Managing Pain

In a paper, “Relieving Pain in America”, published in 2011 by The Institute of Medicine, the authors stated “Our committee recognizes the need for a transformed understanding of pain. We believe pain arises from the nervous system but represents a complex and evolving interplay of biological, environmental, and societal factors that go beyond simple explanation.”

The complexity of pain is matched only by the intricate process of trying to treat and relieve a patient’s pain. Palliative medicine and pain management physicians have a large “toolbox” to draw from when devising a treatment plan.

Treating pain should combine the use of primary treatments directed against the source of the pain – the disease or illness itself (by chemotherapy, radiation or surgery) with approaches to manage the pain (medications, complementary and other therapies). In other words, treat the cause and manage the pain together.

Medications for Treating Pain

Over-the-counter medications (OTC)

They can be purchased at local pharmacies and do not required a prescription.

  • Acetaminophen
  • NSAIDS (non-steroidal anti-inflammatory drugs) – including aspirin and ibuprofen

Prescription medications

  • Opioids
  • Antidepressants
  • Anticonvulants
  • Corticosteroids


Complementary medicine

A method of healthcare that works with traditional medicine and includes:

  • Clinical massage
  • Acupuncture

Interventional therapies

  • Injections
  • Implantable devices
  • Nerve stimulation and ablation

Non-pharmacological techniques

  • TENS (transcutaneous electrical nerve stimulation)
  • Physical therapy (including therapeutic exercise, heat & cold applications)

Cognitive and Psychological therapies

  • Psychotherapy
  • Relaxation
  • Imagery
  • Hypnosis
  • Biofeedback
  • Behavior therapy
  • Art or music therapy


In recent studies, Vitamin D (actually a hormone) has been found to be effective in reducing some types of pain and helping to prevent certain diseases.

Always tell your healthcare provider about all supplements that you are taking or plan to take.


National Drug Court Institute (NDCI) – Drug Court Practitioner Fact Sheet. Vol.XI, No. 2, June 2016, Alternatives to Opioids for Chronic Pain Relief by Sandra Lapham, MD, MPH, DFASAM

Practical Pain Management, July/August 2008. Vitamin D for Chronic Pain by Stewart B. Leavitt, MA. PhD

Medscape Internal Medicine – Vitamin D: Deciphered, Declassified, and Defined for Your Patients by Sandra Fryhofer, MD (Free registration online in order to access articles.)