What is Pain Management?
Pain management, or pain medicine, is a growing medical specialty dedicated to treating acute, sub-acute, and chronic pain. The goal of pain medicine is to improve patient’s quality of life and help them return to everyday activities without surgery.
Pain management, also known as pain medicine, draws on many disciplines in science and the healing arts to systematically study pain, its prevention, evaluation, diagnosis and treatment, as well as the rehabilitation of painful disorders.
Bay State Pain Associates treats many different types of pain including complex pain syndromes. Our medical providers work with your referring physician including physical and occupational therapists, oncologist, and psychiatrist or psychologist, to provide effective pain management.
Pain Management for Chronic Back Pain
Pain, especially intractable or chronic pain, used to be something many patients simply had to learn to “live” with. In recent years, however, researchers have learned a great deal about pain and its physiological and psychological basis, leading to pain management treatments that can provide complete or partial pain relief.
Untreated pain can interfere with the healing process by affecting the immune system and leading to other undesirable results. In cases of back pain, discomfort can impede the rehabilitation process by interfering with exercise and increasing the risk of psychological distress.
New Understanding of Chronic Pain
Patients who report continuing pain in the absence of a definitive pathology (an identifiable, anatomical cause of the pain) are sometimes dismissed by health professionals. Even in the absence of such an identifiable cause, however, chronic pain can lead to neurological feedback processes that only serve to worsen the pain and make it more difficult to treat.
Pain is inherently subjective, and a greater awareness of the need for taking pain seriously is growing among the health community as well as the public at large. This is particularly true for chronic back pain sufferers.
While a great majority of back pain cases are self-limiting and resolve on their own, the risk of recurrence and development of chronic disease is significant. or (also called nerve pain). Chronic back pain tends to be very difficult to treat, especially in cases involving failed back surgery neuropathic pain
The above considerations have led to a proliferation of services available to patients seeking both medical and alternative treatment for back pain.
Pain management is designed to treat chronic pain and allow a person to live a full, enjoyable 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 back pain surgery. It’s important to understand the differences between non-invasive non-drug pain management (e.g. exercise), pain management (e.g. pain medications and anti-depressants), and invasive pain management (e.g. injections).
The focus should be on development of self-management skills, along with lifestyle changes and efforts to improve physical and mental health. The plan should include psychological and behavioral therapy.
Depending on many factors, such as the type of pain and your general health, there are numerous options for treating your pain. Some patients are surprised to learn that a treatment that previously failed to provide relief may be effective when combined with a multi-treatment approach.
Depending on the cause of your pain, a specific plan is developed to try to reduce and manage symptoms. Treatments are specific for each patient, depending on their unique complaints, physical findings, radiological study results, and response to previous injections. We recognize that patients and their pain are different, and as such, approaches may vary
We can classify the most widely used pain management techniques in terms of the degree of intervention they involve:
- Noninvasive, non-drug pain management
- Noninvasive pharmacologic pain management
- Invasive pain management
Patient Pain Evaluation
One of our pain management specialists will begin care by reviewing your medical history and evaluating your physical and neurological condition in order to pinpoint the source of your pain.
An in depth discussion of your pain includes its location(s), duration, and intensity. The doctor may ask you to rate your pain on a scale of 0 to 10 with 10 being the worst pain possible. Alternatively, you may be asked to notate on a picture of the front and back of body where you feel pain and designate its type (i.e. burning, sharp) and intensity (1 through 10).
Further evaluation may require a CT scan, MRI, or other imaging study to further evaluate your pain and diagnose its cause. Many types of minimally invasive spinal injections provide valuable diagnostic information such as a Medial Nerve Branch Block.
Is Pain Management Right for You?
Pain is a complex problem that requires treatment and management by a pain medicine specialist. Millions of people suffer from pain every year at great personal cost. According to the American Academy of Pain Medicine, “… pain affects more Americans than diabetes, heart disease and cancer combined.”
If you find that you cannot safely control your pain with over-the-counter medications, or have failed to find relief from other treatments or practitioners, you should consider consulting with a pain management physician. For most patients, interventional pain management procedures can treat or reduce pain, allowing the patients to regain function, and thereby improving their quality of life. This reflects our practice philosophy.
In many ways, Bay State Pain Associates treats similar patients to an interventional spine practice. Our patients commonly present with sciatica, arthritis of the neck or back, or disc pain and obtain good relief and avoid surgery. Bay State Pain Associates also treats other pain syndromes using interventional procedures.
Our specialists treat complex pain issues. There are many different physical and neurological disorders that contribute to pain, and pain management can provide you more advanced care specifically aimed to control your pain. Examples of pain-causing disorders treated by pain management specialists include:
- Arthritis of the spine
- Back and neck pain
- Cancer pain
- Cervical (neck) radiculopathy
- Disc herniation
- Failed back surgery
- Occipital headaches, other types of headache Nerve entrapment syndromes
- Sciatica pain (low back/lumbar radiculopathy)
- Shingles (post-herpetic neuralgia)
- Spinal stenosis
- Trigeminal neuralgia or other facial pain
- Pudendal neuralgia
- Vertebral compression fracture
If you are interested in learning how pain management can benefit you, please contact Bay State Pain Associates. We would be happy to make an appointment for a consultation and provide additional information about other treatment options.
Spinal Injections for Pain Management
An interventional pain injection, whether it is performed for diagnostic or pain treatment, involves injecting a local anesthetic with or without steroid into an area of inflammation.
Injections can be performed for diagnostic or therapeutic purposes.
- Diagnostic injections are precise injections used to determine the exact cause of pain, if possible.
- Therapeutic injections often involve placing a corticosteroid at the source or a cause of pain.
One of three outcomes can be expected following a spinal injection: no pain relief, temporary pain relief, or longer term pain relief.
- The outcome helps to identify the predominant cause of pain.
- When pain is relieved, the patient benefits more fully from physical therapy or chiropractic adjustments.
- Persistent symptoms may denote the need for additional pain treatment interventions.
- When surgery is recommended, the surgeon may depend on the results of precise diagnostic injections. Our practice retains a photographic image of each needle placement in our patient records.
Pain relief varies among patients. Steroids are a very strong anti-inflammatory medication. Thus, if inflammation is a large component of your pain, you should derive some benefit from the injection. The steroid can help the underlying problem heal and whether you will need another injection depends on your body’s ability to correct the underlying disorder. More than one injection may be recommended.
If your injection is a diagnostic injection, the procedure is performed as a precursor to another procedure intended to provide long term relief. To increase the benefits of a diagnostic injection, a steroid medication may be added to provide pain relief after the local anesthetic wears off.
Other treatments may include:
- Radiofrequency ablation
- Pulsed radiofrequency ablation
- Presurgical injections
Pain Management Specialists
Health professionals in many fields have completed specialized training in pain management. Currently, there is no single field of medicine or health care that represents the preferred approach to pain management. Indeed, the premise of pain management is that a highly multidisciplinary approach is essential.
Pain management specialists are most commonly found in the following disciplines:
- Physiatry (also called Physical medicine and rehabilitation)
- Interventional radiology
- Physical therapy
Specialists in psychology, psychiatry, behavioral science, and other areas may also play an important role in a comprehensive pain management program.
Most pain management specialists are seen by referral from a physician. Any patient who feels it is appropriate should consult his or her physician about a pain management program.
Pain management specialists are most often called upon to treat:
- Severe back pain
- Challenging chronic pain
- Failed back surgery syndrome
Patients should keep in mind that there are many varieties of pain management programs to explore. This process can be confusing or frustrating at times, but the important point is to work proactively with one’s health professionals and not to give up if one initially encounters an unsatisfactory result.
While this process can be a significant challenge for patients enduring intense pain, once patients find an approach that they are comfortable with, it is likely that their condition and pain levels should improve.