Integrative Pain Management 

Chronic Pain Patients Can Find Relief

About 90 percent of the time pain from an acute injury will resolve in a few months, with or without diagnostic work up and  treatment, sometimes the pain can lasts longer. When this pain last longer than expected, generally greater than 3 months, it is considered “chronic pain”.

Approximately 10 percent of adults in the United States have chronic, incurable pain. However, surveys show that 2/3 of those with chronic pain perceive themselves to be able to continue to live a high-quality, functional  life.  This suggests the majority of people with chronic pain have learned to engage in activities that they enjoy, despite living with chronic pain. 

Accepting and Adapting to Chronic Pain

It is natural for people with chronic pain to go through periods of anger, denial and continuing to search or wishing for impossible cures. However, eventually it is important to accept the pain and to accept the fact that life style modification will be required. While some patients must realize they may no longer be able to perform work and/or perform many other activities in the ways they used to, there are many new patterns of activity that can be enjoyed regardless of the pain. Your expectations may need to change, you will need to learn to pace yourself and you will benefit from prioritizing your activities and re-examining your values. People with chronic pain who enjoy their lives the most are those who have been the most flexible in the way they have adapted to the ongoing pain and limitations. A referral to our caring psychologist can provide patients the “tools” required to work through this process.  

Physical Conditioning

It is very important to get regular exercise if you have chronic pain. Though we are not recommending aggressive workouts, we do know that conditioning exercises do help people with chronic pain to feel better emotionally. It can help to improve functional levels while reducing the pain to some extent. Common types of conditioning exercise include therapeutic pool, exercise classes, use of exercise machines, low impact aerobic workouts, etc. A word of caution: Start conditioning exercises for only a few minutes at a time and very gradually increase them over time. Recommendations for a personalized conditioning plan can always be provided with a referral to our physical therapy department. 

Medical Treatment

Your willingness to work on physical conditioning, accept your chronic pain and make lifestyle modifications in order to manage your pain will, in the long run, be more important than any of the medical treatments that can be offered to you. However, we do offer multiple options to assist you with pain control. 

Oral pain medications are typically what most patients feel are the mainstay of pain control and we do utilize them,  when the condition warrants it. However, many medications that help to reduce neuropathic pain are better, and safer options to addictive narcotics. Many anti-seizure medications (anticonvulsants) are routinely used to help reduce pain. Additionally, anti-depressants are particularly helpful to treat patients with chronic pain. Not only do they help with neuropathic pain, they often provide a benefit in the form of improved sleep and mood. Many other categories of medications are also available to promotion pain control in patients with chronic pain.

A variety of interventions are available to assist in reducing or controlling pain. These include cortisone injections to joints, trigger point injections and Botox injections for muscle spasms, epidural steroid injections, radiofrequency ablations, a number of nerve blocks and many more.  Chronic pain patients may also be considered candidates for spinal cord and peripheral nerve stimulator implant as well as pain pump implants. 

Patients can also be referred to a number of specialist to provide adjunct therapy. Some of these include physical therapy, manual therapy (i.e. chiropractic, osteopathic manipulative therapy), and alternative treatments (i.e. acupuncture, TENs unit). 

Living Well With Chronic Pain

Many, but not all, of the treatment options we provide in our office or can refer patients to include: 

• Procedures / injection recommendations may include:

  • Botox for Dystonia

  • Bursa Injections

  • Intra-articular joint injections

  • Peripheral Nerve Blocks

  • Occipital Nerve Injections

  • Epidural Steroid Injections

  • Selective Nerve Root Block

  • Sacroiliac Joint Injections

  • Trigger Point Injections

  • Viscosupplementation

  • Medial Branch Block

  • Facet Injections

  • Spinal Cord Stimulators

  • Peripheral Nerve Stimulators

  • Pain Pumps

• Medication Optimization (Manage, Decrease or Increase)

• Opioid Detoxification Referral

• Modalities (TENSs Units, Interferential Units, Traction Unit, Etc.)

• Nutrition/Wellness

• Pain Psychology

• Pain Center of Excellence Program