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Techniques for managing pain       

There are many ways to manage pain. If one approach doesn’t work, there may be another that does.

  • Often, more than one approach is needed.
  • Healthy life choices can make a big difference in managing pain.
  • Patients who are more successful at managing their pain focus on what they can do instead of what they can’t do.
  • Cognitive behavior therapy is very effective, especially when combined with exercise. It helps people learn how their thoughts contribute to their symptoms, and how to change those thoughts.
  • You don’t have to do it alone. Peer support groups can help.
  • Opioid medications may not provide long-term benefits and may make your condition worse.

Pain is difficult to live with. But the side effects of the drugs used to treat pain can sometimes be even worse.

  • For people who have had pain for years or even decades, it is not realistic to expect that it will go away completely.  It is better to accept that there will always be pain and to focus on the things that you want to accomplish in your life. Think about what you can do, not what you cannot do.
  • It is important to balance the benefits of any treatment against the risks. For example, opioid medications have not been shown to be effective in reducing chronic pain. And opioid medications have many risks, including constipation, drowsiness, brain fog and confusion, and even death. The higher the dose of opioids, the higher the risk of death.

Managing pain with surgery and injections


  • Surgery doesn’t always fix chronic pain
  • There is a lot of good scientific evidence about when surgery helps and when it doesn’t.
  • Even when it might help, your doctor and surgeon will need to balance the benefits of surgery against the risks, and whether there are better options for you.
  • Some things increase the risks of surgery, such as smoking, being obese, or having heart and lung disease.


  • Injections can help some people with some conditions manage their pain.
  • Your doctor can let you know whether an injection is likely to help your condition based on your condition, your symptoms, and your physical exam.
  • If your doctor thinks an injection might be helpful, ask if there are any side effects, if it is likely to need to be repeated, and if so, how often.

Other interventions

  • Nerve block
  • Trigger point injections
  • Botulinum toxin injections (“botox”)
  • Epidural steroid injections
  • Cryotherapy or ablative techniques (to freeze or destroy tissue)

Managing pain with interactive therapies (physical therapy, manipulation, acupuncture, massage)

  • There are many different kinds of hands-on treatment that help people relieve pain.
  • If you have seen any of these health specialists, or would like to, please let your doctor know.
  • Your doctor may be able to help you find providers who have expertise with your condition or provide them with medical background that may help them treat your condition.
  • If you have been paying out of pocket for these services, your doctor may be able to help you get the same services covered by your health insurance (some simply require a doctor’s referral).

Physical Therapy and Occupational Therapy:

  • Physical therapy (PT) helps people build strength and flexibility 
  • Occupational therapy (OT) helps people with their daily activities, such as bathing, swallowing, etc…
  • Both have been shown to improve quality of life and help people be more active.
  • Timing: the frequency and duration depends on your condition. It is not unusual for sessions to be done 1-3  times a week for the first few weeks,… Oftentimes,  these exercises can be done at home.
  • Cost: PT and OT are usually covered by insurance for a limited number of visits, if referred by a doctor.

Manipulation (for musculo-skeletal pain, for types of arthritis, pinched nerve, neck, shoulder, back, hips, etc)

  • Chiropractors and some osteopathic physicians (DOs) offer manipulation.
  • Timing: usually every 2 weeks, then once a month, then as needed.
  • Cost: varies, may be covered by insurance (check your policy) if referred by your doctor.

Acupuncture and massag

  • Many people find that acupuncture and massage helps reduce their pain and helps them relax. These treatments also help give people a sense of control over their pain.


  • Many studies have shown that yoga helps reduce some types of pain, including low back pain. A 12-week yoga program was shown to result in less back pain, less need for pain medication, and less disability.
  • Yoga seems to work about as well as physical therapy for conditions such as chronic low back pain.
  • The type of yoga tested included a physical component (not just meditation, breathing, or chanting).

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