A chronic pain pro answers your questions about how to find relief.

Joyce Willenshas her sisters to thankin partfor her career in nursing. At age 6, she was often called upon to squeeze heated drops into her twin sisters aching ears (kids, dont try this at home). Its a wonder I didnt burn her ear canals, says Willens. Then, her older sister decided to attend nursing school, sparking the Coatesville, Pa., natives interest in medicine.

We asked Willens for her expert advice on what to do when pain relief doesnt come easy.

AP: Why is chronic pain so difficult to diagnose and treat?

JW: Because we cant see it, we have to rely on the patients description, and its very difficult to describe. Also, if pain is not resolved quickly, the nervous system adapts to it. That can cause pain signals to continue long after an initial injury.

AP: What are the most common causes of chronic pain?

JW: Often its acute pain, maybe from an injury or arthritis, that is not well treated. Other common sources are fibromyalgia, a condition involving musculoskeletal pain; headaches; multiple sclerosis; or nerve damage.

AP: When is it time to switch doctors?

JW: Dont stay with a provider too long when treatment is not working. If your pain is not lessening, look for another practitioner.

AP: What are the most effective treatments?

JW: Opioids (prescription narcotics) and non-steroidal anti-inflammatories, or NSAIDs. If you take them, stay in touch with your provider, learn about what the drug does and pay attention to how your body reacts.

AP: How effective are alternative therapies such as exercise, meditation and acupuncture?

JW: They can be very effective, although there is little research about them. Meditation can help relax the brain and decrease anxiety, which can release tightened muscles. Its important to try various therapies and keep a diary while you do, so you can see patterns. Then do whatever is helpful.

This article originally appeared as on American Profile