Pain medicine or pain management specialists provide many diverse treatments, including activity modification, medications, therapeutic injections, physical therapy, and alternative types of care such as acupuncture, manipulation, and music or art therapy. Multidisciplinary pain medicine combines two or more treatments to maximize pain control.

Treatment may include:

• Restrict activities that increase pain (activity modification)
• Prescription medication: Nonsteroidal anti-inflammatory drugs, muscle relaxants, narcotics (opioids), anti-depressants, and antiseizure drugs. Some antidepressant and antiseizure drugs have proven to help manage certain types of chronic pain.
• Injection therapy: Injections may help to pinpoint the cause of pain, as well as provide pain relief. Therapies include epidural steroid, facet joint, and sacroiliac joint injections; and nerve root, medial branch, peripheral and sympathetic nerve block
• Physical Therapy: Heat/ice, massage, spinal traction, transcutaneous electrical nerve stimulation (TENS), ultrasound, and therapeutic exercise.
• Pulsed Radiofrequency Neurotomy is a minimally invasive procedure that prevents nerves from sending pain signals to the brain.
• Rhizotomy uses heated electrodes to turn off pain signals from specific spinal nerves.
• Spinal Cord Stimulation is an implanted device that produces electrical impulses to block pain perception.
• Intrathecal Pumps are sometimes called pain pumps. The device is surgically implanted and dispenses measured doses of medication within the spinal canal.
• Acupuncture is the insertion of very fine, sterile and disposable needles into any of the body's 20 Meridian points or 2,000 acupuncture points. Acupuncture is central to Traditional Chinese Medicine (TCM), which includes other holistic therapies.
• Manipulation is performed by chiropractors, osteopathic doctors (DO), and some physical therapists, although the therapy varies among these professions. Manipulation is described as the therapeutic application of manual pressure or force to treat a musculoskeletal disorder.
• Music and art therapy are ways to distract your thoughts away from your pain. Besides a creative outlet, these therapies promote relaxation, provide a means for emotional expression, help to reduce stress, increases self-esteem, and are fun.

Pain Management Agreement
Some pain patients require strong medications to manage pain. These medications are technically called Schedule II drugs and require a special type of prescription. Schedule II drugs (eg, short- or long-acting narcotic) are carefully regulated. Because of the addiction potential and other risks associated with taking a Schedule II medication, you may be asked to sign a treatment agreement.

The agreement puts into writing important information you and your pain management doctor have agreed to. The terms of the agreement may include using one pharmacy for all prescription medications, how to keep your drugs safe and away from children, dosing information, and what do to if side effects develop. When potent narcotics are prescribed, a pain agreement is simply good medicine.

Questions to Ask About Your Treatment

• What are risks and complications associated with treatment?
• Do you perform the procedure? If so, how often?
• What is your success rate associated with this treatment or procedure?

It is important to trust and be comfortable with your pain management specialist. Asking questions is a good way to keep the lines of communication open.