Effective Management of Pain
To manage pain most effectively, all four dimensions of pain must be addressed. Each dimension can have a dramatic impact on how pain is experienced. As a result, a multi-modal, multi-disciplinary approach is required. Treatments may need to be introduced initially on a trial-and-error basis. Since pain can be caused by a number of different mechanisms, it may require some experimentation until a treatment or combination of treatments is found to be most effective for each individual (Ambrose, Lyden, & Clauw, 2003; Ehde et al, 2003; Flor, 2002; Jones, Clark, & Bennett, 2002; Middleton, 2003; Nielson & Jensen, 2004; Nyland, Quigley, Huang, Lloyd, Harrow, & Nelson, 2000; Siddle, 2004; Sprott, 2003; Thorsteinsson, 1997; Widerström-Noga, Felipe-Cuervo, & Yezuersji, 2001).
In addition to medications, there are effective non-pharmacological strategies to reduce pain. Education of both the person experiencing pain and their caregivers has been cited in numerous studies as a way to reduce pain by increasing understanding, identifying positive coping strategies and improving attitudes and self-efficacy (Agre, Rodriquez, & Tafel, 1991; Ambrose et al, 2003; Cedraschi, Desmeules, Rapiti, Baumgartner, Cohen, Finckh, Allaz, Vischer, 2004; Curtis, Tyner, Zachary, Lentell, Brink, Didyk, Gean, Hall, Hooper, Klos, Lesina, Pacillas, 1999; Gilbert-MacLeod, Craig, Rocha, & Mathias, 2000; Hckkinen, 2004; Häkkinen, Sokka, & Hannonen, 2004; Hammond & Freeman, 2004; Iversen, Eaton, & Daltroy, 2004; Kavuncu & Evcik, 2004; Mannerkorpi, Ahlmen, & Ekdahl, 2002; Nyland et al, 2000; Olanow, Watts, & Koller, 2001; Richards & Scott, 2002; Sprott, 2003; Thorsteinsson, 1997; Weigl, Angst, Stucki, Lehmann, & Aeschlimann, 2004; Young, 1989). Education initiatives among people with disabilities have been associated with considerably lower disability scores and decreased pain scores, in many cases to the same degree as a non-steroidal anti-inflammatory drug (NSAID) (Moskowitz, Kelly, Lewallen, & Vangsness, 2004). Education about the condition itself and the variety of treatment options available allows the individual to be an active partner in decision-making that can improve self-efficacy (Häkkinen et al, 2004; Jones & Clark, 2002). Fitness professionals need to become educated about the impact of exercise on people with various disabilities in order to increase function without increasing pain or disability (Houlihan, O'Donnell, Conway, & Stevenson, 2004).