Pain management is a health care specialty, and most often refers to the treatment of pain from the spine, muscles, joints, and the nervous system. When experienced by an individual with cancer or a terminal illness, pain is usually treated by the specialist in that discipline. This can include an oncologist or palliative medicine physician.
When first line treatment provided by primary care, acute orthopaedic/post-surgical care, or traditional physical therapy are not effective, pain management can provide additional a options. Pain management can be sought when pain limits functionality more than expected, or if the pain causes extreme suffering, regardless of duration. Pain management is also often consulted in complex and/or chronic pain conditions. It can be used both for maintenance and chronic pain flare ups.
Because pain is a complex and individual phenomenon, a thorough evaluation is necessary to determine which combination of pain management treatments is most effective. Once evaluated, a comprehensive treatment plan may include referrals to multiple pain management providers. At UPMC in central Pa., these entry points include the Spine Institute, The Bone and Joint Institute, UPMC Pain Medicine, and UPMC Chronic Pain Management Program.
UPMC Chronic Pain Management Program has a multidisciplinary team of pain specialists. They offer treatment using physical therapy, psychology, biofeedback, aquatic therapy, vocational counseling, and physical medicine and rehabilitation.
The chronic pain managment team works together, in one location, to provide holistic treatment for chronic pain. We use specialized knowledge of how the brain processes chronic pain to create treatment protocols that are not found elsewhere in the region. Upon completion of the program, patients report an average of 46 percent decrease in pain severity. They also leave with the confidence to manage their pain independently and the understanding of how to live well despite their pain. This multidisciplinary approach has been established in the scientific literature as the most clinically effective method of treating chronic pain.
A second area , often referred to as Interventional Pain Management, uses medical procedures to address a specific cause of pain in a specific area. These procedures can be performed at varying frequencies depending on type and purpose. They may be effective alone or in combination with other therapies, medications, or surgery. Although all interventional procedures are invasive by definition, they can range from a simple joint or muscle injection performed in the provider’s office, to a more complex spinal injection or implant performed an ambulatory surgery center. Interventional procedures are available at UPMC Pinnacle Bone and Joint Institute and at UPMC Pain Medicine.
A comprehensive pain management plan can also include the use of medications available both over the counter and/or through a prescription from a medical provider. Muscle relaxers, topical creams, acetaminophen (Tylenol) and NSAIDS (Advil, Aleve) are often used for musculoskeletal pain conditions.
Neuropathic medications, such as Neurontin or Lyrica, work to decrease pain related to nerves and the processing of pain in the nervous system. Some antidepressant medication has shown pain relieving benefit. In addition, steroids can be prescribed for some pain conditions, and for flare ups of chronic pain.
Medical cannabis is now legal for patients who are certified by a state-approved provider as having one of the approved medical conditions, which include neuropathies and severe chronic or intractable pain, among other conditions. To begin the process of application, patients should visit the Pennsylvania Medical Marijuana Program Website.
Research shows opioid medication is most effective for acute or short-term pain management. Although it can be safely used to treat chronic pain, any long-term use of opioid medication should be closely monitored for side effects, interactions, and misuse.
Repeated use of an opioid can result in physical tolerance to the drug, which decreases the effectiveness of the medicine without an increase in the amount or dose. When tolerance has developed, any individual can become physically dependent on the opioid and stopping the opioid requires weaning, or slowly decreasing the dose, in order to avoid symptoms of withdrawal.
Most patients with chronic pain can use opioid medication correctly, and recent government statistics suggests that fewer than 10 percent of the over 49,000 opioid-related deaths in 2017 involved prescription opioids used alone.
Some patients can develop abnormal behavior with adverse consequences related to opioid use, otherwise known as addiction. This is a separate condition from pain and is treated by specialists in Addiction Medicine.
Alternative therapies may not be covered by traditional insurance plans. Researchers continue to study the effectiveness of these treatments, which are gaining in popularity. In addition to psychological counseling for program patients, UPMC Chronic Pain Management Program provides biofeedback, including training in breathwork, meditation, and mindfulness based stress reduction. Outpatient psychological counseling can also be used to decrease suffering from pain across all diagnoses.
The most important thing to remember is there is always hope for relief from pain. Ongoing research and evolving technologies continue to create new opportunities for pain management. The experts at UPMC in central Pa. will assist you in finding the best care to decrease your pain and suffering, regardless of the cause or severity of your condition. Learn more about our pain management services by visiting us online.
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