Pain can be experienced in different ways. For example, it may be
- Dull or sharp
- Spread throughout a wider area or localised (in one specific place)
- Intermittent or constant
Chronic pain can be incredibly hard to cope with and can take a heavy physical, mental and emotional toll. It can easily lead to anger, depression, frustration and close relationships can be affected. While loved ones will usually try to support you to the best of their ability, it is often incredibly hard for them to understand and appreciate the reality of what you are going through and the effect it is having on you. This can often end up putting quite a strain on close relationships.
A Consultant in Pain Medicine may use different treatments to help relieve your pain. These can be split into two categories – medication and interventional procedures.
Pain management – medication
Effective pain relief medications can be helpful for many people, but it needs to be at the correct dose and frequency to provide the best results. A Consultant in Pain Medicine will be able to investigate the different combinations and dosages available in order to formulate the best treatment plan for you.
Different types of pain medicine work in different ways. For example, pain caused by inflammation will often respond best to an anti-inflammatory drug, or a combination of paracetamol and an opioid (a strong painkiller with a similar effect to morphine). Pain caused by a nerve problem will most usually require medication that desensitizes the affected nerve.
Pain management – interventional procedures
Interventional procedures may be carried out for certain symptoms and conditions, or if pain medication isn’t able to adequately manage symptoms. Interventional procedures include:
- Nerve blocks
- Nerve root blocks
- Facet joint injections
Nerves can be thought as the messenger system of the body, transmitting electrical impulses around it. A nerve block deliberately interrupts the signal in specific nerves to try to help relieve pain. This can be done with medication or surgery.
A nerve root block involves injecting an anaesthetic (and usually a steroid) at the point a nerve leaves the spinal cord (this is known as the nerve root). The anaesthetic relieves the pain, the steroid reduces inflammation. A nerve root block will usually be done under X-ray guidance.
Facet joints are small joints in the spine that join back bones (vertebrae) together. A facet joint injection involves injecting an anaesthetic (and again, usually a steroid as well) into a facet joint.
These injections can be diagnostic, to help confirm the cause of your pain, or therapeutic, to treat the pain for a longer time.
Pain management is an extremely important area of medicine. It is important to know that some pain cannot be cured, but your consultant will ensure you receive the most effective treatment for your specific condition to deliver the best possible pain relief
Because of the complexity of pain management, it often overlaps many other areas of medicine, like neurology and orthopaedic surgery. Your consultant works closely with other experts like orthopaedic surgeons to ensure you receive treatment from the most appropriate specialist.