Techniques to relieve chronic pain

Written by: Dr. José Manuel Trinidad Martín-Arroyo
Edited by: Top Doctors®

Chronic pain affects 20% of the European population and is the cause of 13% of absenteeism. The main cause of consultation in units of pain are low back pain and sciatica.

The approach of pain has changed a lot in recent years and have developed new techniques that allow more effective management. Thus, these procedures performed in units of Pain usually performed on an outpatient basis, requiring no income, and are carried out guided with fluoroscopy or ultrasound, which allows an exact location of the treatment to be performed.

All this achieves, in a high percentage of patients, sustained relief over time and improved quality of life. This improvement allows lower doses of painkillers and, in some cases, the complete abandonment of medication, thus avoiding the adverse effects that might be associated with their consumption.

Within these procedures, it emphasizes the use of radiofrequency to treat conditions such as herniated discs, back pain, shoulder pain, headache, trigeminal neuralgia, osteoarthritis of the knee, etc.. Radiofrequency in its different (conventional, pressed, cold, bipolar, etc.) modalities can address the pain through high frequency waves in the nerves responsible for collecting the pain signal there where the lesion is.

Other patients with chronic muscular contracture (myofascial syndrome) may benefit from treatment with botulinum toxin (Botox) injected ultrasound guided way. They may also resort to new therapies such as intradiscal ozone or platelet - rich plasma (PRP) can improve the approach of pain in herniated discs or joint, respectively pathologies.

Pain after spinal surgery

A more complex type of chronic pain is the post - laminectomy syndrome, also called "failed back surgery , " which occurs when a patient has been operated column back pain in the lower back and legs syndrome. This recurrence of pain is due to fibrosis or adhesions that are generated in the epidural space (space outside the meninges that protects the bone) intervened, which causes an inflammation of the nerve root (part of the nerve that is located on each side of the spinal cord). In these cases, there are more invasive treatments such as adhesiolysis or epiduroscopy.

  • Adhesiolysis: also called adhesiolysis or technique Racz, is to access the epidural space through a steerable catheter next generation to reach the site of injury. Once there, the nerve is released with an injection of drugs or serum and bipolar pulsed radiofrequency. These waves get interrupt the conduction of pain, improving the quality of life and reducing the patient's inability.
  • Epiduroscopy: diagnosis and treatment technique for more complicated cases. It is to access the epidural space with a flexible fiberoptic endoscope 3mm diameter to display real time inside the spine. Thus, the site of injury, where a balloon catheter (thin flexible plastic tube with small balloon at the tip) is introduced is located, co-ablative radiofrequency or even a laser intervention system is performed to remove adhesions cause pain.

In more complex cases, there are very specialized treatments, such as the implant stimulators or intrathecal infusion pumps drugs that can treat pain directly at the central level.

Thus, from the Pain Units are available, today, multiple tools that provide novel approaches in the treatment of pain that can become very operative with a low rate of adverse effects.

*Translated with Google translator. We apologize for any imperfection

By Dr. José Manuel Trinidad Martín-Arroyo
Pain Medicine

Dr. José Manuel Trinidad is an expert in Pain Treatment, reaching in 2016 the highest certification in his specialty, the FELLOW OF INTERVENTIONAL PAIN PRACTICE (FIPP) , awarded by the World Institute of Pain. It also has the ADVANCED Accreditation in Radiofrequency by the Spanish Society of Pain (SED).

He is currently Coordinator of the Pain Unit of the University Hospital Puerta del Mar and Director of the "Dr. Trinidad Pain Institute" in the Hospital HLA Jerez Puerta del Sur and San Rafael Hospital. He has a degree in Medicine from the University of Cádiz and a specialist in Anesthesia, Resuscitation and Pain Treatment, accredited by the Andalusian Health Quality Agency with an EXPERT level. At present, he combines his medical activity with that of researcher and teacher. Associate professor at the University of Cádiz, he also coordinates several training courses on pain management strategies and directs the course "Ecopain" in interventionism with ultrasound. As a researcher, he has participated in more than 10 international clinical trials of pain drugs. He also regularly collaborates in numerous papers and publications and has been awarded for his communications. Specialized training in Clinical Management, Quality Management and Patient Safety by the Carlos III Institute and the Andalusian School of Public Health.

*Translated with Google translator. We apologize for any imperfection

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