Thursday, December 29, 2011

Pain Management Options When Your Pain Cannot Simply Be Fixed

By David Greene


As a pain management patient, there are times when your pain cannot be fixed with either surgery or physical therapy. It may be that a previous surgery was performed that either did not work or made the pain worse. It could also be that a situation exists such as peripheral neuropathy where the condition is not amenable to surgery and the patient simply has to live with the pain.

If this is the case and the patient simply has to "live with" their pain, what are the options for appropriate pain reduction? There are multiple options that can benefit the patient so despair should not set in right away. The first option that should be tried is either physical therapy or physical rehabilitation.

These 2 options are very similar, with physical therapy being done by a physical therapist and the rehab option often being performed by chiropractors. They can both be extremely helpful in pain reduction along with increasing an individual's function.

Along with these treatments the patient should be under the care of a pain management doctor who specializes in chronic treatment of pain. This way the doctor can treat the patient with medications that may include anti-inflammatories and potentially narcotics, potentially an antidepressant medication along with something like either Neurontin or Lyrica. The patient may also require muscle relaxant medications, so it's best to be under the care of a specialist for these decisions.

When it comes to other treatments, a lot of it depends on what type of particular pain the patient is experiencing it was a coming from. Interventional pain management treatments may help substantially, for instance if the individuals dealing with pelvic pain a superior hypo-gastric plexus block may help reduce pain substantially.

This is just one example, another may be if a patient is having chronic pain in his neck or back from facet arthritis a radiofrequency ablation may help substantially.

The patient is having a significant pain problem along the spinal column it may very well be that interventional injections can do the trick with pain relief. Another last resort is if a patient is having chronic pain that is not amenable to surgery a spinal cord stimulator may be effective. A stimulator does not cure anything, but it may alleviate pain chronically.

The stimulator has a paddle with multiple diodes in it that is made out of silicone that is put around the epidural space in the spinal canal and e-mail its electrical impulses that can alter the pain signals going to the brain. This may reduce pain from producing those signals.

The implants are placed on an outpatient basis and typically are preceded by a trial of an implant to make sure it's going to work. The trial is left in place for 4 to 7 days, and if it works the patient receives a final implant. This involves placing the paddle as mentioned around the spinal cord and also involves attaching it to a battery that can be placed under the skin either in the abdominal area or on top of the buttock region.

With regards to the spinal cord stimulator's overall results have shown an overall success rate of 62%. For a patient who has chronic pain and very few options for which to work with even a 60% success rate can be very welcoming, even if it only provides 50% relief in a terrible situation.




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