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Treatment options for chronic pain management

Jan 07, 2020

Treatment options for chronic pain management

When you're barely moving because of chronic pain, not only do you suffer physically, but your quality of life is impacted as well. You don't get to enjoy the things you love, like family, friends, and physical activities, or even work. And, as the opioid problem continues to plague the country, doctors are moving towards less-invasive, non-opioid pain management techniques.

For patients who have tried everything from physical therapy to various medications with no success, it may be time to try other options. Daniel Verrill, MD, is a board-certified anesthesiologist at Kettering Brain & Spine who completed fellowship training in pain management. He focuses on nonsurgical, non-opioid treatment of chronic pain known as interventional pain management.

Interventional pain management is ideal for a variety of conditions, including herniated disks, spinal arthritis, fractures from osteoporosis and sciatica. "For chronic, non-cancer-related pain, we don't prescribe opioids. People are looking for non-opioid treatment," explained Dr. Verrill. "The current opioid crisis confirms that this is the best way to manage pain, with a few exceptions like severe pain caused by cancer."

"Interventional pain management is a medical subspecialty where the doctors apply nonsurgical, non-opioid treatments for different types of pain," he said. "Options like injections, stimulators, and pain pumps are a good option for those patients for whom surgery is either not an option or may present unreasonable complications, particularly the elderly."

A number of these noninvasive options are available to manage pain. Nerve block techniques, for example, deliver numbing medication directly to the nerve causing the problem. The process can be used to treat pain as well as diagnose specific problems.

Neuromodulation therapy delivers electrical current or pharmaceutical agents directly to a targeted nerve area. There are two versions. One is like having a pacemaker for the spine, where leads are attached to needles inserted into the spine and a mild electrical current modulates the nerve transmissions.

The second type is more permanent and involves placing wires and a battery beneath the skin, with the current delivered being controlled by a Bluetooth device. Dr. Verrill said these procedures can be used after a surgical procedure as well, even after a repeated injury. "In one instance, I saw a 23-year-old woman who had undergone spine surgery but later re-herniated a disk in her back. We put in a stimulator and now she is pain-free, providing a long-term solution."

Another treatment option is kyphoplasty, a minimally invasive procedure used to treat spinal compression fractures. It reduces pain by using bone cement to repair fractures caused by osteoporosis or cancer.

For chronic disk pain, the doctor can perform an ablation, which burns the specific nerves that carry pain signals from the bony endplates.

All of these procedures are outpatient, and fewer than half even require intravenous anesthetic or medication. Most patients fall into one of three categories. For some, the procedure works the first time and the pain never returns, others require injections more regularly, and the last group may not experience any relief and are still candidates for surgery.

"Everything we do sounds scarier than it actually is," said Dr. Verrill. "The spine injections take only about 2 minutes, and most people talk through the procedure. Most people are apprehensive because it's an unknown and many physicians can't answer any specific questions about it." Patient experiences vary, but for the most part recovery time is minimal and some experience relief immediately.

For more information about interventional pain management at Kettering Brain & Spine, visit our website or call 1-844-211-5482.