What to Expect From a Pain Management Center
Most people have experienced acute pain after suffering from a burn, cut or broken bone. This type of pain is only short term and fades away after the injury heals. But sometimes the nervous system continues to send pain signals to the brain even after the injury has healed. This malfunctioning in the nervous system can cause severe pain that is excruciating, burning and intense. Muscles also can spasm and cause severe pain and stiffness. Other medical conditions, such as fibromyalgia or cancer, can cause chronic pain, too. Treatment at a pain management center can help you control your pain and improve your quality of life.
-
The First Phase of the Evaluation
-
On your first visit, it is important that you bring any x-ray reports, CTs, MRIs or myelograms you have that concern your pain condition. At the pain management center, a complete evaluation of your case will be performed. Your nurse will take your blood pressure, temperature and weight. She will ask you several questions concerning your past medical history, allergies, current and past medications and past surgeries. Be honest about any alcohol or recreational drug use. She also will ask you about your family history and if there are any major health problems affecting your immediate family.
The Second Phase of the Evaluation
-
Your nurse will ask you to complete an extensive pain questionnaire. This questionnaire will ask you a series of questions about your pain levels. It will ask you about things that make your pain better or worse. It will ask you what times of day your pain levels are at their highest and lowest. It will ask if the medications you are taking are effective in reducing pain. Write down any medications that help to lower your pain levels, and any accompanying symptoms you have with pain such as insomnia, fatigue, nausea or stiffness. Many times the nurse will show you a drawing of a human body and you will need to circle or shade in the area that is hurting you. The nurse also will take a psychological assessment. All of these assessments will help your pain management team learn all they can about your pain.
-
The Third Phase of the Evaluation
-
Your pain management physician will do a complete physical examination of the affected area. Your physician will note any signs such as inflammation, abnormal color and sensitivity. He will ask you about your symptoms and the severity of your pain. Once he assesses your pain, he will discuss the medications available for your particular problem. Nonsteroidal anti-inflammatory drugs (NSAIDS) often are prescribed to treat irritation and inflammation. They also may help with muscle aches and muscle stiffness. Topical pain relievers that contain capsaicin or salicylates also are used to treat pain. If you suffer from severe pain, your physician may prescribe stronger painkillers such as hydrocodone, oxycodone and methadone.
Treatment
-
Treating pain is complex and will vary with each patient. The goal of treatment is to reset the sympathetic nervous system so it stops sending abnormal pain signals to the area. Another goal is to reduce inflammation in irritated and injured nerves and muscles. Patients who have a nerve injury or a nerve disorder often are treated with a nerve block. During this procedure, a local anesthetic mixed with a corticosteroid is injected into the affected nerve. Patients who have muscle problems may have a trigger-point injection in which a local anesthetic combined with a corticosteroid is injected into a trigger point (muscle knot) to alleviate muscle spasms. Those who have sciatica (back pain) may choose to have an epidural steroid injection. This procedure involves injecting a local anesthetic and corticosteroids into the sciatic nerve space.
Surgical Options
-
If pain is unresponsive to other treatments, you do have surgical options. Your physician may insert an infusion pain pump under your skin. This pump directly carries medications to the intrathecal area of the spinal cord. An intrathecal pain pump generally has fewer side effects because you need less medicine to control pain. Another option is to implant a spinal cord stimulator under your skin. This device delivers low levels of electrical impulses to the spinal nerves to block the flow of pain signals. These are just a few of the surgical options available to you.
-
