Opiate pain medications are generally not helpful for most chronic pain patients. In addition, substance abuse dependence becomes a major problem with long term analgesic treatment. Sedatives and anti-anxiety medications such as Xanax are not beneficial and often become problems in and of themselves because of their frequent misuse, abuse and side effects which are often additive to the pain medications.
Successive management includes a comprehensive psychiatric examination, objective computerized psychological testing, including a Pain Patient Profile, detoxification from habituating substances, treating underlying or co-morbid psychiatric conditions and working with patients to increase their pain threshold through medical biofeedback training, the use of non-steroidal anti-inflammatory medications and education. Pain is a vicious cycle in which anxiety and depression aggravate spasm and pain. Successful treatment involves a multi-modal approach to reduce each of these factors.