Typically the first approach to pain management is physical therapy. Physical therapy builds endurance and strength and often resolves pain without further treatment. Your physical therapist may have you use equipment, such as a stationary bike, to build up your strength. He or she also may recommend other activities, such as swimming or water aerobics.
You may also see an occupational therapist who can help you relearn how to do daily activities. You might need other specialists, depending on your situation. A physiatrist, a doctor who is a rehabilitation specialist, may help plan and evaluate your physical therapy.
If there is no benefit provided from physical therapy, medications may be prescribed. Medicines can help to block pain, decrease inflammation, and treat related problems. More than 1 medicine may be used to treat your pain. While the benefit of treatment with medication is recognized, we always work to minimize reliance.
Long-term use of opioid pain medicines may lead to increased tolerance, meaning to take more for the same effect, or it may cause physical dependence. This means that to avoid withdrawal, you'll need to "taper off" if you and your health care provider decide to stop the medicines. Tolerance and dependence are normal responses to opioid pain medicines and are not the same as addiction.
Interventional procedures are sometimes combined with medical therapy. They can include epidurals, steroid injections, nerve blocks, trigger point injections and spinal cord stimulators.
At Banner Health, we use local anesthesia and conscious sedation to minimize discomfort during injections. Injections are scheduled at the hospital on an outpatient basis, usually with X-ray guidance for accurate needle placement. These procedures are often done in a series 3 to 4 weeks apart depending on your response to the injections.
Some of our facilities offer integrative therapies to help with pain management. These include massage therapy, music therapy, dog therapy, aromatherapy, acupuncture and Reiki therapy.
Pain class/group therapy is also available at some Banner Health facilities for education and support. Techniques such as guided imagery, biofeedback and progressive relaxation are taught and practiced in the class or group.
Additional offerings, such as herbal medicine, may not be available through Banner Health, but your pain team can make recommendations on where to go.
You may also benefit from psychological treatment. This can include medical and talk therapies to address mental health issues that can cause physical pain.
And in more severe situations, if your pain is not controlled through the other available options, surgery may be needed.
Following a surgery, you may be given a patient-controlled analgesia (PCA), or painkillers, for acute (short-term) pain management.
A PCA system consists of two parts: a pump with pain medication delivered to you through an IV that is kept next to your hospital bed, and a control button. Your nurse will set the pump to deliver the amount of medication your doctor has ordered. When pain medication is needed, you simply press the control button. The amount of pain medication delivered is regulated so that you are only able to use a safe amount.