The use of hot and cold modalities, which the patient can safely use at
home, should be encouraged. The use of devices or treatments that
require the help of other persons or professional settings, such as
ultrasound or massage, are best reserved for acute pain syndromes or
intermittently painful chronic conditions.
Biofeedback
Relaxation
training and biofeedback are behavioral treatment methods, which have
been successfully used to treat a wide variety of pain syndromes,
including myofascial and sympathetically maintained pain syndromes.
Several
relaxation techniques are used for chronic pain. The two most commonly
utilized are autogenic training and progressive muscle relaxation.
Biofeedback is simply a system, which utilizes instrumentation to
provide feedback on a variety of physiological responses such as hand
temperature, muscle tension, and sweat gland activity to facilitate
relaxation and enhance self-regulation.
Relaxation training and
biofeedback are thought to be equally effective. Repeated practice and
experience with relaxation techniques is important to ensure
effectiveness.
Anesthetic Treatments
Anesthetic techniques
are part of the therapeutic armamentarium used in the management of
chronic pain. Some of these techniques are especially helpful when used
as diagnostic or prognostic procedures. They can be powerful tools when
used intelligently for chronic pain, especially in the context of a
multidisciplinary approach.
They also play a role in the
prevention of the chronic pain syndrome. Nerve blocks can be used as
diagnostic, prognostic, or therapeutic procedures. Injecting a local
anesthetic onto the nerves, which interrupts the sensory and
nociceptive pathways, does neural blockade.
Prognostic blocks are
used weight the effects of prolonged afferent interruption. They are
used before neuroblative or neurolytic procedures. Therapeutic blocks
are performed with local anesthetics or with neurolytic agents.
Sympathetic
nerve blocks are some of the more effective therapeutic tools in
dealing with chronic pain. These blocks can be used for diagnostic,
prognostic, and especially for therapeutic purposes.
The
sympathetic chain can be blocked in many locations, including the
stellate ganglia, thoracic ganglia, celiac plexus, splanchnic nerves,
lumbar plexus, hypogastric plexus, and even the impar ganglion.
When
dealing with sympathetically maintained pain, a secondaries of
sympathetic blocks or neurolytic sympathetic blocks or both, can be
effective Therapeutic approach.
Alternative treatments to manage
pain are very popular these days. These have no side-effects and are
relatively inexpensive. The popular ones are Accupuncture, Ayurveda and
Reiki. It is important for the patient to get Accupuncture treatment
done with a professionally qualified person and minimize the risk of
infection with needles
