Clinical research of Opioid Therapy for Chronic Pain

Opioid pain medications like OxyContin, Vicodin, hydrocodone, oxycodone, Duragesic, fentanyl, morphine, etc., are considered to be one of the most potent analgesics. These medications may be available in a variety of forms like tablets or liquids to be taken orally or may also come as opioid injections or patch administrations. These drugs are used to treat moderate to chronic symptoms of pain. Since opioids have narcotic properties, serious side effects may result if used incorrectly. Seek the help of reputable doctors like San Diego pain management doctors for use of opioid medications.

Opioid Therapy for Chronic Pain

What is the mechanism of working?

Clinical research on opioid therapy for chronic pain

All compounds that bind to opiate receptors are referred to as opioids. Opioids can be derived from naturally occurring opiates like heroin from morphine or be artificially synthesized in the laboratory like fentanyl and methadone. Opioids bind to opioid receptors which are widely distributed. The receptors responsible for pain modulation are located in cells of both the central and peripheral nervous systems. The opioid drugs compete with the endogenous endorphins of the body in binding to these receptors. Such binding suppresses the strength of the pain stimulus which reaches the brain. This results in decreasing your sensation of pain.

Clinical research on opioid therapy for chronic pain

Starting from the 20th century, a number of major advances have been made in the use of opioids for chronic pain management. These included the attempts to control opioid distribution by several countries, the discovery of endogenous opioids and the recognition that opioids can be effectively used in alleviating the symptoms of pain. There was also a huge controversy surrounding the long term use of these drugs as professionals believed it could lead to addiction and misuse of these narcotics. However, since the 1990’s, the popularity of opioid medications and its involvement began to rise gradually and this trend continues till this date. Unfortunately, the rise in medical use of this class of drugs has been accompanied by an increase in its non-medical abuse. Still, according to reports by pain specialists, chronic pain can be handled quite effectively using opioid medications. Studies have been conducted to compare the efficacy of opioid pain medications versus that of the non-opioid ones and it has been found that ‘weak’ opioids are not as effective as the relatively ‘stronger’ ones. Some reports also show little or no evidence in support of these pain medications in treating back pain.

Side effects

Opioid medications are not available as ‘over the counter’ drugs at pharmacies and need to be prescribed by a doctor for purchase. It is the sole responsibility of your doctor to regulate the dosage of the medication. Opioids may be administered by registered practitioners like San Diego pain management doctors at regular intervals over a period of many days to treat chronic pain or as a single dose to treat a sudden flare of pain. Some of the common side effects of opioid medications include:

  • constipation, nausea and vomiting
  • drowsiness
  • opioids can be dangerous if used with alcohol, sleeping pills, antidepressants or antihistamines
  • opioid dependence or addiction leading to withdrawal symptoms when attempting to overcome addiction.

Occipital Nerve Block Injection by Pain Doctors San Diego

What is an occipital nerve block?

An occipital nerve block is a type of injection by pain doctors San Diego using steroids or other medications around the occipital nerves which are located on the back part of the head, right above the neck.
Occipital Nerve Block San Diego

What does the occipital nerve block do?

The occipital nerve block is a type of steroid injection used to reduce swelling or inflammation of tissue around your occipital nerves. This can help to reduce pain and any other symptoms which might be caused by inflammation or irritation in your nerves or surrounding structures. In many cases, headaches in the back part of the head, including tension headaches and regular migraines can be alleviated with the use of occipital nerve block

How long does the process take?

This process takes a few minutes at a pain clinic in San Diego for the actual injection.

What is injected?

With an occipital nerve block, the injection contains a local anesthetic used to numb the pain and a steroid medication intended to allow the anesthetic to work for a longer period of time.

Does this process hurt?

Occipital nerve stimulator San DiegoThe occipital nerve block involves a large needle which is inserted by a pain doctor in San Diego into your deeper tissue. It is this which causes the most amount of pain for patients. The skin and the deeper tissue through which the occipital nerve block will be inserted are numbed though, before the procedure, using a local anesthetic. This will help to alleviate any discomfort felt during the procedure. In this case, patients do not require general anesthesia, but rather, they use the local anesthetic.

How is the process performed?

This process is performed at a pain clinic in San Diego with the patient either lying down or in the sitting position. The skin and any hair on the back of the head will be cleaned using antiseptic after which the injection itself will be performed.

What is to be expected after the occipital nerve block?

Immediately after the occipital nerve block you will feel as though your pain is entirely gone, but this is likely due to the anesthetic. This will wear off after a few hours. Once that is done, you may feel sore for a day or two, the result of the mechanical process used to insert the needle. One the third day you will begin to feel pain relief.

What can I do after the procedure?

After the occipital nerve block you should rest. Many patients are able to drive themselves home from the pain clinic San Diego but it is advised that patients remains in the resting area for several hours directly after the procedure before doing this. You might benefit from applying ice to the affected area. You are able to perform whatever activity thereafter that you can tolerate. Unless you had complications during the procedure you should be able to go back to work the day after the occipital nerve block. The most common problem immediately after is a sore feeling at the incision site.

How long will the medication last?

The medication in the occipital nerve block will begin to work after three days and the effects can last up to a few months.

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.

Reflex Sympathetic Dystrophy (RSD) Treatment With Pain Doctor San Diego

Reflex Sympathetic Dystrophy (RSD) Treatment With Pain Doctor San Diego

What is Reflex Sympathetic Dystrophy (RSD)?

Reflex sympathetic dystrophy (RSD) is a condition that is characterized by a group of typical symptoms, including pain, tenderness, as well as a swelling associated with varying degrees of warmth and coolness, shiny skin, sweating, flushing, and discoloration. Reflex sympathetic dystrophy (RSD) is also referred to as, the shoulder-hand syndrome or complex regional pain syndrome. It is a term used to describe a form of Complex Regional Pain Syndrome (CRPS). There are two types of CRPS, Type I and II. Both of these conditions result in chronic pain; however, the main cause of pain is much different. Type I CRPS (Complex Regional Pain Syndrome), is initiated by an injury in the tissue where there is no nerve injury, while Type II CRPS refers to the incidences where a high-velocity impact such as that from a bullet wound is associated with nerve injury.

What are the Causes of Reflex Sympathetic Dystrophy (RSD)/CPRS?

Pain Clinics San DiegoThe major cause of RSD is not known, but the condition is known to occur as a result of malfunctioning of the sympathetic nervous system. The theories behind this include irritation and abnormal excitation of the nervous tissue, resulting to abnormal impulses alongside the nerves that affects the blood vessels and the skin. In most cases, RSD comes after a trauma attack, therefore, some of the conditions that may trigger RSD include; fractures, sprain, damage to the blood vessels or nerves, surgery and certain brain injuries.

What are the Symptoms of RSD/CPRS?

The onset of RSD symptoms may range from rapid to gradual as the condition does not display all the features. There are three stages of RSD together with their symptoms. These are;
Acute Stage: This occurs from three to six months. The patients will experience symptoms such as flushing, sweating, pain, burning sensation, swelling, blanching, and tenderness.
Dystrophic stage occurs from three to six months. The patients experience early skin changes of shiny and contracture with persistent pain.

Atrophic: may be long-lasting. The patient experience loss of motion and function of the part involved (hand or foot) and thinning of the fatty layers under your skin.

How is RSD Diagnosed?

Pain Medication Management San DeigoRSD is diagnosed as per the clinical features seen previously. Sometimes studying images (x-ray, MRI) or nerve conduction tests may be useful. The diagnosis process will be carried out by a San Diego pain clinic. Blood tests may be recommended by a pain doctor San Diego according to the signs and symptoms. Nuclear bone scanning may be used in this process. It will help show characteristic uptake patterns. Overall, diagnosis is thought to help prevent progression of the syndrome.

Is there Treatment for RSD?

Well, there may be no cure for this condition but there is a treatment for such. The objective of the treatment by a pain doctor in San Diego is to help relieve painful symptoms so that the patient can resume their normal activities. Response to treatment of RSD is successful in the earlier stages as compared to the later stages.
The most appropriate treatment include;
• Use of cool and moist applications to the affected areas
• Physical therapy that includes gradual exercises helps relieve contractures
• Medication for pain and inflammation
• Other treatments options include amitriptyline, pregabalin, and clonidine.
• For persistent symptoms, prednisone (cortisone) may be used but in high dosage.
• Treatments such as surgically interrupting the nerves of the nervous system may be used to ease pain.

Remember to keep your pain doctor in San Diego informed of any new symptoms and progress so that they can establish a proper treatment program for you. To learn more about RSD, schedule an appointment with your San Diego pain clinic today.