Introduction to Pain. What Is Pain Management Or Pain Medicine? What is Interventional pain management? What is a pain clinic?

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Clarissa Fitzgerald
5 years ago
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Introduction to Pain Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these.

Pain can be debilitating and frustrating and it may interfere with sleep, work, activities and quality time with family and friends.

2 Introduction to Pain Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these. Pain can arise from many different reasons such as injury, nerve damage and metabolic problems like diabetes. Occasionally, pain can even be the problem all by itself, without any obvious cause. Pain can be debilitating and frustrating and it may interfere with sleep, work, activities and quality time with family and friends. Pain management specialist can offer options for pain control so that you can enjoy your life free of pain. But treatment is complex. That s why pain management may require the involvement of a physician with special training in evaluation, diagnosis, and treatment of all different types of pain. What Is Pain Management Or Pain Medicine? It is a branch of medicine employing an interdisciplinary approach for easing the suffering and improving the quality of life of those living with chronic pain. What is Interventional pain management? Interventional pain management deals with treating pain using precision-guided injection techniques to deliver pain-relieving medicine to specific areas of your body. The injections are performed under X-ray or Ultrasonography guidance. These are also done in the joints and the discs between the spine bones. These injections can help us in avoiding spine surgeries in a vast majority of the patients. What is a pain clinic? A pain clinic is a specialized healthcare facility that focuses on the diagnosis and management of chronic pain. 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 care, not just the pain. Pain clinics are ideal when a patient is looking at pain relief options which are minimally invasive and do not 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 or few days.

3 What Type Of Pain Are Treated In Our Pain Clinic Various types of chronic as well as cancer pain are treated. Most common conditions are : Back pain Cancer Pain Neck pain Headache Spasticity Fibromyalgia Sciatica, herniated disc (or slip disc) Complex regional pain syndrome Chronic Abdominal Pain Osteoarthritis Knee pain Post Herpes Zoster Pain Trigeminal Neuralgia Neuropathic pain Atypical Face Pain Knee and Shoulder pain Myofascial Pain Syndrome How We Treat Such Pain? Peripheral Nerve Block Epidural Steroid Injection Platelet rich Plasma Therapy Sphenopalatine Ganglion Block Facet joint and Medial Branch Block Spinal Cord Stimulation (SCS) Sympathetic Plexus Blockade Botox Therapy Prolotherapy Brachial Plexus Block Radiofrequency Neuroablation Intrathecal Programmable Pump Gasserian Ganglion RF ablation Sacro-iliac Joint Injection Intra-articular Injections Occipital Nerve Block Stellate Ganglion Block Hypogastric Plexus Block Are these procedures safe? Some people are concerned about the safety and side effects of these procedures. When performed by a skilled and experienced doctor under fluoroscopy or ultrasound guidance, the procedures are safe and painless. Are these treatments successful? The treatments can be very effective when experts perform using X-ray or Ultrasonography guidance. Following interventions, patients are put through a rehabilitation programme, which involves relaxation techniques, home-based exercises and lifestyle modifications. The long-term success rates in majority of cases are excellent.

How to take care of your Pain? BACK PAIN Back pain is experienced in 60% 80% of adults at some point in their lifetime. On the brighter side, you can prevent most back pain.

Surgery is rarely needed in back pain treatment when it does not subside, and the injury or illness that caused it has had sufficient time to heal.

4 How to take care of your Pain? BACK PAIN Back pain is experienced in 60% 80% of adults at some point in their lifetime. On the brighter side, you can prevent most back pain. If prevention fails, simple home treatment and proper exercise will often cure your back pain within a few weeks and keep it functional for the long time. Surgery is rarely needed in back pain treatment when it does not subside, and the injury or illness that caused it has had sufficient time to heal. Common Causes of Back Pain Bulging Or herniated (slipped disc) : The jelly-like center of a lumbar disc can break through the tough outer layer and irritate a nearby nerve root. Sciatica : Herniated disc pressing over the nerve going to your leg causing sharp shooting pain in the back & leg. Arthritis : It can lead to narrowing of the space around the spinal cord called spinal canal stenosis. This can cause back & leg pain. Facet joint dysfunction : There are two facet joints behind each disc. These joints can be painful by themselves, or in conjunction with disc pain. Spondylolisthesis : This condition occurs when one vertebra slips over the adjacent one. Structural irregularity : Your spine may have abnormal curvature either side to side(scoliosis) or excessive curve in front/ back (kyphosis). Osteoporosis : Can cause vertebra fracture & can cause back pain. Common in old age. Sacroiliac joint dysfunction : The sacroiliac joint connects your sacrum bone at the bottom of the spine to each side of the pelvis. The sacroiliac joint can become painful if it becomes inflamed (sacroiliitis) or if there is too much or too little motion of the joint. Trauma : Acute fractures or dislocations of the spine can lead to pain. Rare causes include Cancer, infection, cauda equina syndrome. Common Symptoms of Back Pain Persistent aching or stiffness anywhere along your spine, from the base of the neck to the tail bone. Sharp, localized pain in the neck, upper back, or lower back -especially after lifting heavy objects. Chronic ache in your middle or lower back, especially after sitting or standing for extended periods.

5 Sciatic pain or sciatica: Problem is in the back, but you feel pain along the course of the nerve (leg, foot) in addition to back pain. Inability to stand straight without having pain or muscle spasms in the lower back. Back Pain Treatment at GNRC pain clinic There are many non-surgical treatment options for chronic back pain. These includes 1. Pharmacotherapy 2. Interventional Techniques consists of neuropathic agents, muscle relaxants, pain relieving medicines. Interventional techniques : The interventional techniques are non surgical procedures and are used in cases where other methods have failed and the patient requires rapid recovery. These procedures have obvious advantages like being minimally invasive, day care procedures, providing rapid recovery and are relatively inexpensive. Spinal Injections : Interlaminar or transforaminal Epidural Injections are techniques where anti-inflammatory medicines are injected into the opening at the side of the spine where a nerve roots exits. These injections reduces pain, tingling and numbness and other symptoms caused by inflammation, irritation or swelling. Life Style Changes Tips Facet blocks & Median branch block : Potent anti-inflammatory agents are deposited in the small spinal joints and its nerve supply. Radiofrequency ablation : This procedure involves deadening of painful nerves via heat administered through a small needle. Ozone Discectomy : This procedure is used to relieve back pain due to prolapsed disc by injection of Ozone inside the intervertebral disc. Ozone reduces the size of the herniation by dehydration. Spinal cord stimulation: Spinal cord stimulator is a type of implantable neuromodulation device used for the treatment of chronic pain following back surgeries. Exercise regularly. Always stretch before exercise or strenuous activity. Sit in a chair with good lumber support and proper height for the task. Sleep on your side to reduce any curve in your spine. Always sleep on a firm surface. Wear comfortable and low heeled shoes. Avoid cradle the phone between your neck and shoulder. Don t try to lift object too heavy for you. Don t slouce while standing or sitting. Quit smoking. Maintain proper nutrition and diet to reduce and prevent excessive weight.

6 KNEE PAIN Knee is the largest joint in your body made of bone, cartilage and ligaments. The cartilage in the knee acts as a cushion and gliding surface. The cartilage keeps the bones in the joint from Common Causes of Knee Pain Osteoarthritis: This is the gradual breakdown of the cartilage in the knee. Also called degenerative joint disease, osteoarthritis usually develops over years and often is found in patients who have had a knee infection or injury and those who are overweight. Rheumatoid arthritis: Rheumatoid arthritis can affect joints on both sides of the body (both knees, both hands and/or both wrists). In rheumatoid arthritis, your body s cells attack your own tissues. rubbing together. However, when the joint is affected by arthritis, the bones make contact and cause pain. Injuries, aging and degenerative conditions such as arthritis can cause the cartilage to break down. Bursitis: Bursitis is the inflammation of any of the fluid-filled sacs (bursae) protecting the body s joints. This is usually caused by repetitive motions or by a stress such as kneeling. Tendonitis: The tendons rope like tissues connecting muscles to bone at the knee and other joints can become painfully inflamed by repetitive and strenuous movement. Tendonitis is a common sports injury. Patellofemoral pain syndrome (PFPS): Knee pain or discomfort while walking up and down stairs, jumping or squatting may be symptoms of patellofemoral pain syndrome. Common Symptoms of Knee Pain Swelling and stiffness Redness Weakness or instability Popping or crunching noises Inability to extend the knee Knee Pain Treatment at GNRC pain clinic Conservative care: Rest, Ice/heat, pain reliever medicines, knee brace, weight loss etc. Anti-inflammatory agent injections into knee joint: Potent anti-inflammatory agents like steroid can be injected inside the knee to reduce pain and inflammation. Ozone Gas can also be injected into the knee to reduce pain and inflammation. Visco supplement (Synovial fluid replacement)injection: This treatment involves injecting a lubricant into the knee. The filler lubricates and adds cushioning to the joint.

7 Stem Cell/Platelet Rich Plasma (PRP) therapy: PRP therapy involves injecting platelets from the patient s own blood to rebuild a damaged tendon or cartilage. It has been successful in not only relieving the pain, but also in jumpstarting the healing process. Physical therapy: low-impact stretches and exercises that can strengthen muscles in your knee, improve stability and flexibility, and reduce pressure on the joint. NECK PAIN Neck pain also commonly known as cervical pain is described as an aching, burning, stabbing, shooting, or cramping pain and frequently spreads into the Head, upper back, the arm or the hand. It is frequently made worse by activities. Common Causes of Neck Pain & Cervical Pain Muscle sprain: Overuse of a particular muscle and bad posture often triggers muscle sprains. Herniated discs: Herniated discs can press on the nerves branching out from the spinal cord Facet joint pain syndrome: Facet joints are joints between two vertebral bones. They can be painful due to bad posture, whiplash injuries of the neck, arthritis or degeneration in the low back. Stiffness in the neck Radiating pain upto the fingers Difficulty gripping or lifting objects Diseases: Neck pain can sometimes be caused by diseases, such as rheumatoid arthritis, tuberculosis, fibromyalgia, meningitis or cancer. Common Symptoms of Neck Pain Tingling, numbness, or weakness in the hand Headaches General soreness Shooting pain Neck Pain and Cervical Pain Treatment at GNRC Pain clinic Conservative care: applying heat or ice and using pain relievers, nerve medicines, muscle relaxants etc. Physical therapy: Ultrasonic, short wave diathermy, laser and controlled traction. Along with these neck strengthening exercises are performed. No exercises should be performed in acute painful conditions. Cervical epidural injection: These techniques are absolutely safe, effective and produce rapid recovery in all age groups provided they are performed by the experts (pain physicians). Facet joint and Medial Branch nerve injections: Each facet joint is served by medial branch nerves, and if these nerves are blocked with local anesthetic, the pain from the joints will stop. Blocking it by local anaesthetic or radiofrequency current is absolutely safe method of relieving facet joint pain.

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Facet Joint Syndrome / Arthritis

Facet Joint Syndrome / Arthritis Overview Facet joint syndrome is an arthritis-like condition of the spine that can be a significant source of back and neck pain. It is caused by degenerative changes to