TheHealthy discusses the causes of chronic pain according to experts including Seth A. Waldman, MD, anesthesiologist and director of Pain Management at HSS, and others, and how pain specialists use medications and treatments to help manage symptoms.

“The sensation of pain is initially a signal to the brain that there is actual or impending injury to the body,” said Dr. Waldman. “A complex cascade of events follows the initial signal to the brain, including withdrawing from the source of injury—think quickly removing your hand from a hot stove—but also avoiding the painful area, and spasm of muscles around the area.” This goes away as the injury heals. There’s a problem when the source of the pain is ongoing. “When the signal persists, changes begin to occur in the nervous system, including the peripheral nerves, which supply the skin, muscle, and bone, as well as in the spinal cord and brain,” he added. “This can cause the signal to spread to other areas in the nervous system, causing what is known as a ‘chronic pain state.'”

Medications may be part of your treatment, but pain management isn’t just about popping a pill for relief. “Simply providing injections or opioid pain medications is not pain management,” explained Dr. Waldman. That said, some medical treatments may be part of your program, including steroids, anticonvulsants, and antidepressants, he cited. If your underlying condition is not already being treated, “we also refer for other medical or surgical evaluation when appropriate, such as to a surgeon, neurologist, oncologist, or rheumatologist,” said Dr. Waldman.

Dr. Waldman noted opioids are very effective particularly for severe short-term pain, such as after trauma or surgery, but it’s important to minimize their use. In addition to concerns about substance use disorder, they can actually make chronic pain worse over time. “While opioids can provide great relief, because they change the way the body’s self-regulating endorphin system responds to pain, they can at times cause an increase in pain called opioid hyperalgesia.”

The commitment to reducing pain also will likely involve some everyday changes on the patient’s part. “There are numerous treatments for pain, including simple things such as heat and cold,” noted Dr. Waldman. “We also prescribe lifestyle changes, including weight loss.”

Dr. Waldman concluded, “Pain can be difficult to assess and treat, but regardless of the primary specialty of the pain specialist, the most effective therapy results from a combined approach."

Read the full article at Thehealthy.com.