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What are the most common problems that result in chronic pain?

While there are a multitude of conditions that may lead to chronic pain, we have found the following to be most prevalent in our patients:Back pain, Neck pain, Muscle Pain (Myalgia), Nerve Pain, Headaches, Post Herpetic Neuralgia (Shingles), Fibromyalgia, Osteoarthritis, Carpal Tunnel Syndrome.

What is the difference between acute and chronic pain?

Acute pain is of short duration, usually the result of an injury, surgery or illness.

Chronic pain is an ongoing condition, often in the back, neck, head, as wells as neuropathic pain (nerve injury pain), musculoskeletal pain, and pain related to illness. Your physician may refer you to the Pain Management Center because your chronic pain condition has not responded to conventional therapies.

Treatments for acute and chronic pain are generally quite different. In some cases, acute and chronic pain can be stopped or alleviated by a single procedure or series of procedures. Sometimes, chronic pain is part of a widespread disease process, and the specific cause may be difficult to pinpoint. Once we have identified the specific factor causing the pain, we may be able to treat it so that the condition no longer occurs. In some patients, the specific factor causing the pain–such as cancer–cannot be changed, but we may be able to reduce the pain or help the patient to better cope with the pain through a combination of medical, psychosocial and rehabilitation techniques.

What is pain management?

Pain is a complex medical problem that can have profound effects on your physical and mental well-being. The goal of pain management is to help you decrease your level of pain and suffering, to return you to your maximum level of functioning and independence, and to help you restore your quality of life.

When should a person seek a pain management specialist?

Seek out a pain management specialist when pain does not respond to the usual and customary treatments within a reasonable period of time. All too often, people see pain management as a last resort for pain, instead of a first stop on the road to wellness. Be aware of your body and take note when you are in pain. If that pain persists — contact your doctor or an accredited pain management specialist immediately.

What are the major issues surrounding pain?

Chronic pain can become so intense and overwhelm the body and mind to such a degree that it can affect all areas of life. People become so afflicted that they often cannot work. Their appetite falls off. Physical activity of any kind is exhausting and may aggravate the pain. Often, the person becomes the victim of a vicious cycle in which total preoccupation with pain leads to irritability and depression. Adding to these ailments is the fatigue sufferers experience from not being able to sleep at night.

In other cases of chronic pain, issues of secondary gain may arise. This may develop when patients associate pain with some form of benefit — as when a sufferer has a coworker help out at work, or a spouse is extra- supportive. In these cases, the sufferer may receive a benefit for not treating the pain effectively.

At Willamette Pain & Spine Center, we will work with the patient to identify and alleviate these issues.

What medications are most commonly used to manage pain?

While drug therapies differ for each person, the most common are: Adjuvant pain medications, including: antidepressants, anticonvulsants and muscle relaxors. Opiates or “pain killers” used to treat acute pain or cancer-related pain, and often prescribed for chronic pain. Anti-inflammatory drugs to alleviate pain by reducing swelling and irritation.

There are alternative delivery methods for medications. Common methods used at the office are oral medications, topical creams, sublingual medicines, nasal sprays, injections and patches.

What about the stories of addiction surrounding Opiates? Is there a difference between physical dependence and addiction?

A common misconception about Opiates is that they are addictive. The fact is when used properly for the treatment of pain, there is little risk of becoming addicted. Addiction is defined as continuing to use a substance when it has become detrimental to the person’s life. Being dependant is not the same thing as being addicted.

Many people with health problems are dependant on medications, for instance people with high blood pressure are dependant on blood pressure medications. Diabetics are dependant on insulin. Furthermore, when opiates are taken as directed for legitimate pain, the person does not get “high” from taking them.

Opiates consist of the same chemical makeup as your body’s natural painkiller, endorphins. People that have lived with pain over a long period of time sometimes have reduced levels of natural endorphins because the body has stopped producing them.

(Source: © 2014 Pain Management & Rehabilitation Medical Services of New York. All rights reserved.)

Injections: Can I get interventional epidural shots on an outpatient basis? Do I need to be sedated?

All three procedures are performed on an outpatient basis, and you can usually return to your pre-injection level of activities the following day. Some patients request mild sedation for the procedure, but many patients undergo the injection using only local anesthetic at the skin.