Treatment

Each person with pain is entirely unique: a treatment that works well for one individual may cause a negative reaction for someone else. People with pain often go through a long process of trial and error to identify what works best for them. While it’s easy to get frustrated when a certain therapy option doesn’t work, don’t give up. Most likely, something else will help—you just have to keep looking.

Once you receive a chronic pain diagnosis or have lived with pain for more than three months, it’s a good idea to get connected with a pain specialist. While clinicians in specialties like neurology and orthopedics may be able to offer some pain management options, it’s important to have someone on your team who is an expert in pain itself. Primary care physicians can also help manage pain, but ideally, a pain specialist would be involved in the treatment plan.

Whatever type of provider you see, as you begin to explore relief options, remember that it is unlikely one therapy alone will adequately manage your pain. A multidisciplinary, multimodal approach that combines various treatments is typically most effective. For example, even if medication reduces your pain by 20 percent, physical therapy by 20 percent, and injections by 10 percent— when combined, these treatments represent a 50 percent overall decrease in pain, which can have a significant, positive impact on quality of life and daily functioning.

If you are able to get to a pain clinic or center, try to find one that emphasizes multidisciplinary care. A good indicator is when the center employs a range of specialists in addition to traditional pain doctors—for example, psychologists, clinical social workers, sleep medicine experts, nutritionists, and/or physical therapists.

While an experienced pain specialist will have a lot of suggestions for treatment, it’s important to educate yourself on the various strategies and techniques available for pain relief. The list of treatment options in the next section is a great place to start. Keep in mind, too, that researchers are always making headway in discovering new treatments. Don’t lose hope!

Treatment options

Here is a working list of treatment options for pain by category. To print out this list and bring it to your clinician to go over together, click here.

Self-management techniques
  • Activity restriction or modification
  • Assistive devices or technologies
  • Diet and nutrition
  • Exercise and strengthening programs
  • Meditation and mindfulness
  • Sleep hygiene
  • Support groups
  • Stress reduction techniques, including visualization or body scanning
  • Stretching and mobility programs
Restorative therapies
  • Chiropractic care
  • Decompression (traction units, tilt tables)
  • Hot & cold therapy
  • Massage
  • Occupational therapy
  • Physical therapy
  • Pool or aquatic therapy
  • Postural training
  • Strength training
  • Taping (kinesiology tape)
  • Stretching and strengthening programs, like Pilates, yoga, or tai chi
Complementary and alternative medicine
  • Acupuncture or acupressure
  • Aromatherapy
  • Art, music, or dance therapy
  • Color therapy
  • Cupping
  • Craniosacral therapy
  • Dry needling
  • Floatation therapy
  • Herbal and vitamin supplements
  • Hypnosis
  • Reiki
  • Reflexology

Learn more about complementary options on our dedicated page.

Mind-body approaches

A note about mind-body approaches: Addressing the psychosocial impact of pain does not mean your pain isn’t real. But stress exacerbates pain, and likewise, pain exacerbates stress. Interrupting this cycle is essential to improving your quality of life.

  • Acceptance and commitment therapy
  • Biofeedback or neurofeedback
  • Cognitive behavioral therapy
  • Group therapy
  • Meditation and mindfulness
  • Psychiatric care
  • Stress reduction techniques
  • Support groups
  • Talk therapy
  • Virtual reality technology
Medications

The medication categories below are associated with general pain relief; however, there are many other disease-specific medications that treat the underlying condition and therefore relieve pain (e.g. calcitonin gene-related peptide inhibitors for migraine, or immunosuppressive medications for autoimmune disorders). Some pain medications may work across multiple channels and categories of relief, or they may be formulated in combination with other medications to target multiple channels. Medications may be delivered in various ways; for example, orally, intravenously, or topically.

Nonopioid analgesics

  • Acetaminophen
  • Nonsteroidal anti-inflammatory (NSAID) medications
  • Salicylates
  • COX-II inhibitors

Opioid analgesics

Adjuvant analgesics

  • Antiepileptic medications
  • Antidepressants
  • Local anesthetics and topicals

Other pain relievers

  • Benzodiazepines
  • Corticosteroids
  • GABAb receptor agonists
  • Medical cannabis
  • Muscle relaxants
  • N-methyl-d-aspartate (NMDA) receptor antagonists
  • N-type calcium channel blocker
  • Opioid agonists and antagonists

*Working closely together, health care providers and their patients must decide whether the potential benefits of opioid therapy outweigh the risks.

Noninvasive interventions and procedures
  • Cold laser
  • Deep oscillation therapy
  • Electrical nerve stimulation
  • External trigeminal nerve stimulation
  • Functional electrical stimulation
  • High-frequency impulse therapy
  • Infrared light therapy
  • Interferential current stimulation
  • Neuromuscular electrical stimulation
  • Percutaneous electrical nerve stimulation
  • Percutaneous neuromodulation therapy
  • Peripheral nerve field stimulator
  • Pulsed electromagnetic field therapy
  • Scrambler therapy
  • Transcutaneous electrical nerve stimulation (TENS)
  • Ultrasound therapy
  • Vagus nerve stimulation
  • Other electric stimulation therapies
Invasive interventions and procedures

Injections or blocks

  • Botulinum toxin injections
  • Chemical sympathectomy
  • Cryoneurolysis or cryoablation
  • Corticosteroid injections
  • Epidural injections
  • Nerve, facet, & medial branch blocks
  • Neurolysis or ablative techniques
  • Radiofrequency ablation/lesioning (also known as rhizotomy)
  • Thermal intradiscal procedures (e.g. intervertebral disc annuloplasty or transdiscal biaculoplasty)
  • Trigger point injections

Regenerative therapies

  • Platelet-rich plasma therapy
  • Prolotherapy
  • Stem cell therapy

Implanted pain devices

  • Intrathecal pain pump
  • Spinal cord stimulator implant or peripheral nerve field stimulation

Treatment tips

  • Start small. If your pain levels allow it, start with low-risk, noninvasive treatment options, like physical therapy and cognitive behavioral therapy, before moving to more serious interventions. While medications, injections, and surgeries can be vital components of pain management, they come with risks and side effects. Especially when it comes to invasive procedures, consider getting a second opinion.
  • Do your homework. Use the internet or your local library to research your condition and evidence-based treatments. Try to verify that the information is reliable; government agencies, patient-led organizations, and well-known sites like WebMD and Healthline are typically good resources. Educating yourself is especially important if your condition is rare—even with the best intentions, your doctor may not have the time or resources to research the nuances of your disease.
  • Maximize your doctors’ visits. Bring a list of questions, and think carefully about what your goals are for your appointment. Don’t be afraid to advocate for yourself and your needs. If possible, ask a family member or friend to come with you. They can help advocate for you, and having a second pair of ears to absorb all the information from your doctor can be helpful.
  • Stay organized. Dealing with complex health issues can be a part- or even full-time job in and of itself. To help juggle your various appointments, test results, therapy options, and insurance issues, consider starting a binder or folder with everything in one place. Remember, too, that you have the right to request your medical records and test results from any provider you see.
  • Prioritize your mental health. Many people with pain are so busy trying to manage their physical health that they forget to take care of themselves emotionally. But chronic pain can affect your mood and stress levels, and likewise, your mood and stress levels can affect your chronic pain. Talk to your care provider about ways to mitigate the emotional impact of pain, like connecting with a support group or experienced counselor.
  • Be the squeaky wheel. If your insurance company denies a treatment option or says a specialist is not in-network, don’t give up! Ask your clinician to help you appeal the decision, or appeal it yourself. In addition, many states have health advocacy offices that can help with insurance issues. Try reaching out to them for assistance if your appeal is unsuccessful.
  • Specialized programs. Large medical centers and hospitals sometimes offer immersive pain management programs on an inpatient or outpatient basis. These programs can help give you a jump-start on your pain management and provide you with a variety of resources for managing pain. Programs may last for a week, while others may be an entire month or longer.
  • Consider clinical trials. If you are having a difficult time finding a treatment that works, consider finding a clinical trial. These research studies often provide patients with access to cutting-edge therapies that are not available to the general public. Like with any treatment, they may have risks and side effects to consider.