Living with chronic pain is hard to understand - unless you've been there. It can take a terrible toll on self-esteem, relationships (especially marriage), employment, finances, and can cause serious mood disorders like depression and anxiety - and in some cases, can even contribute to alcoholism and other addictions.

The World Health Organization (WHO) has suggested a "pain ladder," which gives medical professionals a common language and process for helping those afflicted with chronic pain. The idea of the pain ladder is to start pain relief treatment at the bottom rung (for mild pain), then continue to the next rung, if the pain persists. A simplified version of the pain ladder follows:

• Bottom rung of ladder - mild pain; treatment: non-opioid medication with or without an adjuvant.
• Next rung of ladder - moderately high pain; treatment: weak opioid medication with or without non-opioids and adjuvants.
• Highest rung of ladder - severe pain; treatment: strong opioid medication with or without non-opioids and adjuvants.

In the description above, adjuvants are drugs or treatments that may have little or no effect on their own, but enhance the effectiveness of other medications. For instance, it has been shown that the inclusion of caffeine in aspirin or acetaminophen preparations can increase the pain relief effects. Another more contemporary adjuvant for pain management is the use of antidepressants (like Paxil, Zoloft, and Prozac).

If you're a sufferer of chronic back pain, you've probably already been introduced to the concept of "escalating" treatments for your pain. Anyone with chronic back pain is already very familiar with ibuprofen and has probably been prescribed some kind of codeine or codeine derivative like Vicodin. The problem: opioid medications can easily become addictive, have the potential for abuse, often cause withdrawal when stopping, and can be dangerous with alcohol or other medications.

If you're concerned about chronic back pain, you owe it to yourself to seek any and all information and treatments currently available. Talk to a surgeon about your pain. There might be a non-surgical combination of therapies that work for you - or you might find out that new, minimally invasive surgery can put an end to the medication roller coaster once and for all.

Back Pain Treatment ¦ Back Pain Alternative Treatment ¦ Back Pain Management ¦ Overview of Back Pain Problem ¦ Back Care at Work