What would be The “right” goal while managing pain

goal to managing pain

It is quite natural that the primary aim of a pain management clinic will be the adoption of successful treatment strategies that will help reduce pain in patients. However, when looking deep, there seems to be a lot more involved in the way the patient responds to these treatment strategies and the after effects of such treatments.

Often, in case of patients suffering from chronic cases of pain, there is a much sinister underlying cause of this pain. Complex disorders and diseases could give rise to painful symptoms in these patients. However, if the focus is only on the reduction of these symptoms instead of addressing the real cause, it might end up in pain recurrence at a later stage or further aggravation of the source disease or disorder. Pain management strategies could involve medication or interventional therapies. Alternative therapies like chiropractic, acupuncture, physical therapy, etc., might also be adopted to treat pain in patients. However, when the doctor emphasizes mainly on the pain aspect of the disease and tries to reduce pain using one or more of the above mentioned therapies, the goal of pain reduction might be easily achieved but the risk of unknown side effects that worsen the underlying cause, remains. Thus, it is extremely important to administer pain treatments that are ‘customized’. An individual’s physical and mental health, lifestyle and profession are all important factors to be taken into account while designing pain management strategies. Besides reducing the pain, attention must be paid to the underlying cause and how the treatment strategy adopted can affect the cause should be estimated carefully. A multimodal therapy plan must be devised that attends to all the needs of the patient.

Besides addressing pain and its underlying cause, pain management must also be administered in a compassionate and caring manner. It is important to remember that most patients of pain are mentally disturbed due to the debilitating effects of a nagging pain on their life and lifestyle. Often chronic pain is associated with depression. Words of sympathy and a caring touch works wonders for such patients and this ‘humane touch’ must be integrated into the goals of managing pain.

Use of pain management drugs must be made extremely cautiously. Often, due to pressure from the patient’s behalf, physicians tend to administer stronger doses of medication to patients to relieve them of severe pain. However, even though immediately effective, these medications might have untold adverse side effects at a later stage. Such is the case with opioid pain medications. Often, improper and excessive use of these drugs have led to drug overuse and abuse in patients who were not known to be addicts. Opioid drugs like oxycodone is known for its effectivity to reduce pain and induce sleep but it is also associated with side effects like memory problems, constipation and tiredness.

Adoption of new scientific knowledge and techniques must also be an important goal when managing pain. Since pain management is based on personalized treatment strategies, knowledge of scientific advances helps the doctors to decide upon a treatment plan more effectively. As more and more research data is pouring in, it is becoming easier to personalize medical treatments according to individual needs. For example, a drug A might work well for younger patients with a back ache while drug B might be more effective with older patients. So, efficient doctors like the ones involved in pain management in San Diego, keep themselves updated with all such information which allows them to take better decisions while treating patients.

Sacroiliac Injections By Pain Management Doctors in San Diego

What are sacroiliac injections?

Sacroiliac injections are injections of steroids or other medications directly into the sacroiliac joint by a pain management doctor in San Diego. These joints can be found on either side of the tailbone, and they connect your tailbone to your pelvis.

What is the purpose of the sacroiliac injections?

These injections are designed to reduce inflammation or swelling in or around the sacroiliac joint space. This can help to reduce pain or any residual symptoms that inflammation may cause to your joint or any surrounding structures.

How long does this process take?

The actual injections take between five and ten minutes at a San Diego pain management clinic.

What is injected?

With the sacroiliac injections a mixture of local anesthetic and steroids are injected to reduce pain and to prolong the positive effects.

Is the process painful?

The sacroiliac injections is an injection performed by a pain management doctor in San Diego through the skin and the deeper tissue which causes some pain. Before the injection takes place the skin and the deeper tissue are numbed using a local anesthetic. This helps to alleviate the discomfort felt during the procedure. Some patients will receive sedation in addition to this to make the process easier. The procedure is conducted under a local anesthetic not a general anesthetic which means that you are not “out” during the process. Some patients opt for additional sedation, as mentioned above, and the amount provided is often contingent upon the tolerance levels of the patient.

How is the process performed?

The sacroiliac injections are conducted with the patient lying on their stomach at a San Diego pain management clinic. There is often an x-ray used to determine the correct placement for the needle but thinner patients may not need this. Patients who have IV sedation will be monitored using a blood pressure cuff, EKG, and blood oxygen monitoring device. The skin where the injection will take place is cleaned using an antiseptic and then numbed using an anesthetic. The injection needle will be placed appropriately and the injection carried out. After the process is complete the needle is removed and a covering applied to the area of injection.

What can be expected after the procedure?

After the sacroiliac injections you will feel no pain or little pain, but this is due to the anesthetic. This feeling will go away after a few hours. You may feel sore at the site of the injection for a day or two. This is because of the mechanical process used to place the needle. After the third day you will begin to notice pain relief.

You should have someone else drive you home following the procedure as the injection can cause temporary leg weakness. Any patient undergoing sedation for the sacroiliac injections is required to have a ride home. Patients are advised to have a day or two to relax after the procedure and ice can be applied to the injection site.
Unless you faced complications you can return to work the following day. The most common complication felt is soreness at the injection site. The medication should bring with it lasting effects for several days to several months. If the first injection is not effective, you may return for another in two weeks.

Hip Pain Treatment With Pain Management San Diego

What is Hip Pain?

Hip pain involves any pain that occurs in or around the hip joint. The pain can either be felt around the hip area or in your groin, thigh or knee. Hip pain experienced on the outside of your hip, outer buttock or upper thigh may be caused by problems with ligaments, muscles, tendons as well as other soft tissues surrounding your hip joint.

What are the Causes of Hip Pain?

Pain may occur in areas within the hip joint or from structures surrounding the hip. The major cause being problems in the bones or cartilage of the hip.

The common cause of hip pain include;

  • Hip fractures. They can be a major cause of hip pain. Hip fractures are more common as pain management San Diego people age since they are more vulnerable to falls and the bones become weaker.
  • Osteonecrosis of the hip
  • Infection mostly in the bones or joints
  • Arthritis that is felt in the front part of your thigh
  • Labral tear of the hip

Pain experienced around the hip may be caused by factors such as;

  • Hamstring
  • Bursitis
  • Hip flexor strain
  • Groin strain
  • Snapping hip syndrome

What are the Symptoms of Hip Pain?

Based on the condition that causes your hip pain, you might feel discomfort in areas such as

  • Groin
  • Inside the hip joint
  • Thigh
  • Outside of the hip joint
  • Buttocks

You will discover that the pain gets worse with activities especially if you suffer from arthritis. Apart from pain, you may have reduced the range of motion.

Diagnosis of Hip Pain

Diagnosis of hip pain begins with a healthcare provider who performs a history check accompanied by physical examination and some tests. By considering the past medical history of the patient, the health care provider can suggest differential diagnosis or a list of potential causes. A physical examination helps refine the tests may be carried out to come up with a specific diagnosis.

The physical examination will focus on the hip, leg and back. The health care provider will look at the results of the findings that may help explain the complaints of the patient. The health care provider may further recommend imaging procedures such as plain X-rays, a CT scan or MRI scan of the hip and pelvis to get a clear view of the bones and joint spaces.

If your pain clinic San Diego doctor suspects that a systemic illness is the cause of hip pain, blood tests may be recommended to confirm the case.

What are the Treatment Options for Hip Pain?

Treatment of hip pain depends on the diagnosis and underlying illness that may be present. Over-the-counter pain medications such as acetaminophen [Tylenol], naproxen (Aleve), ibuprofen [Advil, Motrin], may be taken for pain control. But remember that over-the-counter medications may have some side effects therefore it is wise to ask a health provider for advice and direction.

Crutches, a walker or a cane may be quite useful in the short term once fitted to the patient’s height. Usually, the pain will go away over a few days but if pain persists, medical evaluation may be helpful.
Avoid aggressive walking or running, and strenuous activities. Resting after every activity may be helpful. Also, look for a non-weight bearing activity such as cycling or swimming to allow you maintain aerobic fitness as well as hip range motion. However, if pain persists, seek the help of your health care provider.

Trigeminal Neuralgia Diagnosed By Pain Management Doctors In San Diego

What is Trigeminal Neuralgia?

Trigeminal Neuralgia is a chronic pain condition or inflammation of the trigeminal nerve that causes facial pain. This condition is referred to as tic douloureux since the intense pain can cause patients to contort their face into a grimace causing the head to move away from the pain, a condition called a tic.
Trigeminal nerve sends impulses of pain, touch, pressure and temperature directly to the brain from areas such as the face, gums, jaw, forehead and around the eyes. The pain caused by trigeminal neuralgia is quite intense and may occur in few hours, minutes or seconds. The outcome can be months or years of attack but in some patients it can be fully controlled.

Trigeminal Neuralgia have been known to affect people of any age, but it is more common in people older than 60 years old. The effects are seen in the right side of the face five times more than the left side.

What Causes Trigeminal Neuralgia?

Headache treatment San DiegoIn the vast majority of the common cases, trigeminal neuralgia is caused by compression of the main nerve to the brain, trigeminal nerve. This nerve is the largest in the skull. This compression is caused by a nearby blood vessel pressing on the main nerve inside the skull.

What are the Symptoms of Trigeminal Neuralgia?

Trigeminal Neuralgia is characterized by a sudden, sharp, electric-like, or stabbing pain that may last for several seconds. The pain mostly occurs on the face and around the eyes, lips, nose, scalp and forehead. These symptoms can be transferred from one person to another by brushing the teeth, touching the face, putting on make-up, swallowing or even feeling just a slight breeze.

Being one of the most painful disorders, the pain is felt on one side of the jaw or cheek though different people experience pain at different times on both sides. The attack result to a sharp pain that may be repeated one after the other. This pain may come and go throughout the day lasting for days, weeks or months. The disorder may be seen to disappear for months or years. It is more frequent in women than men and in rare cases does it affect younger than 50 years of age.

How is Trigeminal Neuralgia Diagnosed?

In diagnosing this condition, your pain management doctor in San Diego will first take a history of the situation and perform a physical examination which should be normal. The main area of test is muscle weakness and presence of corneal reflex controlled by V1. V3 is in control of chewing, and there should be no existence of muscle weakness. When the cornea is touched, the eye should blink in response. The two discoveries must be normal if not, the treatment for trigeminal nerve should begin.

Some pain management doctors in San Diego may order for a Magnetic Resonance Imaging (MRI) to help in the diagnosis of other conditions that may cause trigeminal neuralgia. This disorder is diagnosed based on the description of the patient’s symptoms.

How can Trigeminal Neuralgia Be Treated?

Trigeminal Neuralgia is a long term condition. It can be managed through treatment to some degree. The first treatment to be administered by a pain clinic San Diego should be with an anticonvulsant medication (mostly used to treat epilepsy) called carbamazepine. This medication should be taken several times in a day, with an increase of the dose over the course of few days or weeks so that the medication can build up in your bloodstream.

Migraine Treatment San DiegoTrigeminal neuralgia can also be treated with antiseizure drugs including Neurontin (gabapentin) or Tegretol (carbamazepine). Other medication like Depakote and Klonopin may also be quite effective when used in combination with other drugs to achieve pain relief.

If the treatments turn out to be ineffective, neurosurgical procedures are available to relieve pressure on the nerves and also reduce the amount of sensitivity on the nerves. Some patients have shown successive or reduced pain with the help of medical therapies such as chiropractic treatment, acupuncture adjustments as well self-hypnosis.
Well, these treatment options will help you achieve the very best when relieving pain caused by trigeminal neuralgia. To learn more about them, contact a pain clinic San Diego today.