Understanding Pain Management: Techniques and Treatments

Pain management is designed to treat chronic pain and allows a person to live a full, enjoyable life. Chronic pain is pain that lasts more than three to six months or pain beyond the point of tissue healing. Some forms of chronic pain can be linked to an identifiable cause, such as degenerative disc disease, spinal stenosis, or spondylolisthesis. Other forms have no clear cause, such as fibromyalgia or nerve pain. Fighting chronic pain is a lifelong struggle for many.  With an accurate diagnosis and early intervention, we hope to help patients avoid a state of chronic pain, or at least reduce the severity of pain, and improve quality of life.

Pain management requires a person’s dedication, commitment, and knowledge in order to achieve the best results. It can be a great alternative to surgery.  Pain management techniques can be grouped in terms of their invasiveness: non-invasive, non-drug pain management; non-invasive pharmacologic pain management; and invasive pain management.

Non-invasive, Non-drug Pain Management

There are a variety of non-invasive, non-drug pain management techniques. Some of these include:

• Exercise – increasing strength, flexibility, and restoring normal motion is the aim. Includes water therapy, stretching exercises, aerobic routines and others. Exercise is necessary for proper cardiovascular health, disc nutrition and musculoskeletal health.
• Manual techniques- manipulation of affected areas by applying force to the joints, muscles, and ligaments.
• Behavioral modification – Cognitive therapy involves teaching the patient to alleviate back pain by means of relaxation techniques and coping techniques. Biofeedback involves learning to control muscle tension, blood pressure, and heart rate.
• Superficial heating or cooling of skin – These methods include cold packs and hot packs, ultrasound, and diathermy and are used in conjunction with exercise.
• Electrotherapy – the most commonly known form of electrotherapyis transcutaneous electrical nerve stimulation (TENS), which uses a low-voltage electric stimulation that interacts with the sensory nervous system.

Non-Invasive Pharmacological Pain Management

A few non-invasive pharmacological pain management drugs include: acetaminophen (Tylenol), NSAIDs, oral steroids, narcotics, muscle relaxants, and anti-depressants.  These have  benefits and risks and you should speak with your physician or a pain management specialist before using them to relieve symptoms of chronic pain.

Invasive Pain Management

Invasive pain management involves injections.  Some of these include epidural steroid injections (ESIs) and radiofrequency neurotomy.

ESIs are a commonly used for low back pain and leg pain. At times the injection alone is sufficient to provide relief, but sometimes a rehabilitation program is added. A radiofrequency neurotomy is used to treat facet joint pain or sacroiliac joint pain caused by arthritis or other degenerative changes, or from an injury.

While dealing with severe pain is a difficult experience physically, emotionally, financially, and practically, it is best to seek medical attention for your pain as soon as possible.  A pain management specialist provides a personalized approach and comprehensive treatment plan to alleviate your pain and improve your quality of life.

Oren Ambalu, MD