving sleep patterns and teaches various techniques for relaxation and stress busting.


    A 2007 review of 13 studies established evidence of the effectiveness of hypnosis in pain management, however, the studies themselves were themselves inadequate with a smaller number of subjects involved and lack of credibility. Hypnosis has shown to reduce pain in children and adolescents undergoing few noxious medical procedures. In other patients, clinical trials showed that hypnosis reduced pain to a great deal as compared to no treatment or a few other non-hypnotics methods.


    Studies have established that techniques related to mindfulness meditation are helpful in reducing the intensity of chronic pain.

    There are, of course, several medicines available which are helpful in alleviating pain. Recently, VLCC in India, with a panel of 120+ physiotherapist, has also launched a Pain management program which includes treatment for following types of pain:

    • Osteoarthritis
    • Knee pain
    • Shoulder pain
    • Back pain
    • Posture related pain
    • Cervical pain
    • Ankle pain
    • Muscular pain and stiffness
    • Neurological pain
    • Sports injury

    The major benefit of VLCC pain management program is that they use a multidimensional approach to the problem including physiotherapy, diet and lifestyle modification, and specialized therapeutic massage. You can always directly contact VLCC through their toll-free number: 1800 102 8522

    You can also find more information about the same or register yourself for it here.

    Dr. Kishor Kumar
    Dr. Kishor Kumar
    Kishor Kumar is a blogger, writer, entrepreneur, enthusiast learner, and occasional web designer. He is founder of Zigverve, Zigreads, Books & Writers and PastelRed.

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