|
Understanding Pain
The International Association for the Study of Pain (IASP) defines pain as:
an
unpleasant sensory and/or emotional experience associated with
actual or potential tissue damage or described in term of such damage. Pain
is actually a message sent along the nerves to let the brain know that
something is damaging the body. The brain responds by sending a message
to the muscles or organ to take action.
In the medical world, all pain is divided into two categories: acute pain and chronic pain.
Acute pain
is temporary, and goes away quickly. It's useful, since it usually
warns you of sources of harm and tells your body to protect itself
while it's healing.
Chronic pain is
pain that is unpleasant and lasts for prolonged periods of time.
Generally if you've been experiencing pain in the same place for 3
months or more, that pain is likely to be classified as chronic. Since
it lasts so long, it does not serve as a useful warning.
Pain Treatment Options
Pain
treatment begins with an assessment of the severity of the pain.
Commonly, the first steps of treatment are rest, application of cold or
heat and intake of OTC (over the counter) medication.
The next step in the treatment of pain is a combination of physical therapy and prescribed pain medication. It is important to note that sometimes, interventional pain management needs
to be started prior to Physical Therapy in order to stop acute pain
(i.e. acute radiculopathy) and allow the patient to comply with
necessary exercise.
If prescribed pain medication and physical therapy don't work, the next step is usually interventional pain management, unless the patient has acute loss of function or acute neurological deficit (in which case surgery is needed).
If interventional pain management doesn't alleviate the pain, surgery
might be required. However, even after surgery interventional pain
management has a very important role in the treatment of patients,
especially when all other options are exhausted (ex. "failed back
surgery" syndrome).
Head and Neck Pain
The most common origins of head and neck pain
are neurogenic (nerve root compression, peripheral neuropathy, herpetic
neuralgia), soft tissue pain (cervical strain, myofascial pain),
musculoskeletal pain (degenerative joint disease, fracture, neoplasm,
degenerative disk disease), or sympathetic pain. Depending on pain
origin, there are different treatment options.
Low Back Pain
Low back pain originates from any of four major structures: bone (degenerative joint disease, spinal stenos, facet arthropathy, metastatic malignancy), lumbar disk (herniated nucleus pulposus, degenerated ruptured disk), musculoskeletal system (muscles and ligaments strain, muscular spasm), and nerves (neuropatic pain).
One
of the most difficult types of pain to treat is post-surgical
arachnoiditis (failed back surgery syndrome). Up to 85% of patients
with low back pain cannot be given a definitive diagnosis because of
the poor association among symptoms, pathologic findings and imaging
results.
Upper Back and Thoractic Pain
Although upper back pain and thoracic pain are not very common spinal disorders, they tend to result in significant discomfort and pain. Thoracic pain may be caused by internal organ pathology (lung cancer, esophageal disorders, heart disorders), referral pain (cardiac angina, cholecistitis), muscular irritation (myofascial pain), joint dysfunction of thoracic cage and upper back, pain from herniated or degenerated disk, nerve pain (intercostal neuralgia, herpes zoster), pain from osteoporotic vertebra body collapse.
Abdominal Pain
Abdominal pain
is usually caused by disease of internal organs of the abdominal cavity
and is treated by a gastroenterologist or surgeon. Interventional pain
management is offered to patients who suffer from advanced cancer of
internal organs (especially pancreatic cancer) or other chronic
conditions (chronic pancreatitis, abdominal angina). Most of the time,
treatment is very successful.
Chronic Pelvic Pain
Chronic pelvic pain
may occur in the presence of known or suspected organic pathology, or
without any evidence of an underlying physical cause. Pelvic pain is
more common in women, with most common reasons being endometriosis, endometritis, pelvic inflammatory disease, pelvic adhesions, neoplasm, and myofascial pain of the pelvic floor muscles. Pelvic pain may persist even after total hysterectomy.
Central Pain
Central pain
is
produced by lesions of the central nervous system: spinal cord, brain
and brainstem. An example of central pain are: multiple sclerosis,
neoplasm, patients with stroke.
Peripheral Nervous System Pain
Peripheral nervous system pain ( peripheral neuropathy)
results from peripheral nerve lesions. This peripheral nerve lesions
may be caused by Herpes Zoster (postherpetic neuropathy),
diabetes (diabetic neuropathy), entrapment neuropathy ( pain after
inguinal hernia repair), chronic alcoholism (alcoholic neuropathy).
Reflex Sympathetic Dystrophy
Reflex Sympathetic Dystrophy (RSD), or Complex Regional Pain Syndrome (CRPS I),
applies to a variety of seemingly unrelated disorders having similar
clinical feature and manifesting the sane fundamental disturbed
physiology. Causalgia or Complex Regional Pain Syndrome (CRPS II)
is a historical term describing a RSD that follows partial or complete
injury to peripheral nerve trunk. Pain is characterized by constant,
spontaneous, severe burning pain. If persistent, it results in trophic
changes.
Phantom Limb Pain
Phantom Limb Pain
describes
painful sensations that are perceived to originate in the amputated
portion of extremity. In addition, patient may have localized
pain following amputation, which originates from the stump itself.
Click here for a complete listing of procedures that we offer
|
