Expert Q&A: Managing Chronic Pain

Get answers to these common questions
Woman with back pain

We all experience pain in our lives, whether from injury, a tension headache or just sleeping in an awkward position. But for many people, chronic pain — most commonly back pain, headaches and pain from arthritis — can make routine activities very challenging.

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People have many questions about the best ways to address pain. To offer insight, a panel discussion focused on chronic pain and pain management featured six pain management specialists, and was moderated by pain management specialist Teresa Dews, MD, FIPP, vice chair of Pain Management and medical director of the Cleveland Clinic Pain Management Center at Hillcrest Hospital.

The audience asked experts the following questions about chronic pain, and here are the answers:

Q: What is chronic pain, and what causes it?

A: Chronic pain can be defined simply as pain that extends beyond the expected period of healing. It can be caused by a variety of things, including obesity, age, stress, accidents or work-related injuries, and diseases such as cancer, shingles or arthritis.

Q: Are there things I can do to prevent the development of chronic pain?

A: As with everything related to your health, exercise makes a big difference. When we move, endorphin-boosting hormones are released, which decrease pain. Exercise also increases blood flow to vital organs, muscles, joints and tendons and can further reduce pain. And the exercise doesn’t have to be complicated. A regular walking routine can add years to your life, help you lose weight, improve your mood, reduce pain, and more.

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Maintaining a healthy weight and eating a balanced diet also factor in. Some foods actually can increase inflammation (those containing saturated fats, trans fats, simple sugars and white flour), so it’s important to limit the consumption of those. Lack of magnesium can lead to muscle and joint pain, so eat magnesium-rich foods such as leafy greens and pumpkin seeds, or consider taking a magnesium supplement.

It is also important to prevent injuries as much as possible. For example, driving while distracted (texting or calling on a cellphone) increases your chances of having an accident leading to injury.

Q: What are some ways to manage pain?

A: There are many things you can do to manage and relieve chronic pain, including increasing your activity level, modifying how you perform activities of daily living, and achieving and maintaining a healthy weight with exercise and a balanced diet.

Psychological tools (such as relaxation and stress management techniques) and non-narcotic medications are options for treating chronic pain, along with physical rehabilitation and interventional procedures such as nerve blocks.

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According to Dr. Dews, the best solution for most patients is a comprehensive approach, utilizing a combination of all of these pain management tools.

Q: What is the treatment process?

A: While treatment may vary by medical center or hospital, at Cleveland Clinic, the first appointment consists of a comprehensive review of your medical history, along with a physical exam. You’ll be asked questions about previous treatments you have received, medications you are taking, family history and more. After that initial assessment, the pain management physician will consult with your primary care physician and make recommendations to develop a comprehensive, individualized pain management program.

Your subsequent appointments will focus on putting the plan into action. This may include introducing appropriate physical activity, prescribing medication if needed, or performing a minimally invasive procedure such as a nerve block or a steroid injection. You will have a follow-up visit to assess your progress about six weeks later.

Q: How long will it take for the pain to go away?

A: The results of treatment vary by patient. For some, pain may be reduced almost immediately as a result of exercise, behavior modification or medication. For others, the pain may get worse before it gets better, as introducing new exercises and activities can result in pain in other parts of the body. For those who undergo minimally invasive procedures such as injections or nerve blocks, the results can last several weeks or longer.

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