advanced pain managementBy: Dr. Jonathan Tait – 8/24/17

Chronic pain is relentless. It is there when you wake up, and it is there when you go to sleep if you can sleep at all. Sure, you’ve tried the painkillers, steroids and anti-inflammatory treatments. Sound familiar? Now you’re wondering if your only option is surgery, or is there another technique to relieve the pain. Here are some tried-and-true non-surgical advanced pain management techniques.

Physical Therapies

Patients can get relief from certain physical therapies, which have been used for generations.

The Old Standby

Cold and heat is an age-old pain relief method for certain kinds of injuries. Alternating between cold and heat sends different competing sensation signals to your brain to help reduce pain and swelling.

Exercise

When you’re in pain, it’s easier not to exercise, but physical activity can help reduce pain. Some painful conditions like fibromyalgia or arthritis cause pain in joints, so you naturally become less mobile. It is important to keep moving though, so try low impact activities like swimming or walking to keep going.

Other Physical Therapies

Sometimes exercising on your own is not enough, and you need the help of a trained physical therapist to teach you specific movements that will improve mobility and range of motion, and rebuild or maintain strength.

Massage therapy is a wonderfully effective way to ease the pain. Several techniques relieve muscle and joint tension. For example, myofascial release relaxes broad muscle groups and increases blood flow to those large muscles to help alleviate pain and reduce soft tissue inflammation. Techniques like AFR (Active Fibrotic Release) and ART (Active Release Technique) are used to break up scar tissues that are trapping nerves and restricting blood vessels and thus creating pain.

Mind-Body Therapies

Many people get relief from pain by engaging in mind-body therapies.

Meditation

There is increasing scientific evidence that mind-body techniques like meditation and tai chi help you control your own pain. There is a link between raw physical pain (sensory pain) and your emotional reaction to pain (affective pain). Meditation can help you train your mind to perceive the intensity and unpleasant aspects of pain much differently. It’s the same concept that athletes use to “play through the pain.”

Biofeedback

Biofeedback is a related technique whereby the patient learns breathing and relaxation while being monitored. This way, you can see your own physiological reactions (blood pressure, heart rate, etc.) to the calming techniques. Visualizing the reaction helps you to have the same response when you’re not hooked up to the equipment.

Needle/Injection Therapies

Various needle and injection therapies can be quite effective for pain management.

Acupuncture

The ancient Chinese technique of acupuncture is used by millions as a pain relief technique. The practitioner inserts a very thin needle into one or more of the 400 known acupoints throughout the body. Pain is an indication that the body’s energy flow is out of balance, so the needle insertion restores the acupoint to the proper balance, and at the same time, the needles excite the nerves in the area, therefore interrupting pain signals.

Dry Needling

Dry needling is a Western technique, similar to acupuncture, but geared toward needle insertion in muscle trigger points that have become tight, creating pain and limiting the range of motion.The needle causes a tight muscle to twitch and then relax, thus increasing blood flow and setting off a nerve response that alters pain perception.

Injections

The above two techniques are dry needle techniques, but sometimes wet techniques are needed to inject a substance into a painful area. Trigger point injections involve injecting saline, steroids or numbing agents into muscle trigger points that have become irritated, tight and painful. When trigger points are out of balance, they can feel like a pinched nerve and can create localized pain or referred pain in another area. The injections relax the point and increase blood flow.

Injections like viscosupplementation can be used to lubricate a painful joint for conditions like osteoarthritis, in which the body no longer produces its own lubricating fluid (called hyaluronan). The doctor will inject fluids that replace the joint fluid, much like an oil change for your joint.

Corticosteroids can be injected into the joint or bursa as a rapid anti-inflammatory measure in a particular area to quickly decrease swelling and reduce pain. This is more of a “rescue” technique and is used rather sparingly by our practitioners because repeated use of corticosteroids can interfere with your body’s natural healing ability.

Epidural injections are a similar concept but are done under much more directed conditions. The physician uses x-ray guidance (fluoroscopy) to inject irritated nerves that are radiating pain into the legs. Similarly, nerve blocks are done under ultrasound guidance and are used to target particular nerve groups to turn off or reset pain signals originating from a specific body location. Blocking these signals gives the damaged nerve a break from constant irritation and allows the nerve time to heal.

Conclusion

Ongoing chronic pain disables millions of people per year, more than cancer and heart disease combined. When it lasts for months or even years, it is life-altering and affects you physically and emotionally. We hope you find relief in one or more of these techniques.

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