Advances in Pain Treatment

The first step in treatment is to diagnose the specific kind pain. Is it nerve pain, sympathetic pain, muscle pain, cancer pain? Pain specialists conduct a physical examination and review medical records in addition to analyzing the description of a patient’s pain.

“We look at the whole patient,” says Pittsburgh-area anesthesiologist and pain medicine specialist Doris K. Cope, MD.

Since the degree of pain varies from person to person, treatment plans vary and may include a single approach or a combination of medications, therapies and procedures. Some of the available treatments being used successfully to treat pain patients include:

Injection treatments—Local anesthetics can be injected around nerve roots and into muscles or joints to reduce swelling, irritation, muscle spasms and abnormal nerve activity.

Nerve blocks
—Often a group of nerves that causes pain to a specific organ or body region can be blocked, at least temporarily, with local anesthetics.

Physical and aquatic therapy
—An exercise program, whirlpool therapy, ultrasound and deep-muscle massage may help increase daily functioning and decrease pain.

Electrical stimulation
—Transcutaneous electrical nerve stimulation (TENS) is not painful and consists of a small, battery-operated device that can diminish pain by stimulating nerve fibers through the skin.

Injection treatments
—Local anesthetics can be injected around nerves or into joints to reduce swelling, irritation, muscle spasms or abnormal nerve transmissions.

—When other treatments fail, doctors may use heat or chemicals to sever the nerves that serve as pathways for the pain.

Dr. Cope cites the successful use of a surgically-placed intrathecal pump which can deliver less than one-hundredth of a standard opioid dose, but goes directly to the spinal pain receptors. The medication travels through a catheter that is also surgically placed.

Pulsed radio frequency also can bring relief for some forms of back pain. The physician pulses heat to ablate the nerve and stop the pain. The solution is only temporary, but it can offer a year of relief to patients with arthritis, whiplash, degenerative disc disease and other common problems that can’t be helped with many other treatments.


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