The role of medications in treating chronic pain is complex and sometimes controversial. Often, medications do little to relieve chronic pain and may cause debilitating side effects that limit function and mobility. When used appropriately, medications can help reduce pain with limited side effects for some people. Often, other conditions can accompany chronic pain, such as depression and insomnia. Appropriate medication use can help manage these conditions.
The Mayo Clinic Pain Rehabilitation Center (PRC) takes a conservative approach to the management of medications. Despite taking increased doses of pain medications, muscle relaxants and medications for anxiety and sleep, patients who come to the PRC often describe high levels of pain, very poor functioning and poor quality of life. Whether certain pain management drugs are working effectively can be impossible to determine, due to side effects and to interactions with numerous other medications.
The PRC team works with each patient to eliminate the use of pain medications and has had great success in helping patients manage pain and improve functioning without these medications. During the three-week rehabilitation program, medications are gradually reduced through structured tapers tailored for each patient. Factors such as medication efficacy, safety, drug interactions and practical issues such as costs are considered when making medication adjustments.
The potential for addiction is a concern for many patients and families. Addiction, a neurobiological disease, has psychological, social and physical components. Addiction behaviors can include impaired control over drug use, compulsive use, continued use despite harm and craving. Having chronic pain does not immunize a person against the disease of addition. If a person is struggling with addiction, treatment may be delayed in order to address that issue. A chemical use assessment is a program component, when necessary. The assessment can clarify any substance misuse and addiction.
Group classes equip patients with practical information on the benefits and risks associated with the types of medications used in chronic pain conditions. Patients are encouraged to make informed decisions on evidence-based medication use for prescription products as well as dietary and herbal remedies.