In addition to drug therapy, the treatment of chronic pain also includes exercise therapy, physiotherapy and alternative methods. In addition to treating the causes of pain, symptomatic therapy is of great importance, but the psychological side of the disease must also be considered.
Drug therapy
In 1986, WHO developed a step-schedule regimen for the treatment of tumor pain, which has since been applied to other chronic pain with strict patient selection. In addition to the basic analgesic, the regimen considers appropriate concomitant medications in each case, such as:
- Antidepressants
- Anticonvulsants
- Neuroleptics
When using strong opioids, the administration of laxatives to treat the most common side effect constipation is essential. Antiemetics (means against vomiting), but also non-drug measures such as physical therapies or psychological measures should be additionally considered.
In the treatment of chronic pain, alternative therapies (biofeedback, TENS, and acupuncture) are becoming increasingly important.
Biofeedback: learning to influence body functions
Biofeedback involves measuring body functions that normally occur consciously, such as muscle tension, heart rate, and blood flow. Results are reported back to the patient via a computer screen.
In the course of treatment, the patient learns to consciously influence his or her bodily functions. In the area of pain, biofeedback is particularly suitable for treating migraines and tension headaches.
Transcutaneous electrical nerve stimulation (TENS).
This counter-irritation procedure involves sticking electrodes to the skin that deliver weak electrical stimuli. These current stimuli are designed to mask the sensation of pain. Treatment with a high frequency of current prevents the pain-conducting nerves from transmitting pain impulses to the brain. A low-frequency TENS application stimulates the release of endorphins, which temporarily dull the perception of pain.
TENS is used, for example, to treat neurogenic pain, phantom limb pain, or stump pain.
Acupuncture as an alternative pain treatment
An increased release of endorphins can also be observed under acupuncture. Acupuncture is used for various types of pain. These include:
- Headache and migraine
- Back pain
- Arthritis
- Trigeminal neuralgia
- Neuropathies
