We all experience some aches and pains from time to time. But how do you know when pain requires medical attention?
What is chronic pain?
“Chronic pain is typically defined as pain that has been present for three months or longer,” says Daniel Verrill, MD, interventional pain management specialist with Kettering Brain & Spine. “Chronic pain can be associated with signs such as lack of function, changes in activity, or neurological symptoms including decreased sensation, pins and needs sensation, or weakness. Immediate medical attention should be sought when pain is associated with new onset weakness, fevers, or unexplained weight loss, because this could be a sign of serious underlying condition.”
Dr. Verrill commonly sees patients who have pain in the neck, back, lower back, legs, knees, arms, and feet. “My job is to focus on interventions that can help alleviate chronic pain,” says Dr. Verrill. “There are a wide range of pain management options available that don’t involve opioids. Part of what I do is educate patients on their options.”
Dr. Verrill explains that there are multiple minimally invasive interventional strategies he uses to help patients find pain relief. Some of these include:
Epidural steroid injections: One of the most common pain management options is steroid injections. In an epidural steroid injection, the doctor places a needle between the spine bones in the epidural space to inject steroid medications around irritated nerves and disks in the spine. This injection helps to manage pain by reducing inflammation and decreasing abnormal nerve firing.
Radiofrequency ablations: “We can actually burn the lining of the nerves that carry pain signals from certain joints, including the knee and the joints of the spine to interrupt the signal from getting to the brain,” Dr. Verrill explains. “This can be done for patients even after having a knee replacement.”
Neuromodulation: “Neuromodulation allows us to change the way that the body signals pain,” says. Dr. Verrill. There are different types of stimulators, such as spinal cord stimulators, DRG stimulators, and peripheral nerve stimulators.
Stimulators involve two steps. “We start with temporary stimulator leads that are attached to an external battery,” Dr. Verrill says. “After five to seven days, the temporary leads are removed, and the patient and I make a decision together on whether to pursue a permanent stimulator.” Permanent placement involves a small surgery to insert the leads of the stimulator and a permanent battery.
“There is a lot of customizability with this option,” he says. “We can change the stimulation pattern to change the sensation felt by the patient, which allows us to customize the results for each patient and their unique pain. It can be a great long-term solution for many debilitating pain conditions.”
Dr. Verrill shares that one patient who had a DRG stimulator implantation for diabetic neuropathy had a 95% improvement in their pain. “Neuromodulation is best for patients who suffer from nerve pain,” he says. “Good candidates include patients who have pain after spine surgery or who have chronic nerve pain from peripheral nerves due to diabetes, chemotherapy, or a damaged spine.”
“Pain prevention will vary from person to person, but regular physical activity is really important,” Dr. Verrill says.
Often, people who are in pain will have a tendency to reduce physical activity. “But the more you move, the less you will hurt,” says. Dr. Verrill. He also shares that maintaining a healthy weight is a key factor in pain prevention. For every pound of extra weight, the joints take on five pounds of pressure, so even small changes in weight can have a positive impact.
“There are a lot of factors that go into successful pain management,” says Dr. Verrill. “I work closely with patients to help identify their pain, develop a plan, and help them understand what treatment are going to help them manage pain best.”
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To learn more about pain management treatment options, contact the Kettering Brain & Spine team at 1-855-786-2649.