Education
Pain: Causes and Cures
“Thank you for making my life more comfortable. I’m living a normal life again.”
~ John R.
What Causes Pain?
Pain may have many causes, including disease, injuries, surgery, and nerve damage. The most common types of pain are
Cancer Pain
Cancer and cancer treatments can sometimes cause moderate to severe pain. Cancer pain may be caused by surgery, radiation, and chemotherapy; scar tissue resulting from surgery or cancer treatment; or a tumor that has grown into – or crowded out – organs, nerves, or other parts of the body. Cancer pain usually falls into one of two categories:
- Nociceptive pain – caused by damage to tissue; described as sharp, aching, or throbbing
- Neuropathic pain – caused by actual nerve damage; described as a burning or heavy sensation, or numbness
Leg and Back Pain
Chronic back pain is usually felt in the lower back, but can also extend into your legs or feet. A number of spinal diseases or injuries can trigger chronic back and leg pain, including degenerative disc disease, lumbar disc herniation, failed back syndrome, epidural fibrosis, and arachnoiditis. Symptoms range from mildly uncomfortable to completely disabling. You may feel a sharp or knife-like pain, a burning sensation, or a dull muscular ache. Affected areas may feel tender or sore to the touch and the pain may increase with movement.
Complex Regional Pain Syndrome (CRPS)
CRPS, also known as reflex sympathetic dystrophy or causalgia, is a chronic pain condition that most often affects the arms, legs, hands, or feet. CRPS usually develops in a limb after an injury (such as a broken bone) or surgery that may have involved nerve damage. The overriding symptom is extreme pain, frequently described as burning. Other symptoms can include sensitivity to touch, skin changes, swelling, weakness, and decreased function of the hand/foot.
Painful Neuropathy
Painful neuropathy is a neurological disorder which causes severe chronic pain due to nerve damage. Damage may be a result of nutritional imbalances, alcoholism, toxins, infections, autoimmunity, illnesses such as kidney failure or cancer, and nerve trauma. Symptoms include stabbing or sharp pain, burning and numbness in the hands or feet.
How is Pain Treated?
A variety of pain management techniques are available to Advanced Pain Therapy physicians to help ease your suffering. The choice for your treatment depends on your specific needs: the type and severity of pain, as well as how you respond to pain treatment. Not all treatments may be applicable to your type of pain. Treatments include:
- Non-Drug Treatments
- Physical Therapy
- Psychological Therapy
- Nonopioid Oral Medications
- Opioids
- External Drug Delivery
- Drug Pump
- Neurostimulators
- Corrective Surgery
- Therapeutic Nerve Blocks
- Neuroablation
Non-Drug Treatments – Techniques such as relaxation, biofeedback, imagery, hypnosis, acupuncture, exercise, and counseling help many people use less pain medication.
Physical Therapy – Physical Therapy attempts to build or recondition muscles – allowing you to move more normally and with less pain. We may recommend passive physical therapy, such as massage and applying heat/cold, or active treatments, such as exercise.
Psychological Therapy – Chronic pain can bring stress that affects you, your relationships, and your body. Psychologists are available to work with you on relaxation techniques, behavioral modification, coping skills and self-monitoring skills.
Nonopioid Oral Medications (Pills) – If non-drug techniques have not had the desired effect, we will try nonopioid oral medications first. They include mild pain relievers such as acetaminophen and non-steroidal anti-inflammatory drugs like ibuprofen.
Opioids – If nonopioid medications are not effective in controlling your pain, the next step is opioids, such as morphine, hydrocodone, oxycodone or an opioid patch. Opioids are similar to natural substances (endorphins) produced by the body to control pain.
External Drug Delivery – External drug pumps deliver opioid medication through a tube inserted into a vein (intravenous) or into the epidural space of the spine. External systems often can effectively relieve pain.
Drug Pump (Intrathecal Drug Delivery System) – If your oral medication no longer provides pain relief or causes uncomfortable side effects, we may recommend a drug pump. Typically, drug pumps are surgically placed in your abdomen. They send pain medication through a thin, flexible catheter (tube) to the area around your spinal cord (called "the intrathecal space"). Because pain medication goes directly to the area around the spinal cord, the drug pump can offer significant pain relief with a small fraction of the medication used in other treatments.† Unlike some surgeries, you can try a drug pump first to be sure it will be effective before having it implanted. It is also reversible; we can turn it off or remove it.
Neurostimulators – Neurostimlators are surgically implanted in the body to send mild electrical impulses to the spine, masking the perception of pain messages to the brain. Unlike some surgeries, you can try a neurostimulators in advance of surgery to be sure it will be effective. It is also reversible; we can turn it off or remove it.
Corrective Surgery – In doing tests, such as MRI or CT scans, to look for the cause of your pain, we may discover a problem that can be corrected by surgery. If so, we would recommend this treatment.
Therapeutic Nerve Blocks – Therapeutic nerve blocks are local anesthetic and/or steroid injections given at the origin of pain. Nerve blocks usually provide temporary pain relief. If your pain is not managed after multiple injections, we may consider other treatments.
Neuroablation – With neuroablation, the nerves that serve as pathways to the brain are destroyed (usually with heat). Neuroblation is usually a last resort when other treatments have failed.
†Onofrio BM, Yaksh TL. Long-Term Pain Relief Produced by Intrathecal Infusion in 53 Patients. J Neurosurg 1990; 72: 200-209.
Lamer TJ. Treatment of Cancer-Related Pain: When Orally Administered Medications Fail. Mayo Clin Proc 1994; 69:473-480.
Portenoy RK. Management of Common Opioid Side Effects During Long-Term Therapy of Cancer Pain. Ann Acad Med 1994; 23:160-170.
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Advanced Pain Therapy
7125 Highway 98 W
Hattiesburg, MS 39402
(601) 450-7246 Phone
(601) 450-7250 Fax
info@advanced-pain-therapy.com