The first level in the chronic pain treatment continuum includes conservative treatment options. The following describes level-one pain therapies:
Exercise programs. One of the first treatments for chronic pain may be light exercise, such as walking. Exercise stimulates the release of the body's natural pain relievers called endorphins. It promotes flexibility, strength, and endurance, and it helps reduce stress. Exercise can also strengthen unused or weak muscles to compensate for an overworked muscle that is causing pain.
Over-the-counter pain medications. Another early treatment for pain is an over-the-counter analgesic (such as aspirin or acetaminophen) or an anti-inflammatory agent (such as ibuprofen).
Rehabilitative therapy. Rehabilitative therapy includes a variety of techniques—physical therapy, occupational therapy, massage therapy, and chiropractic therapy—to reduce pain and increase function. Rehabilitative therapy is an important part of early pain treatment and is often combined with other treatments, such as medications.
Transcutaneous electrical stimulation (TENS). In TENS therapy, electrical pulses are applied to nerve endings through electrodes placed on the skin over the painful area. Researchers theorize that these pulses temporarily interrupt the transmission of pain signals from small sensory nerves at the site of the pain. TENS may also stimulate the release of endorphins, which relieve pain and produce feelings of well-being.
Cognitive and behavioral modification. Chronic pain is a tremendous psychological burden, and the way people respond to and tolerate pain depends on factors including their personality, culture, and past pain experiences. With cognitive and behavioral therapies, these factors are considered to help a patient learn new skills and strategies for dealing with chronic pain, such as relaxation techniques and visualization exercises.Back to the chronic pain treatment continuum.