Extensive Field of Chronic Back Pain Management

Since long, pain, particularly chronic back pain, has been just something most of the patients had to accept to ‘live’ with. However, just recently researchers have found out a lot about pain and its bases, both physiological and psychological, resulting in various pain management therapies which can offer complete or partial relief from pain.

When pain remains untreated, it can interfere with the curing process by influencing the immune system and thereby resulting in other unwanted outcomes. Regarding back pain, the pain can hamper the recovery process by meddling with exercise and growing the risk of mental distress.

New Approach towards Chronic Pain

Patients suffering from continuous pain without any apparent cause are dismissed by physicians most of the times. However, even any cause is absent in such patients, chronic pain can result in neurological responses that simply worsen the pain and make it more problematic to treat.

Today awareness is growing among doctors as well as laypeople of the need to look seriously at pain. And this is happening particularly with patients of chronic neck and back pain.

Even though many of the cases of back pain are self-limiting and recover on their own, there is always a significant risk of recurrence and development of chronic disorder.

Chronic back pain is typically difficult to treat, particularly when it is resulted from failed back surgery or nerve pain. And this has resulted in increasing number of services for patients in need of medical as well as alternative treatment for neck and back pain.

Pain Management for Chronic Back Pain

Chronic back pain management involves factors, like:

• Identifying the cause of neck or back pain
• As an alternative to surgical procedure
• Identifying areas to be treated surgically
• Helping recovery of a patient after surgical procedure
• Helping the patient to manage residual or recalcitrant pain

Techniques

Pain management techniques are roughly classified on the basis of their invasiveness. Thus, there are three types of techniques:

• Those which are totally noninvasive and even don’t include any medication (non-invasive, non-drug)
• Those which are purely pharmacological (non-invasive pharmacological)
• Those which are totally invasive, e.g. injections (invasive)

Non-invasive Non-drug Pain Management Techniques

This class of techniques involves a wide variety of procedures for treating back and neck pain. Following are only a few of them:

Manual Procedures – Application of pressure to the affected areas, to their muscles, joints and ligaments. There are evidences available for the efficacy of these procedures.

Skin Heating or Cooling – Applying hot or cold packs, diathermy or ultrasound to aching area comes under this category.

Behavioral Changes – These methods include relaxation techniques to alleviate back pain. Biofeedback comes under this technique which includes learning of controlling muscle tension, heart rate and blood pressure for symptom relief.

Exercise – Exercises for management in turn include a lot of procedures like stretching exercises, water therapy, McKenzie method, aerobic exercises and many more. They help to ensure cardiovascular, musculoskeletal and disc health.

Electrotherapy – The commonest example of electrotherapy is TENS or Transcutaneous Electric Nerve Stimulation, which reduces back pain by using a low-voltage stimulation which intermingles with the sensory nervous system.

Non-invasive Pharmacological Pain Management Techniques

Drugs are used on a large scale in the management of pain. They are:

Analgesics – These are pain-relievers like acetaminophen. Their long-term use may give rise to liver or kidney damage

Muscle-relaxants

NSAIDs (Non-steroidal Anti-inflammatory Drugs) – Drugs like aspirin, naproxen, ibuprofen, etc. They may give rise to ulcers in the long run.

Neuromodulating Drugs – These are used for muscular and neuropathic pain.

Anticonvulsants and Antidepressants

Invasive Pain Management Techniques
Some of the most popular invasive techniques are:

Injections – Due to injections, anesthetics or steroids reach directly to the muscles, joints or ligaments and offer pain relief.

Implantation of Electrotherapy Devices – Devices like spinal cord stimulators or SCS and peripheral nerve stimulators are implanted through surgery. Clinical data regarding their efficacy is inconclusive; however, SCS have been found more effective for leg and arm pain, than for spine pain. Also, spinal cord stimulators are pricey.

Implantation of Opioid Infusion Pumps – Pumps of opioid agents are surgically implanted in the spinal cord. These too are high-priced. Their efficacy is a matter of controversy.

Radiofrequency Radioablation – With this method, painful nerves are deadened. This is done through a small needle administering heat to the nerves. This works in 60% of patients and pain relief ranges from some months to years.

Prolotherpay – Prolotherapy involves injecting an irritant solution to boost up blood circulation and thereby ligament repair in the affected area. Efficacy of this method is unknown.

Specialists in Pain Management

Nowadays, health professionals in various fields complete a training course in pain management. At present, there is no specialized field of medicine dedicated only to pain management. In fact, a multidisciplinary approach is believed to be essential for managing pain.

Generally specialists in pain management are seen in disciplines, like Anesthesiology, Physiatry, Physical Therapy and Interventional Radiology.

Patients will have to remember that pain management programs come in a variety and can be confusing and at times depressing. It is therefore important to keep in touch with one’s healthcare provider and not to give up, though there is a failure in initial attempts. Though the process of pain management may be a huge challenge for those undergoing severe pain, once the patient comes across the right technique, there are high chances of his or her improvement.