But you are undecided as to whether to go out for a jog or soothe your muscles and bones by taking complete rest? How about taking opioid, the well-known pain killers available at the chemist’s shop? And what about the innumerable advertisements proclaiming ‘instant cures’ that you come across in newspaper and television? Sometimes, the pain becomes so excruciating that the person suffering from it would try anything to get rid of it. At times, this can force people to try something which can even be harmful.

Always consult your doctor for chronic pain

It is imperative to know what treatment options you have to get to rid of or at least to manage your chronic pain that has bogged you down for so long. Some renowned experts in the field of pain management shed light on the common myths and facts about chronic pain.

Fact and myths about chronic pain

Myth – Treating the underlying cause is necessary to cure chronic pain
Many people associate a chronic pain with some sort of underlying cause and believe that instead of just trying to address the pain, it is important to treat the cause behind it for permanent cure. But it is easier said than done. Anne Louise Oaklander, MD, PhD, an associate professor of neurology at Harvard Medical School says that only a thorough check-up of the condition will reveal if there indeed is a relationship between the pain and any associated disease which needs attention.

Sometimes, there may not be any real or treatable conditions that can be correlated to chronic pain. Some other times, the patient may still have the pain even after undergoing treatments for the underlying cause. Like Steven P. Cohen, MD, director of pain research at Walter Reed Army Medical Center in Washington, D.C points out, “ In case of some patients, no clear-cut disease or condition could be found that can be responsible for the pain even after conducting a whole range of tests.” So, treatment of the pain as well as the underlying cause if any is the best approach. This of course can only be done by taking the help of medical experts.

Fact: Any pain however mild it may be needs medical attention
Many people often continue to live with the pain throughout their life. Since they are able to bear the pain and can go through their daily activities unhindered, they believe that it doesn’t warrant medical consultation.

But diagnosis and its treatment of any mild pain is important for it can either be the result of an underlying disease or at times, can lead to an serious chronic pain. Chronic pain develops gradually but you end up with some serious problem if left untreated. What is more, you might get used to coping with it by using the over the counter medicines and pain killers, which can be harmful and dangerous the long run. In some cases, it can also result in sleeping disorder and depression.

Myth: Taking bed rest is the most effective cure
It was earlier believed that having bed rest is the most proper way to treat chronic pains like back pains. Experts do not advise it any more. Cohen says that bed rest is not that helpful for most chronic pains including back pain. On the contrary, it may sometimes accentuate the pain and can also make it worse. Going through the normal routine of physical activities is better way to get relief.
Having said that it is true that taking proper rest is necessary in case of an injury. Hence, going by the medical advice is the best approach.

Myth: The pain is bound to increase progressively with age
Some people are under the impression that the pain they suffer from would definitely worsen with passing age. According to Cohen, even some doctors have this pre-conceived notion and take it for granted. And when an old man approaches them with chronic pain, they do not try to make a detailed diagnosis of it.
While it is true that the pain we feel or the conditions like arthritis worsen with age, they still can be treated.

Fact: Chronic pain and depression are related
Chronic pain has also got a psychological root. It can be the manifestation of anxiety and depression. According to Cohen, there exists a definite relationship between depression and pain but it is difficult to establish in what way or to what extent it is responsible for it. Not surprisingly, some people do not buy this idea.

A relationship between emotional turmoil or the disturbed state of mind and chronic pain is also substantiated through brain imaging studies. It shows that the same parts of the brain is activated both by physical as well as psychological trauma.

That apart, it has been found that certain anti-depressant medicines can alleviate chronic pain. So, at times, doctors also prescribe an anti-depression drug for chronic pain even if you may not be suffering from any psychological disorder.

Myth: Drug addiction can result if you take opioid pain killers
Many people are apprehensive that taking opioid for a long period would make them dependent on it. This fear of becoming addicted to it forbids them to take medication even if they may be suffering from severe chronic pain. So, Cohen suggests using opioid for short-term use after taking the advice of the doctor. In such cases, the chances of addiction will be less.
Oaklander agrees with Cohen and says that some people have to be cautious while taking opioids. This is so especially for people who have a family history of addiction. But such people can surely use the drug after consulting a pain specialist.

Myth: Opioid will relieve you of chronic pain for good
Using opioids is undoubtedly a good and effective treatment for chronic pain. But the truth is it is not the sure and definite way of curing chronic pain. The drug is also fraught with side effects. People often make the mistake of taking the prescription of the doctor or the use of opioid as a ticket of ‘freedom from chronic pain’.

As Cohen points out, “The drug is not effective for all types of pain and also known to have the risks of side effects.” Its prolonged use makes the body dependent upon it and as the body gets acclimatised to it, higher doses are required to get relief. So, constant monitoring of the pain and treatment is necessary to avoid it.
Some evidence also suggests that opioids can make other treatment options ineffective. At times, when you use it to get relief from a pain, it can increase the pain or make it chronic. For instance, if a person suffers from mild headache will develop severe head-ache after taking high dose of opioids.

Hence, the effectiveness of opioids in curing chronic pain depends upon its cause, intensity and nature. But they are still not the only or complete treatment option. Like other treatments of chronic pain i.e. acupuncture or anti-inflammatory drugs, it is one of the way of treatment.

Fact: An all-encompassing, complete treatment of chronic pain is rare
Sometimes people are under the false notion that a sure and effective cure for their chronic pain can be indeed be found. Advertisements in the newspapers or an info-commercial aired in the television propagating such tall claims could be behind this. But such advertisements only bank on the ‘hope or desperation’ of the people. There is no such single and straight way to cure the chronic pain. Coping with chronic pain instead requires adopting a whole lot of treatments like drugs, physiotherapy, counseling etc. It will take time and you can only control chronic pain after going through the different techniques.

Fact: Chronic pain is too stubborn
It may sound discouraging but you may not be cured even after going through a whole gamut of treatments by good doctors. Cohen says that it is unrealistic to expect a cure from a chronic pain that has been bothering you for two decades with a short span of time. Coping with chronic pain is a long drawn process and needs grit and perseverance in ample measure to be cured of it for good.
But do not be despondent about it. Although you may not be able to get rid of the pain completely, still with proper treatment you will surely be able to manage it. The pain will lessen considerable which will allow to you to go through the range of physical activities like bending, stretching, running or squatting. So, managing the chronic pain will usher in a qualitative change in your lifestyle.

The arrangement in the office causes migraines in three possible ways.

• The overhead lighting may create glare on the computer monitor.
• Glare from the incandescent lighting.
• The flickers emanating from the fluorescent and tubes.

Let’s explore the solutions to remove factors that causes migraines:

The glare on the monitor can easily be tackled in the following ways:

• Place the monitor in the room in such a way that the light does not fall on it directly.
• Fix the monitor with a ‘glare screen’.
• Cover the monitor with a hood in order to obstruct any light falling on it directly.
• Switch off the lights in your working place, so that it wouldn’t get reflected on the monitor.
• If it is difficult to switch off the lights, you may discuss it with your supervisor of the office to remove all the lights in your working area.

The glare from the incandescent lighting can be minimized in the following ways:

• Change the position of your to a place, where the glare would be less.
• Cover any bare bulbs in the working place with fixtures to cut down the glare. The fixtures should either be frosted or opaque. If it is clear, then request the supervisor to change it with opaque or frosted fixtures. If the problem still persists, then it is better to turn off all the overhead lights or remove the bulbs of the work area.

The flickers emanating from the fluorescent and tubes causes migraines

Although not discernible to human eye, the fluorescent lights continuously emanate flickers, which causes migraines. So, even if the bulbs are covered with fixtures, people who are sensitive to flickers would surely be affected. In such cases, removing them from working area would be the most sensible thing to do. Hence, contact the office supervisor and make him aware of your problem. If he thinks that fixtures sans the bulbs would look inappropriate, then ask him to fix burned-out bulbs and tubes in stead.

I queried Scott Strickler, M.D. about these and how they put the eyes under strain. He revealed that as far as ‘work lighting’ is concerned, the incandescent lighting is better than fluorescent lighting. Although the fluorescent lighting is capable of covering a large area, it is not ideal for conducting office works. So, people, who work in the offices with files, should have desktop in addition to the overhead fluorescent lighting. “And if you have problem with fluorescent lighting, simply turn them off. No employer should really object it.” He said.

Make an assessment of the time period of your headache and migraine. If its occurrence is more prevalent during office hours, take a careful look at the lighting arrangement in your office and ascertain if that is what causes migraines for you.

Fortunately, managing migraines have become possible in the last decade. Although there is still no cure, medications can help reduce the frequency of migraine and stop the pain once it has started. The right medicines combined with self-help remedies and changes in lifestyle can make a tremendous difference in migraine management.



A variety of drugs have been specifically designed to treat migraines. Migraine medications are broadly divided into:

• Pain-relieving medications- these drugs are normally taken during migraine attacks and are designed to stop migraine symptoms that have already begun.
• Preventive medications: Taken regularly, often on a daily basis, these drugs reduce the severity or frequency of migraines.

Pain-relieving medications: These drugs must be taken as soon as the signs and symptoms of a migraine are experienced. They consist of:

Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help relieve mild migraines but aren’t effective for severe migraines. If taken too often or for long periods of time, these drugs can lead to ulcers, gastrointestinal bleeding and rebound headaches.

Triptans: For people with severe migraine attacks. They are effective in relieving migraine associated pain, nausea and sensitivity to light. Side effects of triptans include nausea, dizziness, muscle weakness and, rarely, stroke and heart attack.

Ergots: Ergotamine, a common prescription medication for more than 60 years now, was used before triptans were introduced. Ergotamine, however, is not as effective or as expensive as triptans. Dihydroergotamine is an ergot derivative that is more effective and has fewer side effects.

Anti-nausea medications: Since migraine attacks are often accompanied by nausea with or without vomiting, medication for treatment of these symptoms is usually combined with other medications like metoclopramide (oral) or prochlorperazine (oral or rectal suppository).

Butalbital combinations: Medications that combine the sedative Butalbital with aspirin or acetaminophen are sometimes used to treat migraine attacks. These medications, however, have a high risk of repeat headaches and withdrawal symptoms. It is for this reason that they should be used infrequently.

Opiates: Medications containing narcotics, particularly codeine, are sometimes prescribed to people who can’t take triptans or ergots. These drugs can be addictive and are usually used only as a last resort.

Preventive medications: These drugs can reduce the frequency, severity and length of migraines as well as increase the effectiveness of symptom-relieving medicines. These drugs include:

Cardiovascular drugs: Beta blockers, calcium channel blockers and antihypertensive medications, commonly used to treat high blood pressure and coronary artery disease, can reduce the frequency and severity of migraines. Considered among first-line treatment agents, these drugs can have side effects which include dizziness, drowsiness or lightheadedness.

Antidepressants: Certain antidepressants can positively prevent all types of headaches, including migraines. These medications may reduce migraines by affecting the level of serotonin and other brain chemicals.

Anti-seizure drugs: Although unclear, some anti-seizure drugs seem to prevent migraines. In high doses, however, these anti-seizure drugs may cause side effects, like nausea and vomiting, diarrhea, cramps, hair loss and dizziness.

Cyproheptadine: This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure.

Botulinum toxin type A (Botox): Some people receiving Botox injections for facial wrinkles have noted improvement in their headache. It is believed that the drug causes changes in the nervous system, modifying a person’s tendency to develop migraines.

Managing migraine

Whether or not you take a form of medication for migraine, small lifestyle changes and can help manage migraines better, both in terms of how often they occur and the severity of symptoms. Establishing a daily routine, eating and exercising regularly, waking and going to bed at the same time every day will undoubtedly help to manage migraines.

In addition, you must learn to things that may cause migraines. The challenge is to learn about your own independent triggers so that migraine management becomes easy. Moreover, keeping a written record of migraine attacks, including what you eat, drink, or do, can help you spot a particular trigger.

Limiting your caffeine intake, i.e. coffee, tea or cola drinks per day will prove to be beneficial because caffeine withdrawal is a potent headache trigger. Cutting out foods with migraine triggering ingredients is also a good idea.

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Interestingly, a recent study headed by Dr. Christopher I. Li of Fred Hutchinson Cancer Center in Seattle, after evaluating the data of more than 9,000 women, came up with the conclusion that women affected by migraine have 26 percent less chances of being affected by breast cancer and conditions like age, the initial occurrence of migraine, the kind of drugs the women took to alleviate the problem, the state of menopause or the immediate causes that triggers it (smell, light or sound) had no bearing on it. The results of this study were in agreement with an earlier study by Dr. Li and his group of scientists last November that pointed to a 33 percent less risks of occurrence of breast cancer amongst women suffering from migraine.

Dr. Li was hopeful that this relationship of lower risk of breast cancer to migraine could throw light in understanding the biological mechanisms associated with breast cancer and its prevention. Although the researchers are still unaware of the exact reasons behind this relationship, they do believe that hormones, especially estrogen could have a role in it.

“It is quite obvious that migraines are also a hormone-related disease like breast cancer and some of the things that bring in a lowering of estrogen levels in the body also sets in migraine. Higher level of estrogen is also associated with breast cancer. Hence, this could be the possible explanation for the fact that women suffering from migraine are less likely to be affected by breast cancer.”

Researchers also opine that non-steroidal drugs like aspirin, NSAID, naproxon and ibuprofen taken by women suffering from migraine in order to alleviate the pain would also be the reason. In fact, a recent study of this aspect pointed out that there exists 12 percent of reduction in the risks of breast cancer amongst women who took NSAID.

But Dr. Li advised caution and said that women suffering from migraine should still go for breast cancer screening and check-ups. Dr. Michael Kraut, Director of Oncology at Providence Hospital in Southfield, Michigan, also agrees to this. He also believes that migraine could be due to the reduction in the level of estrogen amongst women and is another pointer of the dangers associated with breast cancer. Li and his research associates are doing further study to find out the relationship between the lowering risks of breast cancer to the various types of migraines.

This study report has been published in the July issue of the journal of American Association of Cancer Research called ‘Cancer Epidemiology, Biomarkers and Prevention’.

This original article is presented to you by MyHealthToday.com © 2009