Interventional Pain Medicine

We talk about a person's threshold for pain or a person's ability to cope with pain. We talk about living with pain. Now we can talk about the diagnosis and treatment of acute and chronic pain.

Pain of any type or severity is the body's signal that something is wrong, something needs attention. Acute and chronic, recurring and unmanageable pain often leads to dramatic changes in a persons ability to function in day to day activities and lead a normal life. Continual pain can lead to costly and ineffective medical treatments in the search for relief. Wasted time, energy and productivity only adds to the frustration of those suffering from acute and chronic pain.

Pain Medicine
The American Medical Association (AMA) recognizes Pain Medicine as a distinct medical specialty. The specialty of Pain Medicine encompasses prevention, evaluation, diagnosis, treatment, and rehabilitation of painful disorders.

A specialist in Pain Medicine works in consultation with primary care providers and other physicians as consultant and educator in the assistance and treatment of patients in pain. Pain Medicine Specialists also provide direct care to patients with various conditions by prescribing medication, rehabilitative services, preforming pain-relieving procedures and counseling with patients and their families. Pain Medicine Specialist are able to treat a wide range of painful disorders.

Consequences of Mismanaged Pain
Mismanaged or under-managed pain may cause:

• Nonproductive testing and treatment
  
• Increased disability costs
  
• Escalating healthcare expenditures
  
• Patient dysfunction in work, family and social life
  
• Patient mental and physical anguish and suffering

  
  Goals of Pain Management
  The Pain Physician's goals are to work with the Patient and referring Physician to conservatively:
  

• Decrease the patient's personal experience of pain and suffering
  
• Decrease the patient's utilization of medication
  
• Improve the patient's functional capacity and return the patient to normal daily activities
  
• Improve the patient's quality of interaction with family, friends and co-workers
  
• Return the patient to work or work duties
  
  The Treatment Program
  Initial Visit
  A comprehensive examination and evaluation will be performed by the Pain Medicine Physicians who are trained in the recognition and treatment of difficult pain problems. Attention will be given to behavioral, social and psychological factors.
  
  A conservative approach will be directed at improving the patient's sleep, pain tolerance and mood. Various classes of medications may be prescribed along with education regarding the patient's condition will be given. Physical therapy and therapeutic injections will be prescribed if their acute or chronic pain is not controlled with conservative medical management.
  
  Follow-up Visits
  Diagnostic and Therapeutic Injection Therapy may be prescribed such as:
  
  
• Epidural Steroid Injection
  
• Selective Nerve Root Treatment
  
• Sympathetic Nerve Blocks
  
• Facet Joint Therapy
  
• Trigger Point Therapy
  
  Some patients who have not found successful pain relief through previous attempts of surgical or non-surgical treatments may be candidates for interventional pain therapy such as:
  
  
• Diagnostic Discography
  
• Radio-Frequency Lesions
  
• Spinal Cord Stimulation
  
• Intraspinal Opiate Delivery
  
• Intra-discal Electro Thermal Therapy (IDETT)
  
  Common Pain Disorders
  
• Neuropathic:
  
  • Lumbar radiculopathy
    
  • Cervical radiculopathy
    
  • Reflex Sympathetic Dystrophy
    
  • Post Surgical Scar Neuroma
    
  • Post Laminectomy Pain Syndrome (Failed Back)
    
  • Herniated/Disrupted Disk
    
  • Shingles/Post Herpetic Neuralgia
    
  • Nerve root entrapment from post-surgical epidural scar
  • Peripheral neuralgias
    
• Somatic:
  
  • Discogenic Low Back Pain
    
  • Facet Syndrome
    
  • Post Whiplash Chronic Pain
    
  • Headache, Neck Pain
• Visceral Pain
  • Cancer Pain
  • Pelvic and Abdominal Pain
    

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