Pain is an unpleasant feeling or discomfort caused by injury, illness or emotional disorder. Pain can be differentiated into two basic types such as:
- Acute pain – It results from disease, inflammation, or injury. This type of pain starts suddenly, for example, after accidental trauma or surgery.
- Chronic pain – It is caused by a disease itself. Both environmental and psychological factors can worsen it. It persists for a longer period of time. Chronic pain conditions include chronic fatigue syndrome, endometriosis, fibromyalgia, inflammatory bowel disease, interstitial cystitis, temporo-mandibular joint dysfunction, and vulvodynia.
Complete acute and chronic pain conditions evaluation
Your doctor will make a diagnosis based on the history of pain you have narrated such as type of pain – whether sharp or dull aching pain, duration and location of pain.
There are various diagnostic techniques used to find the cause of pain and some of them include:
- Electro diagnostic procedures – Electromyography (EMG), nerve conduction studies, and evoked potential (EP) studies.
- Electromyography (EMG) – help to find out which muscles or nerves are affected by weakness or pain.
- Nerve conduction studies – determine if there is any nerve damage.
- Evoked Potential (EP) – is used to record the speed of nerve signal sent to the brain.
- Imaging, especially Magnetic Resonance Imaging (MRI) is use of magnetic waves to differentiate diseased and healthy tissues.
- A neurological examination involves testing for movement, reflexes, sensation, balance, and coordination.
- X-rays used to see the deformities of bones and joints.
Treatment
The ultimate goal of pain management is to improve the function of an individual by enabling him to carry out his day-to- day activities in a normal way. There are many ways by which pain can be treated.
Medications
Analgesic medications: These are pain relieving medications. Anticonvulsants are used to relieve pain caused by trigeminal neuralgia. Antidepressants are also prescribed. In addition, anti-anxiety drugs are used to relieve muscle pain. Antimigraine drugs are used to relieve migraine headaches. These medications should be taken only on doctor’s advice as they can cause serious adverse effects.
Physical therapy
Physical therapy involves use of physical techniques and methods, such as heat, cold, exercise, massage, and manipulation, in the treatment of certain chronic pain conditions. These techniques help to increase function, control pain, and rehabilitate the patient.
Heat and cold therapy help to relieve pain when applied to the painful areas. Physical exercises include stretching and range-of-motion exercises to maintain strength, flexibility, and mobility. Regular exercises relieve stress and also increase production of endorphins-natural pain relievers.
Psychological evaluation and therapy
Psychological counseling such as behavioral therapy improves your mental health and manages conditions such as stress and depression which can aggravate chronic pain. It is important to be physically as well as emotionally stable to manage chronic pain.
Interventional Pain Management
Interventional therapy can alleviate chronic pain by blocking the transmission of pain signals to the brain. Interventional pain management involves special procedures such as an injection of local anesthetic, steroid, or narcotic around nerves, tendons, joints or muscles, nerve blocks and spinal cord stimulation to treat and manage pain. In some cases of extreme pain, drugs are often given in smaller doses through the catheter directly into the spinal cord. Even though interventional procedures for treating pain seem simple, extreme care should be taken when conducting these procedures. These procedures should be performed by well-trained and experienced Specialists.
Cervical Epidural Steroid Injection: A cervical epidural steroid injection places powerful anti-inflammatory medication directly into the epidural space of the spine in the neck region.
Discography: Discography is performed under X-ray guidance, the needle is placed inside the suspected disc and a contrast dye is injected. This test is used to determine whether the disc is the source of pain in patients with neck or back pain.
Lumbar Epidural Steroid Injection: A lumbar epidural steroid injection places powerful anti-inflammatory medication directly into the epidural space of the spine in the lower back region.
Radiofrequency lesioning: This technique uses electrical impulses to interrupt nerve conduction and the transfer of pain signals for 6 to 12 months. During the procedure, a special needle is directed into the involved nerve tissue with the guidance of an X-ray. The needle tip is then heated for 90-120 seconds so that the nerve gets cauterized and destroyed thereby reducing the pain.
