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Multimodal Pain Management

Chronic pain – especially musculoskeletal pain – affects many people in the US. It can result from injury, overuse, a degenerative joint condition or an immune system disease such as rheumatoid arthritis. Acute pain often results from injury or surgery. In many cases, patients need pain relief to be able to work or perform various activities of daily living or to recover fully from an injury or surgical procedure. Multimodal pain management offers multiple benefits in dealing with chronic pain.

About Chronic Pain

Chronic pain is usually defined as pain that lasts more than six months. The severity of the pain can vary from mild aches to severe, debilitating pain. Headaches, joint and muscle pains, and nerve pain may all occur. Treatment strategies may differ depending on the source of the pain, but generally, include medications as well as other forms of therapy. For example, if the pain is the result of nerve damage, medications are typically more effective than exercise. However, pain from tense, tight muscles may be helped by massage or gentle stretching exercises.

What is Multimodal Pain Management?

Multimodal simply means using several different pain management techniques. The idea is to target different parts of the nervous system or body that are contributing to pain – such as a tense muscle that goes into spasm – or receiving/modulating pain signals in the nerves and brain. For example, non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen have a completely different effect from narcotic (opioid) medications. Many NSAIDs are available over the counter while opioids require a prescription.

Managing Pain

In all cases, the idea behind pain management is to use the least amount of medication possible to decrease the risk of side effects or complications. In managing postoperative pain, the use of local anesthetics or nerve blocks may allow the patient to escape from common side effects of opioid pain medications, like constipation or nausea. Using combinations of medications such as NSAIDs, muscle relaxants and opioids targets different symptoms. The NSAIDs have anti-inflammatory effects, muscle relaxers help decrease spasm and opioids affect the central nervous system.

Other Strategies

Health care professionals also use a variety of other techniques to help relieve pain. Joint injections, for example, deliver steroid medications to reduce inflammation and a local anesthetic to relieve pain directly into a painful joint space. Anticonvulsant medications can “slow down” over-excited nerves that increase a patient’s reactivity to pain impulses. Physical therapy helps by stretching and strengthening muscles. Massage and acupuncture are helpful for many people who have chronic pain or migraine headaches.

No single strategy is ideal for helping patients with pain. Acute pain must be managed differently from chronic pain. Some patients can tolerate more pain and still function. Each person’s response to pain is very individual and treatment must be targeted to the individual. Multimodal pain management offers great benefit to those in pain. If you have questions or want to schedule an appointment, please contact us – Orthopedic Research Clinic of Alaska.


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