Pain is a complex process that involves multiple steps. An injury damages your body which in turn causes specific nerves to send a pain signal through your neural network to the brain. Although in most cases, pain doctors try to heal the initial injury and eliminate the need for your nerves to continue firing pain signals, in some circumstances, they may use other pain management techniques to reduce nerve impulses and to interrupt this sequence.
These pain management procedures employ various techniques to reduce the intensity of the pain impulses or stop them entirely. Many of these methods are specific to certain types of chronic pain.
- Acupuncture—for centuries Eastern medicine has used needles precisely inserted into sensitive locations on the body to counteract pain. In recent times, more of the medical community has accepted acupuncture as a legitimate pain management procedure. There is still ongoing research into how exactly this process reduces pain, but the prevailing opinion is that when needles are inserted, they stimulate the body’s ability to produce natural pain-killing chemicals called endorphins.
- Cognitive retraining—pain signals do not travel immediately from a sensory nerve to the pain centers in your brain; instead they must traverse a multi-step network of nerves throughout your body and brain. It has been shown that pain signals are influenced by cognitive processes like intense concentration or emotion, so pain doctors have developed a behavioral modification method that can reduce the intensity of pain. Cognitive retraining utilizes coping strategies like stress reduction, massage therapy, physical therapy and conversational therapy to help you function better.
- Nerve blocks—if your pain is localized to a single or small group of nerves, then you may be a candidate for a nerve block. Pain doctors will use an x-ray-guided injection to implant an anesthetic in or near the damaged nerve. This numbs the nerve for up to 12 months following the procedure, after which the procedure must be repeated. It may take multiple injections to achieve numbness.
- Radiofrequency ablation—in more extreme cases of neuropathy (injured nerves continually send pain signals despite the absence of an injury), your pain doctor may recommend a radiofrequency ablation procedure. Using a x-ray-guided needle, the physician will apply a small amount of electricity to the damaged nerve. This destroys the nerve, preventing it from sending pain signals. This numbness may last from six to nine months, after which the nerve may regrow, and the procedure must be repeated. The procedure only takes 60 to 90 minutes to complete.
- Nerve stimulation—certain patients with back or leg pain may respond to peripheral or spinal cord stimulation. This involves sending a low-level electrical signal to the target nerve or spinal cord, which inhibits pain signal transmission to the brain. After a successful trial that ensures the therapy will work, pain doctors then surgically implant a small pulse generator in the upper buttock for long term therapy. Patients are able to adjust the intensity of the current using a remote control device. While some patients experience a mild tingling sensation, others do not feel anything when the generator is in operation.
Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care
M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.