Chronic pain management is the process of increasing activities of daily living as well as helping to reduce or eliminate pain, while simultaneously teaching ways to cope with symptoms that cannot be completely relieved. It is a multi-disciplinary approach that may involve a pain management physician, a physical therapist and/or services of a psychologist. The ultimate goal is to reduce pain, increase physical activity and promote a wellness lifestyle.
We treat many kinds of pain including but not limited to back and neck pain, cancer pain, neuralgia, muscular/myofacial pain, shingles/post herpatic neuralgia, complex regional pain syndrome Types 1 (RSD) and Type 2 (causalgia), nerve entrapment, fibromyalgia, ischemic/vascular pain and phantom limb pain. In addition, we see patients who have been injured, on the job or otherwise, and those looking for alternatives to surgery.
Chronic pain has traditionally been treated with medication. Many medications require increasing doses and/or result in dependency. After a while, these medications are not always successful in alleviating pain and/or have side effects that interfere with daily life. An alternative approach is to find out exactly what is causing the pain and treat it using minimally invasive techniques. Some examples of minimally invasive procedures are trigger points or acupuncture, epidural or caudal steroid injections, nerve root blocks, facet blocks or radiofrequency treatments.
Re-training injured muscles that have been passive for some time is one of the best ways to relieve some types of chronic pain. We realize that performing physical therapy when you are in pain defeats the purpose so we find out what is wrong and treat it before sending you for physical therapy. Once the pain is controlled, we work with trained physical therapists who will help you develop a specific plan to strengthen muscles and improve flexibility. Achieving these physical therapy goals may ultimately serve to reduce pain and/or dependence on medication, improve mobility and enhance quality of life.
The emotional strain of dealing with chronic pain can leave even the most optimistic patients depressed. Inactivity can decrease social and family interaction. Chronic pain can also interrupt sleep, leaving one tired and irritable. Add this to lethargy and constant pain and it is no surprise that depression and despair are a common side effect for chronic pain patients and their families. We work with counselors and psychologists who can help patients and their families to learn coping skills to deal with these symptoms, as well as with intractable pain and the physical limitations it imposes. They offer group support and family sessions as well as individual therapy.
The purpose of the first visit is for us to evaluate your situation to determine the best course of treatment. We will do a complete history and physical and talk to you about your pain and when it is most severe. Many treatment alternatives are available. We will discuss our findings with you to determine if less invasive procedures are more appropriate to try first. If epidural steroids, or other types of more invasive injections are indicated, we will perform them at a future date. As such, those procedures must be scheduled for a subsequent visit.
Our physicians are trained in the field of chronic pain management. Like any other physician, they must make their own evaluation of your pain. While they heavily consider the information provided by your physician, and by you and your family, they must also make their own evaluation before starting a treatment plan.
The needs of each patient vary according to diagnosis and severity of the condition. Thus, it is impossible to predict beforehand how many procedures a person will need. However, on average, you will see significant improvement after four or five procedures.
We do all of our blocks in an operating room under x-ray (fluoroscopic) guidance. The use of an x ray machine allows us to see that the needle has been inserted in the most appropriate place to provide maximum results. You will be sedated but not asleep (anesthetized), not only to ensure your comfort but also to keep you still and relaxed during the procedure.