The promise of research
Advances in basic and clinical genetics are making it possible to both characterize genetic factors related to pain sensitivity and develop novel therapeutic approaches. NIH-supported scientists, for example, identified a gene variant of an enzyme that reduces sensitivity to acute pain and decreases the risk of chronic pain.
COX-2 (cyclooxygenase-2) is a major contributor to pain associated with inflammation. A study of genes affected by COX-2 led to the discovery of its role in connection to multiple cellular pathways that contribute to pain relief and adverse side-effects. With these discoveries will come the ability to better personalize pain management strategies.

Other therapies for pain

Your therapists may suggest nondrug treatments instead of or along with taking medicines. Not only do women use more nondrug therapies than men, women are more likely to respond well to them.

Physical therapy
Many patients with chronic pain move as little as possible, thinking that physical activity will harm them. In fact, the opposite is true. When you get out of shape, your pain may become worse. If you have a chronic pain problem, a physical therapist can help you find a physical activity program that is gentle, moderate, and right for you. You should follow the program, even if you feel some pain during physical activity. In this case, the pain does not mean that you are harming your body.

Types of physical therapy that may help your pain include:

• heat treatment—hot water baths, heating pads, high-frequency sound waves to produce gentle heat deep in your tissues
• cold treatment—ice packs, ice baths, ice massage
• gentle stretching
• muscle—strengthening physical activities
• massage—applying pressure to specific points on the body
• vibration therapy—a probe is applied to a part of your body with moderate pressure and vibrated several thousand times per second
  

Nerve stimulation therapies
These therapies involve the use of low electrical currents and/or fine needles that are placed in specific parts of the body. Acupuncture is one example. These therapies seem to interfere with the sending of pain signals to the brain. They may also cause the body to release natural painkillers, called endorphins.

Psychological and behavioral therapies
Therapies that help you relax or change your thinking patterns can sometimes help you cope with pain. Examples of these therapies include:

• Cognitive therapy—helps you to gain control over your pain by teaching you to recognize and change emotions that can make pain worse, such as anxiety, anger, and sadness
• Progressive muscle relaxation—tensing and then relaxing muscles helps to ease muscle tension that may be adding to your pain
• Deep breathing exercises—helps you to relax
• Guided imagery—imagining a pleasant scene takes your mind off your pain
• Biofeedback—electronic equipment  tells you about your muscle tension, skin temperature, and other body functions, so you can learn to control these functions and reduce your pain