Pain management is a medical specialty called pain medicine. Pain medicine specialists treat all types of pain problems, and pain defined as acute and chronic. Neurosurgeons are one type of specialist/expert trained to diagnose and treat pain. The goal of pain management is to improve your quality of life, which includes helping you be more functional and active.
How is pain evaluated?
Do I need diagnostic testing?
What are the options to manage pain?
Are there possible risks and side effects?
Acute and chronic pain
Pain can be classified as acute or chronic. Acute pain can become chronic.
- Acute pain begins quickly or suddenly and can be severe. It is short-lived sometimes lasting a few hours or days. Acute pain is classified as pain that does not persist longer than 3 months.
Example: post-operative pain.
- Chronic pain is characterized by its persistence. This type of pain lasts longer than 3 to 6 months. The intensity of pain varies from mild to severe.
Example: osteoarthritis (spondylosis).
Your medical history and physical and neurological examinations are very important. You and your doctor discuss your pain and symptoms, their severity, when they started, and treatments tried. The doctor tests your reflexes and evaluates you for muscle weakness, loss of feeling, and signs of neurological injury.
- Has pain changed over time? Intensity, duration.
- Does anything help to relieve your pain?
- What makes the pain worse?
- List current medications and herbal or vitamin supplements taken.
Your pain—its intensity, duration and other characteristics—is unique to you. Your doctor wants to understand your pain. Your doctor provides tools to help you explain your pain.
- Pain drawing. An illustration of the front and back of the body is provided. On it, you mark where you feel pain and describe the type in each location. Descriptive terms include burning, dull, throbbing, sharp, tingling, and weakness.
- Pain scale. Rate your pain on a scale from zero to 10. Zero represents no pain and 10 the worst pain imaginable.
- Pain diary. A record of your pain and symptoms. The diary helps you and your doctor to identify pain patterns, which treatments relieve pain, or activities that exacerbate symptoms.
To diagnose the cause of your pain and its source, your doctor orders tests. CT or MRI scans, or myelography enhance the surgeon’s examination of your nerve roots and spinal cord. Other studies your doctor may perform include testing your nerves and muscles; nerve conduction study (NCS) and electromyography (EMG), respectively.
Spinal injections can obtain diagnostic information about the nerves associated with your pain. Many types of spinal injections provide valuable diagnostic information such as a Selective Nerve Root Block.
Your pain management program is tailored to meet your needs. Your doctor considers several factors.
- Pain type and history
- Your general health and disorders
- Your mental health
- History of substance abuse
- Your family situation
- Most importantly, your preferences
Pain management often involves a combination of therapies. You may learn that a previous treatment that didn’t relieve pain is now effective when added to a different therapy. Pain specialists talk with patients to manage their expectations. Complete pain relief may not be possible.
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Muscle relaxants
- Anti-seizure drugs
- Narcotics (opioids)
- Cervical epidural steroid injection
- Lumbar epidural steroid injection
- Peripheral nerve root block
- Sacroiliac joint injection
- Selective nerve root block
- Physical therapy
- Spinal bracing
- Spinal cord stimulation
- Spinal (intrathecal) pump
Possible risks, side effects
Any medical treatment has potential risks and side effects. Most pain management treatments pose few risks. Risks and side effects are often drug-related. Your doctor will thoughtfully and carefully inform you about possible risks and side effects associated with his treatment recommendations.
Can you live without pain?
Please keep in mind that there are many ways to control pain and improve your quality of life. Many patients live with unnecessary pain—talk to you doctor today about how you can live with less or no pain.