Treatments For Pain -- All About Pain -- Doctors For Pain

Modern medicine is rapidly advancing. There are many types of treatments available. Pain differs from person to person, so a treatment plan will be designed by your pain management specialist that is appropriate for your individuals needs. Treatment can include a single approach or a combination of medications, therapies and/or procedures.

PHARMACOLOGICAL MEDICATIONS:

Narcotics - Narcotics can be used to treat acute pain or cancer pain but are prescribed on a more limited basis for chronic pain. Narcotic can be addicting, so your physician will be very careful about prescribing them. However, according to research, when taken properly, many chronic pain patients do not become addicted. When you are taking narcotics, it is important to remember that there is a difference between psychological addiction and physical dependence. Using narcotics can be dangerous and may not help your particular type of pain.

Anti-Inflammatory Medications - Aspirin-like drugs reduce swelling, irritation and relieve pain.

Anti-Depressant Medications - Originally used to treat depression, however studies now show these medications can alleviate pain in certain situations. They may also have added benefit of helping patients sleep.

Anti -Seizure Medications - May help relieve certain types of pain by reducing abnormal electrical discharges in damaged nerves.

Other Medications - Other types of medicine may be prescribed that are more specific to other types of pain.

DIAGNOSTIC AND THERAPEUTIC NERVE BLOCKS:
Diagnostic nerve blocks are done as a means of determining more precisely the cause of certain types of pain, they may also be therapeutic (help relieve pain) in certain situations. Therapeutic nerve blocks are done in an effort to relieve certain types of pain and may be done in a series, two or more over a period of days or weeks.

SPINAL ENDOSCOPY:

Spinal Endoscopy is a minimally invasive procedure used to diagnose and treat the causes of chronic low back pain and radiculopathy. Using an instrument called a flexible fiberoptic epiduroscope and steerable guiding catheter, the physician is able to visually inspect anatomical structures, tissue and nerves inside the epidural space.

Spinal Endoscopy is not for everyone and not everyone can benefit from the procedure. Your physician can determine your eligibility after performing a through History and Physical Examination. You are probably a candidate for spinal endoscopy if your back pain radiates to the legs (called Radiculopathy) and you have failed other less invasive or conservative therapies or surgery. You are less likely to be a candidate if you have other serious diseases or psychiatric/psychological disorders.

OTHER PROCEDURES:

Implantation of device for intratheal or epidural drug infusion, subcutaneous reservoir
Spinal neurostimulators pulse generator
Spinal neurostimulator electrodes
Radiofrequency Nerve Lesioning

Acupuncture

PHYSICAL AND OCCUPATIONAL THERAPY:
Therapeutic exercise, whirlpool, ultrasound, moist heat and massage are some of the types of treatment that will be suggested. Therapeutic activities and patient education are also of benefit.

PSYCHOLOGICAL SUPPORT:
There can be psychological effects from chronic pain. It can produce feelings of anger, sadness, hopelessness and despair. It can alter your personality, disrupt sleep and interfere with work and personal relationships.

RELAXATION/MEDITATION:
There are numerous forms of relaxation therapy that are helpful to patients. Relaxation training and stress management, biofeedback and meditation can all be beneficial.

We believe that a time set aside each day to close your eyes, take some deep breathes, listen to some relaxing music and think only pleasant thoughts, with the idea of you controlling the pain rather than the pain taking control of you. Perhaps 15 minutes twice a day.

WHAT YOU CAN DO TO HELP YOURSELF:

Diet - Many people suffering from chronic pain are overweight. Being excessively overweight can be very damaging to muscles, tendons, and joints, not to mention the increased stress on the cardio-respiratory system and the general body physiology. We believe weight loss is something overweight people can and must do to help relieve their pain.

Exercise - Exercise increase the tone of muscles, helps to relieve spasms and increases oxygenation of muscle tissue. Exercise improves function of tendons and joints, as well as benefiting the cardiovascular-respiratory system. A systematic, daily exercise program is something people can do to help themselves with many pain problems.

Attitude - How you feel about your health is probably more important to your well being than anything else you do. You need to maintain a positive attitude - "I WILL CONTROL THE PAIN- THE PAIN WILL NOT CONTROL ME" ATTITUDE. THERE IS USUALLY NO MAGIC BULLET OR MIRACLE CURE.

PAIN FACILITIES WILL ATTEMPT TO DO ALL THAT THEY CAN TO HELP YOU MANAGE YOUR PAIN, BUT YOU MUST ALSO BE WILLING TO COOPERATE.

Author: Robert V. Plehn, M.D., DABA, FACA
Medical Director, DoctorsForPain.com


Acetaminophen
Acetaminophen (Tylenol)
Non-Steroidal Anti-Inflammatory Drugs
Diclofenac (Cataflam, Voltaren) Etodolac (Lodine) Ibuprofen (Advil, Motrin, Nuprin) Indomethacin (Indocin) Naproxen (Anaprox, Naprosyn) Piroxicam (Feldene) Tolmetin (Tolectin)
Salicylates
Aspirin Salsalate (Disalcid, Mono-Gesic, Salflex, Salgesic, Salsitab)
Narcotic Analgesics
Codeine Fentanyl Topical (Duragesic) Meperidine (Demerol) Morphine (Kadian, MS Contin, Oramorph, Roxanol) Oxycodone (OxyContin, Oxyir, Percolone, Roxicodone) Propoxyphene (Darvon) Tramadol (Ultram)
Narcotic Combinations
Acetaminophen and Codeine (Tylenol with Codeine) Acetaminophen and Hydrocodone (Lorcet, Lortab, Norco, Vicodin, Zydone) Acetaminophen and Oxycodone (Endocet, Percocet, Roxicet, Tylox) Acetaminophen and Propoxyphene (Darvocet, Wygesic) Acetaminophen and Tramadol (Ultracet) Acetaminophen / Butalbital / Caffeine (Fioricet) Aspirin and Codeine (Empirin with Codeine) Aspirin and Hydrocodone (Panasal) Aspirin and Oxycodone (Endodan, Percodan, Roxiprin) Aspirin / Butalbital / Caffeine (Fiorinal)
Tricyclic Antidepressants
Amitriptyline (Elavil, Endep, Vanatrip) Amoxapine (Asendin) Clomipramine (Anafranil) Desipramine (Norpramin) Doxepin (Adapin, Sinequan) Imipramine (Tofranil) Nortriptyline (Aventyl)
Antihistamines
Hydroxyzine (Atarax, Rezine, Vistaril)
Anticonvulsants
Carbamazepine (Carbatrol, Epitol, Tegretol) Clonazepam (Klonopin) Neurontin (Gabapentin) Phenytoin (Dilantin) Valproic Acid (Depakene)
Muscle Relaxants
Baclofen (Lioresal) Carisoprodol (Soma, Vanadom) Chlorzoxazone (Paraflex, Relaxazone, Remular) Cyclobenzaprine (Flexeril) Methocarbamol (Robaxin) Orphenadrine (Norflex)
Corticosteroids
Dexamethasone Prednisone
Neuroleptics
Fluphenazine (Permitil, Prolixin) Haloperidol (Haldol)
Local Anesthetics
Mexiletine (Mexitil)
Other Drugs
Clonidine (Catapres) Calcitonin Capsaicin (Zostrix)