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Chronic Pain 101

Many people throughout Nigeria and her diaspora suffer from chronic pain. This is often experienced as lower back pain, joint pain (e.g, knees, hips, fingers) and chronic headaches or migraine. Chronic pain can have a significant, negative impact on physical, psychological and financial wellbeing. Chronic pain almost inevitably leads to decreased productivity at work and at home due to avoidance of pain-provoking activities. Many people find their spirits sagging when they realize they can no longer do the activities they were previously able to do with ease.

Fortunately, you do not have to suffer endlessly in silence! Chronic pain physicians can offer the diagnostic and therapeutic options to help you minimize your pain and regain your functionality. The initial consultation typically includes a thorough history taking where the provider asks in-depth questions about the nature, duration and associated features of your pain followed by a thorough physical exam to determine the source of the pain. Often, this evaluation includes imaging (e.g, x-rays, ultrasound, MRI) to further narrow down the source of your pain. Once this initial evaluation is complete, the physician will then detail a plan for management of your pain. This may include referral to specialized providers, medications or interventional treatments.

Chronic pain providers include an array of specialists. This may include physicians for pain medication prescribing and injection therapy, physiotherapists for range of motion and strength training exercises, chiropractors for neck and spinal alignment and psychologists who can teach coping strategies, biofeedback and mindfulness. Pain physicians often seek assistance from pain psychologists in determining which patients are good candidates for more advanced pain therapies such as opioid management and implantable pain management devices. Nutritionists can often be a helpful addition to a pain management team as obesity can exacerbate many common pain complaints including low back pain and joint pain. Acupuncturists are also useful in managing chronic muscular and soft tissue pain as well as chronic migraine headaches.

In terms of interventions, pain physicians are trained in many advanced techniques. Steroid injections calm inflammation from painful joints in the hands, feet, knees, hips, shoulders, neck and lower back. These injections can be useful for minimizing or even eliminating the need for pain medications and can often delay the need for surgical interventions or provide crucial information for surgical planning. The therapeutic effect from these injections can last several months to a year.

Neurostimulation is an emerging field that is showing great promise in the field of interventional pain management. Precise placement of a tiny set of electrodes near pain generators in the body or near the spine can actually prevent nerve signals from traveling to the brain, ultimately lowering or preventing the body from experiencing the pain. These therapies, while new, have shown much promise and are helpful for those patients who want to avoid oral or injected medications and/or surgery.

The field of chronic pain management continues to expand as the life expectancy lengthens and there are several treatments that may be right for you. Contact your local pain physician for your consultation and start to envision your life pain-free!

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