In addition to drug therapy, chronic pain also includes exercise therapy, physiotherapy and alternative procedures. In addition to the treatment of the causes of pain, the symptomatic therapy has a high priority, but also the psychological side of the disease must be considered.
In 1986, the WHO developed a phased plan scheme for the treatment of cancer pain, which is now being applied to other chronic pain with a strict selection of patients. In addition to the basic analgesic, the scheme also considers appropriate concomitant medications, such as:
When using strong opioids, the use of laxatives to treat the most common side effect constipation is essential. Anti-emetics (anti-vomiting agents), but also non-pharmacological measures such as physical therapies or psychological measures should also be considered.
In the treatment of chronic pain, alternative therapies (biofeedback, TENS and acupuncture) are becoming increasingly important.
Biofeedback measures body functions that are normally conscious, such as muscle tension, heart rate, and blood flow. The results are reported back to the patient via a computer screen.
During the treatment, the patient learns to consciously influence his bodily functions. Biofeedback is particularly useful in the area of pain for the treatment of migraine and tension headache.
Transcutaneous Electrical Nerve Stimulation (TENS)
In this method of counter-irritation, electrodes are stuck to the skin, which release weak current stimuli. These current stimuli should cover the pain sensation. Treatment with a high current frequency prevents the painful nerves from passing pain impulses to the brain. A low-frequency TENS application stimulates the release of endorphins, which temporarily attenuate pain perception.
For example, TENS is used to treat neurogenic pain, phantom or stump pain.
Also under acupuncture an increased release of endorphins can be observed. Acupuncture is used for various types of pain. This includes:
- Headache and migraine
- back pain
- Trigeminal neuralgia