Advanced Pain Management Intervention In Laguna Hills, California
Andrew H. Messiha, MD, Double Board Certified in Anesthesiology and Pain Medicine, Laguna Hills, CA / Advanced Pain Management Intervention
Advanced pain management techniques may be recommended for severe chronic pain.
What is chronic pain?
Chronic pain can be medically defined as pain that lasts for more than three months, because acute pain is a sudden pain that is caused by injury, illness, or surgery but can heal soon once its cause is addressed, but in the case of chronic pain, it does not, and this is why people seek medical care that has a significant impact on physical function, emotional well-being, and quality of life. One key feature of chronic pain is when pain signals continue to trigger the nervous system even after the normal cause of the pain has healed. It can interfere with daily lifestyle, such as sleep, mental health, and work performance, and could be the cause of fatigue, anxiety, depression, and reduced mobility. Complex chronic pain is a treatable medical condition that requires the right combination of medical, interventional, physical, and psychological therapies, and many people achieve pain relief.
Difference Between Chronic Pain and Acute Pain
Acute Pain: Pain: It is temporary pain that has a clear cause that lasts for a few hours, days, or weeks and is easily treated by medicine or therapy and can be better with proper rest.
Chronic Pain (persistent pain): it can last more than 3 months, even after the injury has healed, frequently comes and goes, and does not fully respond to regular pain medicines and affects sleep, daily activities, and work. Some common symptoms are: Fatigue, poor sleep, depression, anxiety, and reduced physical activity.
Classification Of Chronic Pain
- Neuropathic Pain: It can be caused by a disease affecting or damaging the somatosensory nervous system and leading to abnormal signals being sent to the brain.
- Post-traumatic pain or postsurgical pain: chronic or persistent pain develops after surgery or injury and lasts longer than the normal healing time.
- Primary Headache or Orofacial Pain: Primary headaches are headaches with no underlying medical causes, such as migraines or tension headaches, and orofacial pain is any pain that occurs in the face, jaw, or mouth, which can have many causes, such as TMJ disorders, dental issues, nerve irritation, etc.
- Chronic Cancer Pain: Pain occurs due to cancer or its treatments that are persistent.
- Chronic Musculoskeletal Pain: The pain is long-lasting pain in bones, joints, or muscles caused by injury, overuse, or degenerative conditions.
- Chronic Neuropathic Pain: pain that lasts more than three months and is caused by diseases of the nervous system (neuropathic). It occurs after damaged nerve fibers cause abnormal pain signals to be sent to the brain.
- Chronic Primary Pain: Ongoing pain with no obvious injury, usually linked with strong emotional stress.
- Chronic Visceral Pain: Long-lasting pain originating from internal organs such as the chest, abdomen, stomach, or bladder.
- Coccygeal Pain syndrome (Coccydynia): long-term pain in the tailbone, getting pain when sitting or rising.
- Complex Regional Pain Syndrome (CRPS): It is a chronic pain condition that usually affects an arm or leg that occurs after injury and causes intense, disproportionate pain.
- Fibromyalgia: A chronic condition that causes widespread body pain and symptoms like fatigue, sleeping problems, and fibro fog.
- Musculoskeletal Pain: Pain directly affects muscles, bones, or ligaments due to strain.
- Nociceptive Pain: Pain caused by potential damage to tissue
- Psychogenic pain: Pain that is triggered by psychological factors such as stress or emotional distress
- Visceral Pain: It originates from internal organs in the chest, abdomen, etc.
Common Symptoms of Chronic Pain
Chronic pain symptoms can vary for each person, but one thing is common: the pain lasts for more than 3 months and stays beyond normal healing time and is usually mildly to severely painful. People with chronic pain conditions commonly state their pain as:
- Burning
- aching
- sharp
- stabbing
- pulsatile
- squeezing
Not even these, but also chronic pain affects the entire body and mind, so many people also experience it.
- Changes in appetite
- memory issues
- muscle tightness issues
- mobility reduction
- anxiety
- Insomnia
- low energy
Chronic pain is also connected with emotional and psychological symptoms.
- Anxiety
- depression
- insomnia
- irritation
- panic issues
- feelings of stress
Chronic pain is not only a painful feeling but also impacts us physically and mentally and also our daily life activities.
Chronic Pain Causes
Chronic pain could not be caused by only a single reason; it has multiple factors behind it, such as nerve damage, joint and muscle disorders, inflammation, internal organ problems, and psychological factors like stress, anxiety, and insomnia. In most cases, people’s brains become overly sensitive to pain signals, causing pain to persist without active tissue damage, and lifestyle factors can also influence chronic pain conditions and worsen over time.
Risk and Factors
The risk of developing chronic pain does not only depend on a single factor, but there can be multiple reasons behind it, such as several physical, emotional, and lifestyle factors. Age can be one of the main factors, as joints, muscles, and the spine weaken over time. A major risk can come from severe pain episodes, surgery, or past injury, and heavy body weight is also a risk factor because excess weight puts pressure on joints and other organs or parts of the body. Mental health is also a risk factor, as stress, anxiety, depression, and trauma can increase pain sensitivity. If we talk about lifestyle risks, smoking and physical inactivity can raise the risk. And it also weakens the muscles that support the body.
How chronic pain is diagnosed
Chronic pain is diagnosed through a detailed review of the patient’s medical history, a physical exam, and some specific diagnostic tests, such as:
- Medical History: The Healthcare provider needs to know when pain started, what type, location and characteristics
- functional and Psychological assessment: The healthcare provider asks how it impacts a patient’s daily life activities like walking, sleeping, mood, etc.
- Physical exam: The doctor will perform a physical examination to look for signs of injury, pain, or illness, and then the doctor will assess movement, strength, flexibility, and neurological function.
- Diagnostic Tests: After all kinds of the patient’s complete history, the doctor can recommend various tests to get the exact cause of the pain to start the chronic pain treatment.
- X-rays: examine the bones and fractures or arthritis issues.
- MRI: To get a better image of soft tissues, nerves , and organs
- CT scan: to view a cross-sectional image of the body
- Nerve conduction studies: to get information about the health of nerves and muscles.
Based on this information, doctors create a personalized chronic pain treatment plan.
Pain Management Intervention
It is important that pain treatment is guided by a healthcare specialist, and pain is generally treated with:
Medication: Chronic pain can be managed with a variety of medications, including non-prescription pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), steroid medication, and some prescription drugs such as opioids, antidepressants, and nerve-stabilizing medications.
Physical therapy: A treatment approach that uses exercise and physical methods to relieve pain, along with manual therapy. It helps patients manage long-term chronic pain conditions. Exercise programs can include strengthening exercises, stretching, aerobic exercise, and movement therapies, and manual therapy consists of massage, joint mobilization, and therapeutic modalities, including heat and cold therapy, transcutaneous electrical nerve stimulation (TENS), ultrasound, etc.
Alternative therapies: these may be used alongside medical treatment in which patients are recommended for acupuncture, massage, and chiropractic treatment.
Advanced Chronic Pain Intervention
In some cases, Chronic pain requires advanced pain management and a doctor might recommend specialized interventions to help patients to get target long-lasting pain relief. These interventions should always be performed by healthcare specialists.
Patient-Control Analgesia (PCA)
Patient-control analgesia is a method of pain management that is useful after surgery or during severe pain episodes. It involves a computerized infusion pump is activated by the patient at the press of a button whenever feels increasing pain and get a specific prescribed dose of medication through an intravenous ( IV) line this method helps offers pain relief while maintaining safe dosing limit
Nerve Blocks:
A method that reduced pain signals by targeting specific nerves with medication
Trigger point injections treatment for chronic pain
In many chronic pain conditions muscles do not properly relax and make knots and are associated with pain. A highly qualified doctor injects an injection at the trigger point, a tight knot in a muscle that causes pain. Trigger point injections are used for muscle pain in the arms and legs and some other conditions, such as fibromyalgia and myofascial pain syndrome.
Surgical Implants
An implant may be surgically placed to manage chronic pain, and commonly used implants include:
Intrathecal pumps: it is an implantable device under the skin that delivers medication directly into the intrathecal space of the spine to treat chronic pain.
Spinal Cord Stimulation: This stimulator delivers electrical signals to block pain impulses, which travel from the spine to the brain, and patients can control the intensity by using a remote device.
Transcutaneous Electrical Nerve Stimulation (TENS): Through skin electrodes, low-voltage electrical current is supplied to the painful area that helps to reduce pain by altering nerve signal transmission
Bioelectric Therapy : this therapy is a treatment that uses electrical impulses to block pain signals. And enhances the production of natural pain analgesics (painkillers) called endorphins.
Psychological Therapy: psychological conditions can also cause the pain. Also, when emotions such as anxiety, sadness, hopelessness, and frustration influence pain, then doctors suggest psychological therapy, which involves many structured activities that help the patient with stress and manage pain.
Multimodal chronic pain management
Multimodal chronic pain management is a modern technique and evidence-based approach that uses a combination of drugs and non-drug therapies to manage chronic pain safely. This method targets multiple pain pathways at the same time, which helps to reduce pain and reduce dependency on painkillers. It is commonly used in orthopedic surgery, injury recovery, and chronic pain conditions. It is known for giving better results with fewer side effects. After combining different analgesic agents, physical therapy, psychological support, and other non-pharmacological techniques, this multimodal chronic pain management provides balanced long-term pain control and gradually improved patient safety.
Benefits of advanced pain management for chronic pain
After combining different therapies and medications, it helps to reduce side effects while effectively managing chronic pain.
When should you consult a pain specialist
If you have been suffering with pain for a long time, but after taking prescribed medication, your pain does not improve, then you should go to the doctor for a checkup to determine whether it is an acute pain symptom or chronic pain, which usually requires a multiple-treatment approach to recover from severe pain.
FAQ
1. What is the best management for chronic pain ?
It depends on the patient’s condition, but a multimodal, team-based approach combining physical therapy, medications, psychological care, and lifestyle changes is considered the most effective.
2. What is the best medication to cure chronic pain ?
There is no single medication to cure chronic pain; it requires proper medical techniques, which should be under the care of a professional healthcare guidance.
3. What are the Most painful chronic pain conditions ?
There are many, but some of them are sciatica, trigeminal neuralgia, stomach or peptic ulcer, kidney stone, and many more.
4. What are the common causes of chronic pain?
Common causes of chronic pain depend on conditions such as rheumatoid arthritis, osteoarthritis, and fibromyalgia.