No one can deny that to be born human is to experience pain at some point in your life, and regardless of age or economical situation, everyone is vulnerable. But today, interventional pain management, a relatively new and exciting branch of medicine can help ease suffering to a great extent. Experts in pain management are professionals from varied medical fields who specialize in helping people cope with pain more effectively.
"No matter what your ailment, staying pain free is a basic human right," says Dr Madujeet Gupta, anesthetist and consultant pain physician, PSRI hospitals, New Delhi. "Pain can be either acute (as in the case of post surgical pain which occurs for a brief period but requires intense care) or chronic (when the pain persists and despite the unease, one learns to live with it.) In both cases, pain management therapy can bring a patient great relief and transform their lives. Earlier, pain management was provided only for terminally ill patients, to ease their suffering, but today, even minor ailments (that are chronic in nature) can be effectively treated."
If you or someone you know is suffering from severe pain, here are some of the therapies that can help.
Pain killing medication
A cornerstone of pain management therapy is the effective use of pain killing medication. While medication shouldn't be used excessively to treat minor ailments, it takes on great importance when it comes to recovering from terminal diseases like cancer or the trauma of major surgery.
Any major surgery takes a toll on the body and providing a pain free period just after the procedure is crucial for healing and wellbeing. "Pain relief therapy in such cases focuses entirely on the recovery of the patient in the window period of three months post-surgery and is planned by assessing his/her condition immediately after the procedure. It involves the correct prescription of drugs and painkillers to keep them free of debilitating pain and hasten healing. The patient is advised to walk as soon as possible. Deep breathing exercises help aid recovery by preventing the chances of contracting a lung infection that can interfere with healing," says Dr Gupta. "Cancer patients, particularly those with cancer of the abdomen, urinary bladder, uterine, pancreas and some facial cancers can all benefit from pain killing medication."
Radiofrequency Nerve Ablation Techniques
This is a rather advanced pain management technique that can be employed to relieve acute and chronic pain in several areas of the body. However, it is most commonly used to treat lower back pain and to soothe arthritic joints. If you suffer from constant lower back pain, it is possible that a portion of your spinal chord is pinching a set of nerves. "With the help of radio frequency nerve ablation techniques, heat is employed to numb the pain transmitting nerves and this doesn't hamper with any of the other body processes," says Dr Gupta. Interestingly, the procedure is similar to the energy generated by microwave ovens to heat food, except in this case, the heat is transmitted to the tip of a needle which when applied directly to the nerves, relieves pain. One shouldn't expect the results to be instantaneous though. Pain relief is a gradual process and may take several weeks after the procedure.
Steroid Injections
Steroid injections are particularly effective for patients suffering from arthritis of the knee. "Unfortunately, this condition occurs because of old age and cannot be reversed," says Dr Gupta. "However, steroid injections greatly reduce inflammation (especially at the site of a nerve compression) and can offer great relief from tortuous knee pain." However, one must be aware of the fact that steroid injections aren't without their risks. In a study conducted by the Journal of Bone and Joint Surgery, older patients with low bone density were advised caution while using these injections, because as many as 150 patients out of the group of 3000 who had steroid injections in their spines were later diagnosed with vertebral fracture, with a risk of 21% with every progressive injection. Despite its risks, these injections were found very effective for cases of severe leg pain caused by a herniated disc crushing a nerve.
Proliferative Therapy
Also called prolotherapy, this procedure involves injecting an anaesthetic, combined with an irritant, into the site of pain. This irritant stimulates the body's natural response, so that it creates a thin film of fibrous tissue around the painful area, thereby relieving chronic pain. This can be done in major joints across the body. Another way to do this is to withdraw platelet rich plasma from the blood and inject it into the knee (or the joint which aches); it also stimulates natural healing processes. "Everyone's body reacts differently, so these techniques have a success rate of only 50-60%" says Dr Gupta.
Antidepressant Treatment
Irritability, depression and pain are often interconnected. In such cases, when your pain is an obvious outcome of psychological issues, anti-depressants are prescribed. "These pills will restore the chemical seratonin in your brain, a lack of which can lead to chronic pain," says Dr Gupta. "But they should be taken as a long-term course in order to be effective."
Critical evaluation
Before any treatment is done, it's important to allow your physician to judge your pain threshold, or the maximum amount of pain that you are capable of bearing. Pain threshold is very subjective and differs from person to person. The pain that you may find unbearable could be quite tolerable to someone else. This can only be assessed by a complete psychological evaluation. You will be asked to rate your pain on a scale of one to ten with ten being the most painful. Try to answer as accurately as possible. Frequent evaluation will allow your physician to judge if his pain intervention therapy is having the desired results or whether you should opt for another technique for greater relief.
The author can be contacted at kamala.metroplus@gmail.com
