Pain disorder

Prescription and nonprescription pain medications often do not work very well. These medications also can have side effects, and may carry the risk for abuse.

Chronic pain syndromes of all types can often be treated with antidepressants and talk therapy.

Cognitive behavioral therapy (CBT), a kind of talk therapy, can help you deal with your pain. During therapy, you will learn:

• To recognize what seems to make the pain worse
• To develop ways of coping with the painful body sensations
• To keep yourself more active, even if you still have the pain

Antidepressant medications also often help with both the pain and the worry surrounding the pain. Commonly used antidepressants include:

• Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro)
• Tricyclic antidepressants

Some patients may not believe that their pain is connected to emotional factors and may refuse these treatments.

Supportive measures that also can be helpful include:

• Distraction techniques
• Hot and cold packs
• Hypnosis
• Massage
• Physical therapy
• Stress reduction exercises

People with this disorder may benefit from treatment at pain centers.

The outlook is worse for patients who have had symptoms for a long time. Your outlook will improve if you can start doing your previous activities, even with the pain.

Seeking out a mental health professional who has experience treating people with chronic pain has been shown to improve outcomes.

• Addiction to prescription pain medications (if they are not used correctly)
• Complications from surgery
• Depression and anxiety

Call your health care provider if you or your child experiences chronic pain.

Review Date: 08/09/2010
Reviewed By: Linda Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Michelle Benger Merrill, MD, Instructor in Clinical Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)