Friday, January 13, 2012

Taking a Hard Look at Some Pain Management Myths

By David Greene


Pain management in the United States is big business. Well over 100 million individuals suffer from chronic pain, and the problem costs well over $500 billion annually. There are quite a few mis-perceptions in the field of pain management. Here are a few of them described

1. Narcotics are always bad. Each year, there are over 15,000 overdose fatalities from narcotics and there is plenty of bad press on a weekly basis regarding narcotic pill mill medical practices. So a significant amount of the general population looks at narcotics as always being a bad thing.

However, opiate medications do in fact have a legitimate place in pain management. For instance, a patient who has cancer may live his or her last few months in horrific pain if they do not have narcotics to assist in the relief that they deserve.

In individuals who do not have an indication for surgery and are dealing with chronic pain, opiates as a pain management treatment may allow individuals to maintain employment and to enjoy functional lives and to continue playing with their kids.

So narcotics do in fact have a place in the treatment of patients dealing with acute and some types of chronic pain.

2. An MRI always gives a definitive back pain diagnosis. Even with the most highly trained medical specialists, only 50% of the time is impossible to tell a patient definitively what their diagnosis is further back pain.

This include patients who have had a complete musculoskeletal workup which includes a history, physical examination, x-rays, and even an MRI. So an MRI is not always the go to trustworthy part of the workup.

3. Back surgery fixes most back pain. A significant amount of time there is not really a true cure for a person's lumbar pain. Spinal fusion surgeries and United States have increased 15 fold over the last 10 years and the population in America has not gone up nearly that much. So it is a fact that with all these surgeries being performed the results have not improved substantially and in fact they remain moderate at best.

4. Only 3 steroid injections are permitted per year. Pain management specialist are not in agreement with, injections are definitively allowed annually. This is because research has not shown what is the best number. So some individuals say 4 injections per year and others say a lot more than that is okay.

With the steroid being injected into one particular area, cortisone is able to stay in that region for quite a while and very little of it actually gets into the bloodstream. So in fact more than 3 steroid injections can be given in a year but we just don't know the exact number that is okay.

5. All pain management involves opiate prescriptions. This is definitely a myth. The most modern types of pain management involve a comprehensive approach. This includes multiple pain doctors from different specialties collaborating and may include physical therapy, interventional pain management, or chiropractic treatment. Injections may include trigger points, epidural injections, or facet injections. This comprehensive treatment approach allows patients a lot of pain relief and tries to minimize the narcotics necessary.




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