Introduction to pain management
Pain management can be simple or complex, depending on the cause of the pain. An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down the leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. Sometimes, however, the pain does not go away. This can require a wide variety of skills and techniques to treat the pain. These skills and techniques include:
- Interventional procedures
- Medication management
- Physical therapy or chiropractic therapy
- Psychological counseling and support
- Acupuncture and other alternative therapies; and
- Referral to other medical specialists
All of these skills and services are necessary because pain can involve many aspects of a person's daily life.
How is pain treatment guided?
The treatment of pain is guided by the history of the pain, its intensity, duration, aggravating and relieving conditions, and structures involved in causing the pain. In order for a structure to cause pain, it must have a nerve supply, be susceptible to injury, and stimulation of the structure should cause pain. The concept behind most interventional procedures for treating pain is that there is a specific structure in the body with nerves of sensation that is generating the pain. Pain management has a role in identifying the precise source of the problem and isolating the optimal treatment.
Fluoroscopy is an X-ray guided viewing method. Fluoroscopy is often used to assist the doctor in precisely locating the injection so that the medication reaches the appropriate spot and only the appropriate spot. Ultrasound is also used to identify structures and guide injections.