Not only is pain difficult to treat, but it is difficult to explain as well. Many patients visit a physician who specializes in pain management, and say that they "hurt all over."
When a patient visits a pain specialist it's better to be prepared. You need to be able to rate your pain on the level of severity. You need to describe specifically where the pain is located and talk about the pain's characteristics. Is it sharp, constant, burning or stagnant? How does the pain impact your life? What makes the pain feel better? What makes the pain worse?
In years past, physicians "shotgunned" pain symptoms with medication. Today, physicians who specialize in pain management have a better understanding of pain and tailor treatments to fit a patient's needs.
While opiates (pain medication) still have their place, newer therapies such as intrathecal injections and spinal cord stimulators have come into focus. Spinal cord stimulators introduce low levels of electric current to the dorsal columns of the spinal cord to block the sensation of pain. It may be used on patients who suffered from failed back surgery or sciatica, for example.
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An intrathecal device (or pain pump) delivers low-dose pain medication directly to the spine. Medication in the pump is added periodically by injecting medication through the skin into the pump reservoir. Because the medication does not need to be processed through the liver or cross the blood-brain barrier to access the direct pain area, a patient may feel significant relief through very small doses with perhaps less side effects.
These devices have been around since the late 1960s, but the technology has vastly improved. Both treatments are done on a trial basis at first. If the trial proves effective there will be a surgical procedure to implant either device permanently.
Cost-benefit analyses have shown these devices to be more favorable than extensive surgeries and over time lessens the financial burden on the healthcare system by reducing medication and physician and emergency department visits in chronic pain patients.
The goal of physicians who specialize in pain management isn't necessarily to alleviate all of the pain. We measure success on a decrease in pain and increase in functionality.
These treatments have proven to be safe and effective options and can frequently be more effective than medication management alone.