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    Pain Management Q&A

    Marjorie Oropilla, MD Deaconess Comprehensive Pain Centers 04/10/2014

    When someone is in pain, it affects every aspect of their life, and can lead to many questions about how to address pain.  Below, I’ve provided answers to some of the most common questions I receive as a pain management specialist.
     
    Q. What types of pain do you treat?
    A. The Deaconess Comprehensive Pain Centers treat patients who have chronic pain or patients who have been in pain for over 3-6 months. Most of our patients are referred to us by their primary care physicians or surgeons. The most common types of pain that we treat include back, neck or joint pain.
     
    Q. How is a Pain Management Specialist different than my doctor?
     A. Primary care physicians are an important part of the pain treatment process, and in many cases, they can provide the care you need.  There can come a time when your doctor may decide that specialized care is needed. At Deaconess Comprehensive Pain Centers, we offer a comprehensive approach to pain management. That includes a detailed medical history, review of past treatment records, and a complete physical examination, focusing on the areas that are causing pain. We offer medications and procedures that help relieve the pain. A large part of pain management involves physical therapy; we also offer counseling and nutrition information.
     
    Q. Occasionally, patients recover from surgery, but the pain is still there. Why is that?
    A. It could be the result of scar tissue that has developed, deconditioned muscles or permanent damage. There could be a variety of reasons. This is why we recommend physical therapy, to recondition and strengthen muscles so that they can best support the body.
     
    Q. What are common causes of pain?
    A. Pain can come from problems with bones, muscles, tendons, ligaments and skin. It can also be caused by nerves, which is called “neuropathic pain.” Pain that comes from nerves is usually described as burning, numbing, or electric type pain that might be a "shooting" pain. Pain from muscles and tendons would be described as stabbing, throbbing, achy, dull or pinching. It is important that you can describe your pain and tell us where it is coming from. Treatment approaches can be different for different types of pain.
     
    Q. I have a lot of back pain. What should I do?
    A. You will need to be evaluated by your primary care physician first, to determine the potential causes of your pain. Not everyone who has back pain needs to be treated by a pain specialist. Most back pain can be treated by your primary care physician. Research shows that 90% of back pain episodes resolve within 6 weeks regardless of treatment.
     
    Q. I am worried about (someone) who constantly talks about all the pain she has. I told her she needed to see her primary doctor but she didn't think she should. She feels she should learn to "live" with the pain. I told her about how important her quality of life should be to her. How do you know if your pain is serious enough to see a doctor? Is there pain that you should just ignore? Any ideas of anything else I might suggest to her to help persuade her to see her doctor?

     
    A. All pain should not be ignored.  Pain is the way your body tells you something is wrong. You should see a doctor if you have had a recent trauma, like a fall. Patients who have a history of cancer who have new pain should be assessed. Any new pain that doesn’t seem to resolve itself through over-the-counter medications, or home therapies like heat or ice, may be a problem. Any of these things could suggest a bigger issue and need to be evaluated.
     
    Q. Does lumbar support help with back pain?
    A. It can offer temporary relief, especially in acute back pain. If you are having muscle spasms it helps to immobilize the area by decreasing the spasms in that area. We do not recommend using it on an ongoing basis. It can weaken the back muscles in the long run. The main point to remember about pain is that if you are having pain for several days and it is affecting the functions of your daily life, you need to be evaluated by your primary care doctor.
     
    Q:  Can a pain management specialist relieve my pain completely?
    A: One of the misconceptions about pain management is that we can make the pain totally go away for all patients. Sometimes we can treat the cause of the pain to help it go away completely, but many times we have to be realistic and work to manage pain to acceptable levels so the patient can still function in their daily life.
     

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