Because chronic pain is so complex, there are often multiple
treatment goals. These goals may include more comfort
(being "pain-free" is often not possible when pain has become chronic),
better physical functioning, improved coping and less distress, getting back
to work, helping the family cope, and other positive outcomes. To accomplish
these goals, chronic pain often is best managed using what is
called a "multimodality" approach.
The patient's response to therapies may be influenced by age, gender,
race or ethnicity, cultural beliefs, or any of a variety of physical,
emotional, social, family, occupational, and spiritual circumstances.
Treatments for pain must be tailored to the individual, based on each
person's unique condition.
A multimodality approach to chronic pain includes a
combination of therapies selected from eight broad categories:
- drug therapies
- psychological therapies
- rehabilitative therapies
- anesthesiological therapies
- neurostimulatory therapies
- surgical therapies
- lifestyle changes
- complementary and alternative medicine therapies (See our Integrative Pain
Therapy website,
HealingChronicPain.org
In many cases, a multimodality strategy requires
the involvement of several types of health care
professionals -the interdisciplinary team.
Effective pain management is therefore collaborative in nature,
involving good communication among the patient, family, and the
practitioners involved in the care. A sense of partnership in
trying to find the best therapeutic approach promotes the most
creative, and ultimately the most effective, approaches.
Patient-practitioner partnership can maximize the patient's
involvement and sense of control in the healing process. Patients
must feel empowered to seek the best care and to act in a way that
uses their own resources in the service of health. If an interdisciplinary
team of practitioners is involved in developing a multimodality approach,
the members must communicate freely to ensure the appropriate targeting of
therapy. Family communication helps promote positive patterns within the
family and may reduce the stress caused by prolonged pain and
impaired function.
Modifying the Underlying Disorder
One of the goals of the pain assessment is to identify the potential causes
of the pain. Treatment directed at the cause always should be considered
as part of the therapeutic strategy. For example, a drug or nutrient that
helps regulate the immune system and reduces the inflammation of rheumatoid
arthritis is likely to have positive effects on the pain. Similarly,
radiation given to the site of a malignant tumor is likely to relieve pain.
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