What Are The Components Of A Pain Management Agreement

Pain Management: Types of Pain

Pain is a general term that describes any kind of unpleasant or uncomfortable sensation in the body.

There are many different types and causes of pain, and these can be grouped into eight different categories to help with pain management:

  • Acute pain
  • Chronic pain
  • Breakthrough pain
  • Bone pain
  • Nerve pain
  • Phantom pain
  • Soft tissue pain
  • Referred pain.

Acute pain

This starts suddenly and only lasts for a short period (ie, minutes, hours, a couple of days, occasionally a month or two).

It is usually caused by a specific event or injury, such as:

  • A broken bone
  • A car crash or other type of accident
  • A fall
  • Burns or cuts
  • Dental work
  • Labor and childbirth

Chronic Pain

Chronic pain is pain that has persisted for longer than six months and is experienced most days. It may have originally started as acute pain, but the pain has continued long after the original injury or event has healed or resolved. Chronic pain can range from mild to severe and is associated with conditions such as:

  • Arthritis
  • Back pain
  • Cancer
  • Circulation problems
  • Diabetes
  • Fibromyalgia

Chronic pain can severely affect a person’s quality of life and prevent them from returning to work or participating in physical activity. In some people, it may lead to depression or social isolation.

Breakthrough Pain

Breakthrough pain is a sudden, short, sharp increase in pain that occurs in people who are already taking medications to relieve chronic pain caused by conditions such as arthritis, cancer, or fibromyalgia.

Breakthrough pain may also be called a pain flare and it may occur with exercise or physical activity, coughing, illness, stress, or during the period between pain medication doses. The pain level is often severe, but the location of the pain is usually the same as the person’s chronic pain.

Bone Pain

This is a tenderness, aching or discomfort in one or more bones that is present during both exercise and rest.

Bone pain is commonly associated with conditions or diseases that affect the structure or function of bone, such as cancer, a fracture (broken bone), infection, leukemia, mineral deficiency, sickle cell anemia, or osteoporosis. Many pregnant women experience pelvic girdle pain.

Nerve Pain

Nerve pain is caused by nerve damage or inflammation. It is usually described as a sharp, shooting, burning or stabbing pain and may also be called neuralgia or neuropathic pain. Some people describe it as being like an electric shock and it is often worse at night.

Nerve pain can severely interfere with a person’s life and affect their sleep, work, and physical activity levels. They are often very sensitive to cold and may experience pain with even the slightest touch. Many people with chronic nerve pain also develop anxiety or depression.

People with neuropathic pain are often very sensitive to touch or cold and can experience pain as a result of stimuli that would not normally be painful, such as brushing the skin.

Common causes of nerve pain include:

  • Alcoholism
  • An injury to the brain, a nerve, or the spinal cord
  • Cancer
  • Circulation problems
  • Diabetes
  • Herpes zoster (shingles)
  • Limb amputation
  • Multiple sclerosis
  • Stroke
  • Vitamin B12 deficiency.

Phantom Pain

Phantom pain is pain that feels like it is coming from a body part that is no longer there. It is common in people who have had a limb amputated, but is different from phantom limb sensation, which is usually painless.

Historically, Doctors believed phantom pain was a psychological problem but they now realize these are real pain sensations that originate in the spinal cord and brain. It often gets better with time, but managing phantom pain can be challenging in some people.

Soft Tissue Pain

This is pain or discomfort that results from damage or inflammation of the muscles, tissues, or ligaments. It may be associated with swelling or bruising and common causes include:

  • Back or neck pain
  • Bursitis
  • Fibromyalgia
  • Rotator cuff injury
  • Sciatic pain
  • Sports injuries, such as sprains or strains
  • Temporomandibular joint (TMJ) syndrome.

Referred pain

This is pain that feels like it is coming from one particular location, but is the result of an injury or inflammation in another structure or organ. For example, during a heart attack, pain is often felt in the neck, left shoulder, and down the right arm. An injury or inflammation of the pancreas is often felt as constant pain in the upper stomach area that radiates to the back. A ruptured spleen can cause pain in the shoulder blade.


Manual and physical therapies


Before you begin massage therapy you will typically talk to the therapist about which areas of your body are painful and what you feel comfortable with. During massage the therapist will use varied pressure on specific areas of your body to help your muscles to relax, providing relief from pain and stress.

Sometimes massage can feel a bit uncomfortable, particularly if your muscles are very tight. If you are worried, talk to your massage therapist. They will be able to reassure you and make the experience as comfortable as possible for you.


  • Can help to relieve pain
  • Provides relaxation/reduces stress
  • Tailored to your individual needs


  • Can be uncomfortable
  • May not be offered readily through your doctor
  • Must attend a therapist’s office (need transport)


You might have heard physiotherapy referred to as physical therapy. A physiotherapist will work with you to build up your range of movement. They will teach you how to strengthen your body in a way that prevents pain flares. Typically, physiotherapists will carry out passive treatments, meaning treatments in which they do the work. These might involve them manipulating and moving your body to strengthen it and target specific muscle groups.

You will also engage in active treatments, meaning you take an active role while being guided by your physiotherapist. These are often specific strengthening and flexibility exercises. You will usually be given exercises to practice at home, to continue building and maintaining strength.


  • Reduces pain
  • Increases range of movement
  • Strengthens body
  • Tackles fear avoidance
  • Increases confidence
  • Has long term results
  • Increases level of functioning
  • Reasonably easy to access
  • Active treatments can be carried out using an online pain therapy program


  • Requires effort and dedication
  • Can be uncomfortable at times
  • Could cause flares during the learning period


Ideas to treat acute pain before it becomes chronic

Treatments for chronic and acute pain will differ depending on the underlying cause(s) of the pain. Furthermore, certain pain treatments will work for some people, but not for others. It is very important to be aware of the level of pain you are feeling and discuss this with your doctor. You may need to try different pain management techniques before finding one (or more) that work the best for you.

Here are some ways, including complementary and homeopathic techniques, to treat acute pain so it doesn’t become chronic:

1 nerve blockers: Local anesthetics can be used to block the group of nerves associated with pain.

2 non-prescription, non-habit forming drug treatments: Some examples include Aleve, Tylenol, or Motrin.

3 physical therapy: Some examples of passive physical therapy include hot packs, cold packs, TENS units, and ultrasound. Some examples of active physical therapy include stretching, pain relief exercises, strengthening exercises, and low impact aerobic conditioning.

4 psychological counseling: Some examples include talk therapy, relaxation training, stress management, and pain coping skills training.

5 behavior modification techniques: One example of this is cognitive behavioral therapy.

6 transcutaneous electrical nerve stimulation (TENS): Developed in the late 1960s, this technique uses electricity to help alleviate pain. The low electrical impulses block certain pain receptors so that the brain does not receive the messages that you are in pain. A session is typically 15 minutes, but may require multiple sessions for successful pain relief.

7 alternative pain management treatments: Some examples may include relaxation, acupuncture, hypnosis, and biofeedback.


Pain Management Treatments Worth Trying

This is why so many people are eager to find a pain management treatment that is successful for them. Chronic pain affects everyone differently, but most of the following therapies have proven effective for a wide population of people, so they may provide at least some pain relief for you. Before you start any new pain management treatment, consult your physician to avoid any health risks.

  • Physical exercise—chronic pain has the unfortunate effect of immobilizing you. If you are suffering from lower back pain or a migraine, one of the last things you want to do is expend energy running or biking. However, exercise provides many benefits. In the short term, physical activity produces endorphins, natural pain killers that relieve pain and boost mood. It also helps you sleep more easily and restfully. Over the long time, exercise also helps relax tense muscles that may produce secondary pain symptoms. Many fitness programs that emphasize movement or stretching also specifically mitigate certain pain conditions like arthritis or fibromyalgia. Discuss with your doctor any exercise program prior to starting it to prevent additional injury.
  • Physical therapy—although physical therapy may include exercises, there are some key differences. First of all, you will be under the supervision of a medical professional so there should be less risk of injury. Their expertise should also help you focus on specific pain management treatments that are most likely to reduce pain. Secondly, a physical therapist can also offer access to treatments unavailable to the general public like acupressure, ultrasound or transcutaneous electrical nerve stimulation (TENS).  Finally, scheduled physical therapy sessions means that you are more likely to adhere to a rehabilitation program that produces benefits.
  • Therapeutic massage—many people think that a massage is merely a relaxing indulgence, but a massage administered by a qualified medical professional can produce significant pain relief. One of the types of massage that is gaining more support in the medical community is acupressure which applies gentle rubbing or pressure to key points on the body. Not only does this relax muscles and promote the production of endorphins, but it also helps increase circulation, allowing more oxygen and nutrients to reach damaged tissue. Ultimately, enhanced circulation accelerates the healing process. More than one session is usually required to achieve optimal benefits.
  • Mindful meditation—one of the most insidious effects of chronic pain is how it re-wires the brain. Studies show that chronic pain sufferers can lose up to 11 percent of their gray matter, primarily in the prefrontal cortex. This region regulates emotions, and this loss of regulation allows anxiety and fear to predominate thought processes. Stress and fear act to intensify pain feelings. Mindful meditation helps minimize this secondary processing of pain symptoms. Long time practitioners of mindfulness can virtually neutralize pain symptoms entirely.
  • Pain relief medications—almost everyone who encounters pain wants immediate relief which most people equate with medications. Intense pain may compel you to ask your doctor for more potent drugs like opioids, but new research suggests this may not help as much as you think. Not only do opioids make some people more sensitive to pain, but they also interfere with sleep which also amplifies pain symptoms.  More physicians are recommending that chronic pain patients take over-the-counter medications like acetaminophen or ibuprofen which have been shown to be as potent for some patients as opioids.


Ways to treat pain if it becomes chronic

If acute pain becomes chronic, your doctor will need to overcome some unique challenges.

It is very important to communicate your pain and symptoms with your doctor. Prospira PainCare treat chronic pain by using a multidisciplinary approach.

Your treatment plan can include any of the following techniques:

  • physical therapy
  • chiropractic care
  • pain medications (non-addictive)
  • injections
  • surgery as a last resort

What Is Manual Therapy Chiropractor

What Makes A Good Chiropractor

Today we’re going to talk about going to a chiropractor and how to tell your out-of-town loved ones how to choose a good one on their own. Without your help even! We’re also going to talk about being the kind of chiropractor that your colleagues are happy to send their family to.

OK, we are back and you have found the Chiropractic Forward Podcast where we are making evidence-based chiropractic fun, profitable, and accessible while we make you and your patients better all the way around.

We’re the fun kind of research. We’re not the stuffy, high-brow kind of research oh no…. we’re talking about research over beers.  If you haven’t yet I have a few things you should do, like our facebook page, join our private facebook group and interact, and then go to chiropracticforward.com and check out the store link. Sign up for our weekly newsletter there too.

Now if you missed last week’s episode, we covered a lot of research. It was Episode 100 so make sure you don’t miss that info. I know there were some good solid knowledge nuggets found there within so make sure you’re up to date and not falling behind the rest. Keep up with the class, man!

On the personal end of things I cannot tell you what a trying and what an emotional week it’s been. These episodes are recorded a week or two ahead of time so you’ll note the time difference of when this happened and when it’s making its way live. On Saturday November 9th, my dad had a stroke. He got out of bed that morning and said he’s got a tall bed so he always has to sort of find his footing before he gets out and walks. He said on this day, he got out of bed and got out a bit awkward and fell.



People have been obsessed with staying young for almost all of recorded history. As the medical profession finds ways to keep people living longer, the problems with aging are becoming more obvious. Back pains are a common ailment for adults, and age only makes the pain worse. In fact one of the images that first springs to mind about older people includes the person holding their back.

You may not be able to stop the passage of time, but you can slow the aging process through proper care of your back. All of the things that your mother and teachers tell you to do as a child are habits that you should adapt. By strengthening your back from an early age, you can reduce the likelihood of problems, or minimize the pain if you are injured. Even if you aren’t young anymore, there are things you can do to help your back feel younger.


If someone were to say that you are the backbone of a project or group, you know that means you are the main support. You are the spine of that project or group.

This shows just how the spine has come to be synonymous with support. Your spine is literally the support for your entire body. By strengthening it, you reduce the likelihood of suffering back pain. More importantly, you will ensure that your back can support you over the course of your life.

Here are some things you can do to focus on strengthening your spine and the muscles around it.

Do planks, not sit-ups or crunches. While these older exercises can help strengthen a back, doing them wrong will do far more damage. Planks are just as effective, and it helps build other muscles.

Work on your stomach muscles. One of the best ways to strengthen your spine is by not requiring it to be your only support. Strong muscles will provide support for your spine.

Avoid repetitive movements that put a strain on your back.

If you have to lift heavy objects, use a back brace to provide extra support.

Stand Up and stretch over the course of a workday. If you just stand and stretch your arms over your head once an hour, you are helping your entire body, including your eyes. The human body was not designed to sit for long periods of time, so give it some movement every hour.

Carry objects close to your body, including backpacks. This distributes the weight of the object over other body parts instead of straining the back and arms.

Wear comfortable, well-balanced shoes.

Avoid staring down at your phone or tablet. If you look around you now, there are probably people staring at their phones, their necks bending down. Over time, this will have an adverse effect, just like slouching.

Meditate to help you get accustomed to sitting properly and learning to think about your body more often.


Those things that you’ve been ignoring for years are exactly what you need to do to have a healthier back. Yes, it will be annoying. It will definitely take you a while to get accustomed to many of the things that you have been ignoring most of your life.


What’s the Difference Between a Physical Therapist and a Chiropractor?

Many patients coming to physical therapy have at some point considered going to, or have been to, a chiropractor. Physical therapists and chiropractors often treat similar conditions and areas of the body, leading patients to wonder, “What’s the difference between a physical therapist and a chiropractor?” While chiropractors and physical therapists treat and even co-treat many of the same conditions, they both offer unique perspectives on the focus and methods to reach a positive outcome for clients. Below is a quick examination of the differences in training, focus, and treatment offered by chiropractors and physical therapists. Understanding what your healthcare provider can offer makes you a much more informed advocate for your own health!


Chiropractic means “to be done by hand,” which is an accurate representation of this field’s focus. Chiropractic care emphasizes diagnosis and treatment of mechanical disorders of the spine and joints, with a particular focus on how the joints can influence the nervous system and overall body alignment. The chiropractic field was first established in the 1890s with a focus on using spinal manipulation and joint adjustment to avoid reliance on other forms of medical intervention. This emphasis on use of more conservative methods of treatment rather than reliance on medication or more invasive procedures continues to be a primary focus of the chiropractic field and is one of the reasons it’s attractive to many patients! To become a chiropractor, a student must complete a Bachelor’s degree, attend an accredited chiropractic program and receive a Doctor of Chiropractic degree, and then pass a certification exam to be able to receive licensure. Depending on how recently they were licensed and their status, chiropractors in Oregon are required to complete anywhere from 6 to 20 hours of continuing education annually. The mission statement of the American Chiropractic Association is: “To inspire and empower our members to elevate the health and wellness of their communities,” and their vision statement is: “The American Chiropractic Association is leading a modern movement of chiropractic care based on higher standards and a focus on patient outcomes.”

Physical Therapists:

Physical therapy can mean something different to each patient because, similar to MDs, the field is split into many different medical specialties. In general, physical therapists embrace the description of “the movement specialists,” paying close attention to how the body moves and functions as a whole. Because of this, physical therapists perform both hands-on, “manual” therapy (which ranges from soft tissue work to adjustments or manipulations that you might receive from a chiropractor), as well as prescribe exercises and neuromuscular education to encourage independent healing and empowerment to self-manage symptoms. This field grew out of the many nurses who helped rehabilitate soldiers following World War I. This filled a gap in the medical field that gave individuals who would have been unable to walk or function independently a chance to lead a fulfilling life with the maximum amount of function. Currently, to become a physical therapist one must complete a Bachelor’s degree, attend an accredited physical therapy program and receive their Doctorate of Physical Therapy, and pass a licensing exam. Additionally, many physical therapists choose to specialize in a specific field, often going through residency programs or participating in fellowships to receive several years of additional training in a particular field. physical therapists are required to complete 24 hours of continuing education every 2 years. The mission statement of the American Physical Therapy Association is: “Building a community that advances the profession of physical therapy to improve the health of society,” and the vision statement is: “Transforming society by optimizing movement to improve the human experience.”

Being familiar with your health care providers and what they are able to offer is a great way to advocate for your own health! While both physical therapists and chiropractors offer an alternative to more invasive procedures, they also offer a wide variety of other healthcare options and interventions. Feel free to ask more about what your healthcare provider can do for you. You might be surprised!



Everything that takes place in the body is regulated by the information contained in the brain and the nervous system. The brain is the control center of all bodily functions. The spinal cord and branching nerves send signals from the brain to control and coordinate the function of all the organs, tissues and systems. Nerves also send signals from the body back to the brain.

This relaying of electrical and chemical signals to and from the brain allows the body to function and adapt to everything that we do and experience.

All organ systems and processes in the body connect to the brain, including the:

Heart and blood vessels

Digestive system

Production of hormones

Skin and sensory perception

Immune system

Muscular and skeletal systems

Detoxification and elimination of waste

Reproductive system

Respiratory system

Regulation of body chemistry

The brain controls all that we see, hear, smell, taste, touch, and feel. It is also the center for our thoughts, emotions, and behavioral responses, both conscious and subconscious. The delicate brain and spinal cord are protected by bone. Pound for pound, bone is harder than cast iron or steel. In order for the body to be healthy, it must be able to adapt to internal and external forces.

The body can be subjected to experiences that may overwhelm its ability to fully adapt. These stressors impact the body and may create vertebral subluxations. Vertebral subluxations are disruptions in the motion and/or alignment of spinal bones with related irritation or obstruction of proper nerve function. Vertebral subluxations alter the ability of the brain and nervous system to properly control and coordinate the body, which results in decreased body function, adaptability, and vitality.


Back Pain: Can a Chiropractor Help?

Back pain is one of the most common-and debilitating-ailments people face. And finding the right pain relief is no easy feat: A paper in The Spine Journal likened choosing a treatment to relieve back pain to supermarket shopping, comparing the wide array of treatment choices to the vast inventory on grocery store shelves.

Getting your back on track

Modern chiropractic treatment is based on the assumption that back pain is caused by misalignment of the spine. Spinal manipulation involves physical pushing, pulling, and methodical repositioning of the head, shoulders, neck, back, or hips to help alleviate back pain.

Caveats to consider

Other treatments can also relieve back pain, from over-the-counter pain relievers such as ibuprofen (Advil, Motrin), to physical therapy, massage, or a combination of therapies. Research has found that spinal manipulation works about as well as anti-inflammatory and pain relief medications and other traditional interventions

Why consider chiropractic treatment?

According to the American Chiropractic Association (ACA), chiropractors treat not only back pain, but several other health conditions, including neck pain, headaches, and muscle, ligament, and joint injuries and disorders. Doctors of chiropractic (DCs) undergo extensive training to diagnose and treat musculoskeletal problems.

Chiropractors perform spinal manipulation by using their hands or a device to apply a small amount of force-or a more forceful thrust-to readjust the bones in the spine and neck. Spinal manipulation is typically most effective when combined with more traditional therapies to treat back pain, such as:

Heat and cold therapies


Relaxation techniques

Electrical stimulation or ultrasound

Exercise and stretching

Patient education

Tips How To Learn Pain Management

Pain Clinics: What to Know

What Is a Pain Clinic?

Also called pain management clinics, they’re health care facilities that focus on the diagnosis and management of chronic pain. There are two kinds. One focuses on procedures to deal with specific types of pain, like neck and back pain.


They also may teach you about your pain, coach you on lifestyle changes, and offer complementary or alternative medicine.

What’s the Goal?

It’s to cut your pain and raise your quality of life. Treatment at a pain clinic can give you the skills to manage your chronic pain on your own and make you more able to function, possibly so that you may return to work.

Do They Work?

Multiple studies say folks who have comprehensive pain management have less pain and emotional distress. Research says they also can do their daily tasks easier.


Tips to Help Get the Best Chronic Pain Treatment from Your Doctor

  • Don’t bring any bad experiences you may have had with other doctors to your appointment.  You don’t want to muddy your doctor relationship.  Start with a clean slate.
  • Go with a stated purpose but don’t go with any pre-conceived expectation about getting a certain treatment, like opioid therapy, or a specific diagnostic test, like an MRI.  Unfortunately, there isn’t an easy answer for chronic pain.  It’s not like prescribing an antibiotic to cure an infection.  Most chronic pain doesn’t have a cure.  You may not be able to be fixed.
  • Ask your doctor about arranging recurrent appointments (quarterly, etc.) just for pain management as well as scheduling extra time, if needed, for those appointments.
  • If you’re seeing the doctor about other medical conditions unrelated to your normal chronic pain, don’t talk about your chronic pain.  Keep it for your regular pain visits.
  • If you find you and your doctor aren’t a good match, then keep looking for another provider.  Some patients have found a nurse practitioner a viable alternative to a physician.  There are a variety of healthcare providers available to team with.


Stop Living With Pain

Always maintain a good posture

Maintaining a proper posture while you sit, stand or sleep is extremely important. Especially, sitting in a good posture is a good way to stay away from back and neck pain. Always sit in a neutral position while sitting on a chair. If you are suffering from chronic pain and seek to give some rest to your neck, choose a neck supporting chair. Make it a point to use a headrest wherever you sit, be it a car or a chair.

Watch your phone usage

Using the phone in the wrong manner can worsen your pain. People cause unnecessary strain on the neck is by cradling it between the ear and neck. This causes strain in the cervical spine which increases the pain level.

Opt for a therapy

There are various types of activities that help in improving chronic situations. For example, acupuncture is an effective therapy for the treatment of various physical and mental conditions. It involves inserting needles in specific areas of the body for treating diseases.

Use ice therapy

Many backs and neck pain center suggest ice therapy for pain relief, which is actually an effective technique for chronic pain.

Eat healthy food

Let food be thy medicine, thy medicine shall be thy food. The saying by Hippocrates is true for people with chronic pain. A well-balanced diet has an array of benefits. It improves blood circulation, keeps weight in control and prevents various diseases.


Tips for Chronic Pain Management

Chronic Pain Management Tip: Journal About Your Feelings

Writing out your feelings can help you cope with pain. Getting them out can release negative feelings, and re-reading your thoughts can help you better understand what you can do to make life easier moving forward. Re-reading your thoughts over time can show you the progress you’ve made and remind you of the good things you have. It can give your life meaning and help you focus on the positives.

Chronic Pain Management Tip: Maintain a Healthy Diet

Food can be very powerful in helping you combat pain. Certain foods can help you reduce inflammation to ease pain, so consider switching up your diet. Foods rich in Omega-3 fatty acids such as tuna and salmon can help those suffering from rheumatoid arthritis, while fruits contain carotenoids, which help fight inflammation at a cellular level. Try adding in some leafy green vegetables and yellow, orange and red fruits and veggies to your next meal.

Chronic Pain Management Tip: Try Alternative Medicine

Some alternative techniques to traditional medicine can have positive effects. Acupuncture, massage and chiropractic treatments have been found to help in treating pain. Studies have shown that chiropractic care can benefit patients suffering from fibromyalgia, carpal tunnel syndrome, headaches and musculoskeletal pain.

Chronic Pain Management Tip: Stay Busy with Hobbies

Distraction won’t relieve pain, but it can cause it to be less of a focus. When you’re thinking about something else, you won’t be thinking about your pain as much. Make sure your hobbies don’t cause your pain to flare up. Like exercise, make sure they are low impact; some good ones to try are knitting, crossword puzzles, playing board games, gardening and golf.

Chronic Pain Management Tip: Engage in Physical Activity

Physical activity is important when you’re battling pain. It’s one of the most effective tools in chronic pain management, although it sounds difficult to do. Regular exercise keeps your joints flexible and the muscles around your joints strong. The important thing is to do low-impact exercises to avoid exacerbating your pain level. These include swimming, walking and strength training. Also, make sure to warm up and cool down, and start slow and add on repetitions over time. And don’t forget to stay hydrated throughout your workout!


Effective Pain Management Techniques that Work

Manage Your Stress

It sounds like simple advice, but stress management is a crucial component of pain management. Stress and fatigue increase pain and make it worse. Schedule appointments, keep a daily routine, avoid stress triggers, and learn to say no to added responsibilities. By decreasing the stress in your life, you can also decrease the pain.


To help your body relax, try deep breathing with meditation to relieve tension and tightness from your muscles. Focusing on your breathing, repeating a phrase or word (mantra), and ignoring other thoughts all cause your body to relax. With meditation, you reduce the stress that intensifies chronic pain and worsens conditions like anxiety, depression, and anger. Meditation with progressive muscle relaxation enhances the release of endorphins and serotonin, two chemicals that help with pain management.

Massage Therapy

One of the oldest pain management tips around is massage therapy. The reliance on a variety of massage techniques allows you to increase water flow and decrease swelling. Massage relieves tense muscles, promotes endorphins, and soothes aching joints. The massage therapist can use a comprehensive approach of massage techniques, such as reflexology, neuromuscular therapy, or Swedish massage.


A pain management tip fairly unknown to many is electrotherapy. The doctor or therapist uses a transcutaneous electrical nerve stimulator (TENS unit) to attempt to reduce your pain. This device produces low-voltage electric stimulation that corresponds with the sensory nervous system to reduce pain sensations.

Cutaneous Stimulation

Cutaneous stimulation involves the superficial cooling or heating of the skin. This age-old technique yields the best results when used together with exercise and other circulatory methods. Heat and cold treatments alleviate the pain and stiffness associated with arthritis and disc disorders. The cold therapy works by numbing the area and reducing inflammation, while the heat increases blood flow to the area.

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