Chronic pain affecting any part of the body can be a real challenge to treat. In fact, most experts agree that the goal isn’t to cure as much as it is to manage the pain. Improving function without necessarily decreasing the pain is often the underlying approach to chronic pain.
Pain specialists take a careful history of the patient’s health, past medical treatment, and current health condition. They assess the pain’s severity, duration, and type. A psychosocial history is also taken. This looks at the patient’s values, circumstances, and beliefs. There’s plenty of evidence from studies to show that paying attention to the psychosocial aspect of healing is as important as treating the biologic side of injuries, illness, or disease.
Treatment is usually multimodal, meaning many different tools and approaches are used. This might include a rehabilitation protocol with an occupational and a physical therapist. Medications such as antiinflammatories and analgesics (pain relievers) are used. Analgesics can range from mild choices such as Tylenol to stronger opioids such as Darvocet or Oxycontin.
Drug treatment should be just one part of the overall plan. Keeping in mind the goals of improving pain (if possible) and decreasing disability, the pharmacologic approach is not the central focus of the plan. If necessary, steroid injections may be considered. Surgery is often not helpful so it is not an early treatment option unless there is a clear-cut biologic cause that can be aided by surgery.
When all else fails and pain is unrelieved by any other means, then a spinal pump may be considered. The pump is implanted inside the body with a reservoir or supply of opioid medication. It has a pump delivery system that injects small doses of the pain-relieving drug into the epidural space of the spine. The drug is taken up quickly directly into the nervous system so there is an immediate effect without adverse side effects.