Q- What
is pain?
Ans- Pain is a protective/safety system of the body, where
the nerves conveying pain signals to the brain, warn of impending or on-going
injury/insult to the body and to take appropriate action.
Q- What is Chronic Pain?
Ans- Chronic pain is the pain that lasts more than 3-4
months and is unresponsive to conservative treatment (Medications, physical
therapy).
Q- What are the consequences of
pain?
Ans- Chronic pain not only causes physical & mental
suffering but also adversely affects family, social and professional life.
Q- What happens if pain becomes
chronic?
Ans- Treating pain promptly can prevent it from turning
into hard-to-treat chronic pain, when the nervous system becomes
hypersensitive. Many times pain lasts beyond healing; when errant nerve
impulses keep alerting the brain about tissue damage that no longer exists.
Q- Who treats pain?
Ans- Large number of generalized aches and pains responds to
simple pain-killers but should be used with caution in patients with
kidney/liver diseases/gastritis.
Moreover these conditions, to a large extent, are as a
result of misuse or excessive use of pain-killers. Patients with obvious
surgical conditions like trauma/ tumour etc. will need surgery. However large
number of patients, who were earlier treated with surgery, like sciatica, are
now very well treated with minimally invasive procedures, by pain physicians.
Most neuralgias and neuropathies {Diabetic neuropathy/Trigeminal/ Occipital
neuralgia/ nerve entrapment/ischemic pain (due to poor blood supply)/abnormal behaviour
of nerves} will need specialized pain management; when only medications fail or
produce unacceptable side-effects.
Q- How pain specialists treat
pain?
Ans- Pain specialists are specially trained physicians,
who diagnose exact source of pain or pain generators. For example back/leg pain
can be due to muscles/ligaments, joints (facet joints/sacroiliac joints), tear
in disc (annular tear/fissure), disc prolapse, Pyriformis syndrome etc; each of
which require different treatment modality. Pain physicians non-surgically
(Called Interventional Pain Management or IPM) deliver healing/numbing
medications to the target. These procedures are generally safe in expert hands.
Q- Are any specialized equipment’s
or devices used for managing pain?
Ans- Common pain interventions are performed in OT, using
special imaging equipment’s / contrast media & vital sign monitoring.
However when the numbing medications at the pain source do not produce lasting
effect, the offending nerves are destroyed with Radiofrequency generator; after
testing and saving useful nerves. In few cases of intractable pain, a pacemaker
like device, called Spinal Cord Stimulator with cordless remote control, is
implanted inside the body, which converts the pain message to a pleasant
feeling (Neuromodulation). In advanced cancer patients and patients with
multiple sources of pain, pain medications are delivered directly into the
central nervous system in the spinal cord, through an implantable device
(Intrathecal Pain Pump with remote control) that needs only 1/300th of oral
medications, thereby drastically reducing side-effects and providing excellent
pain relief.
Q- Where can I find a pain
specialist?
Ans- Pain specialists run pain clinics in majority of
large hospitals in western countries but only in a few selected hospitals in
India.
Q- What are the side effects
& complications of Interventional Pain Management?
Ans- Like any drug or medical therapy, Interventional Pain
Management has its share of side-effects. However they are very minimal in
expert hands and mostly due to technical reasons. Drug related complications
are very few. The amount of drug used is very less, it remains at the target
site and does not circulate to other parts of the body.
Q- What next if IPM fails?
Ans- In some situations, like in long standing back pain where
the prolapsed disc has hardened, surgery will be required.
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