What is pain management ?

Pain management (also called pain medicine or algiatry) is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with pain. The treatments for chronic pain are as diverse as the causes. From over-the-counter and prescription drugs to injections and advanced interventions like radio frequency lesioning and intrathecal pumps, there are a lot of approaches. But when it comes to treating chronic pain, relief may be found by using a combination of treatment options.

What is a Pain Clinic?

A pain clinic is a health care facility that focuses on the diagnosis and management of chronic pain. Some specialize in specific diagnoses or in pain related to a specific region of the body. Also called pain management clinics, pain clinics often use a multidisciplinary approach to help people take an active role in managing their pain and regaining control of their life. These programs are focused on the total person, not just the pain.

Pain clinics are ideal when a patient is looking at pain relief options which are minimally invasive and donot involve surgery. These treatment options are focused on relieving pain with minimal impact on life and with a short recovery time of a few hours (compared to recovery periods of 20+ days in case of surgeries)

Drug Therapy: Non prescription and Prescription

Milder forms of pain may be relieved by over-the-counter medications such as acetaminophen or non steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and pyroxene. Both acetaminophen and NSAIDs relieve pain caused by muscle aches and stiffness, and reduce inflammation (swelling and irritation). Topical pain relievers are also available, such as creams, lotions, or sprays that are applied to the skin in order to relieve pain and inflammation from sore muscles and arthritis. If over-the-counter drugs do not provide relief, pain physicians may prescribe stronger medications, such as muscle relaxants, anti-anxiety drugs (such as diazepam), antidepressants (like Cymbalta for musculoskeletal pain), prescription NSAIDs such as Celebrex, or a short course of stronger painkillers (such as codeine, Fentanyl, Percocet, or Vicodin).

Trigger Point Injections

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. During this procedure, an injection is given at the trigger point. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief.

Trigger point injection is used to treat muscle pain in the arms, legs, lower back, and neck. In addition, this approach has been used to treat fibromyalgia, tension headaches, and myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatment. BOTOX® injections can be used to alleviate chronic migraine headaches. The procedure involves injections around the head and neck.

Nerve Blocks & Injections

Nerve blocks are injections containing potent anti-inflammatory agents directed at a particular nerve or nerve group that is intended to reduce inflammation and relieve pain. Ozone Gas can also be injected into the knee to reduce pain and inflammation.

Surgical Implants

When standard medicines and physical therapy fail to offer adequate pain relief, you may be a candidate for a surgical implant to help you control pain. There are two main types of implants to control pain:

Intrathecal Drug Delivery. Also called infusion pain pumps or spinal drug delivery systems. In this procedure, a pocket is made under the skin that’s large enough to hold a medicine pump. The pump is usually about one inch thick and three inches wide. A catheter is also inserted, which carries pain medicine from the pump to the intrathecal space around the spinal cord. The implants deliver medicines directly to the spinal cord, where pain signals travel. For this reason, intrathecal drug delivery can provide significant pain control with a fraction of the dose that would be required with pills. In addition, the system can cause fewer side effects than oral medications because less medicine is required to control pain.

Spinal Cord Stimulation Implants. In spinal cord stimulation, low-level electrical signals are transmitted to the spinal cord or to specific nerves to block pain signals from reaching the brain. In this procedure, a device that delivers the electrical signals is surgically implanted in the body. A remote control is used by the patient to turn the current off and on or to adjust the intensity of the signals. Most people describe the feelings from the simulator as being pleasant and tingling.

Other Advanced Interventional Pain Management Techniques

Pain clinics also provide several other advanced interventional pain management techniques like ozone discectomy, platelet-rich plasma (PRP)/stem cell therapy, vertebroplasty, to name a few. Details of such techniques available at Deep Pain Management Centre.