At MedStar Orthopaedic Institute, our pain management physicians specialize in interventional pain management techniques to help alleviate pain. These procedures may nerve blocks or the injection of medicine at the target site, to help relieve symptoms and give patients an improved quality of life.
Read the answers to many common questions you may have below:
Do I need to see a specialist for my pain?
Certain types of pain require the attention of a medical specialist, such as a neurologist, physiatrist, orthopedic, spine, or shoulder surgeon. There are also doctors who specialize in treating pain, as well as pain clinics that offer comprehensive pain management programs. Finding the right doctor and the right pain management program is critical to the success of your treatment. MedStar Franklin Square has pain specialists that are trained in the latest treatment and pain relief techniques.
What is chronic pain?
Chronic pain is pain that continues a month or more beyond the usual recovery period for an injury or illness or that goes on for months or years due to a chronic condition. The pain can interfere with daily life at all levels.
What is your practice philosophy?
The first step is to identify the source of pain, through the use of careful history, physical exam, review of medical records, imaging studies, test results, and labs. Once the cause has been determined, we develop a treatment plan tailored towards the needs of that specific condition. It is difficult to completely eliminate pain, but we set goals towards improving functionality and quality of life. We want our patients to be able to live the lives they want to live. We use interventional techniques to target the source of pain, physical therapy to replenish strength and gait analysis, electrical stimulation with devices such as TENS units, biofeedback, acupuncture, hot and cold treatments, conservative medication management with anti-inflammatories, muscle relaxants, nerve stabilizers, anti-depressants, and, when indicated, low dose opioids.
What are interventional modalities in the management of chronic pain?
Interventional modalities are procedures that target the source of pain. Our procedures are all performed in our newly renovated procedure suite with our hand-selected nursing care team. Most of our procedures are image guided through the use of ultrasound or fluoroscopy with an X-ray technician. We perform a wide variety of techniques, such as trigger point injections for muscle spasms, occipital nerve blocks and BOTOX® injections for headaches, joint injections for arthritis pain, nerve blocks for arthritic pain originating from the joints of the spine, radio frequency ablation to lesion nerves involved in pain signaling, epidural steroid injections for pain arising from disc bulges and nerve root impingements, sympathetic nerve blocks, neurolysis to chemically destroy nerves involved in cancer pain, spinal cord stimulation for post-laminectomy pain.
We continuously research and study to stay updated on the most advanced techniques. Ask your doctor if interventional techniques would be helpful.
Is there a role for psychiatry in pain management?
Pain can make you feel sad, angry, vulnerable, and lonely - or a host of other negative emotions. In turn, these emotions can exacerbate pain. Many people have learned to cope with these emotions through professional counseling or patient support groups. MedStar Othopaedics has many of these services.
People respond to pain in different ways. Some people even believe that acknowledging pain is a character weakness. Keep in mind that pain is a medical condition. You should expect to be treated for pain just like you expect treatment for other medical problems.
What non-prescription medications are available to reduce pain?
Over-the-counter (OTC) drugs like aspirin, acetaminophen (Tylenol), and ibuprofen (Advil) are all marketed as pain-relief medications. To decide which of these FDA-approved drugs is best for you, you should consult with your physician and read the label for side effects. Don't ignore the label when taking a nonprescription medicine. When it comes to medicines, more does not necessarily mean better. You should never misuse OTC medicines by taking them longer or in higher doses than the label recommends. Symptoms that persist are a clear signal it's time to see a doctor.
Will pain medicine help me?
Several types of pain medications are available to relieve pain, including NSAIDS, neuropathic agents, muscle relaxers, opioids but not all pain medications work effectively in all people or are recommended for all conditions. Work with your doctor to find the treatment plan that's best for you. Keep in mind that medication is only one aspect of effective pain management. Ask your doctor if non-drug treatments, such as physical therapy, exercise, or relaxation techniques would be helpful.
Do pain medications cause side effects?
Most pain medications cause side effects, some more serious than others. The commonly prescribed NSAID pain relievers irritate the lining in the stomach and intestines, which can cause ulcers or gastrointestinal bleeding. Side effects of other commonly prescribed pain drugs include constipation, drowsiness, nausea, vomiting, or dizziness. Sometimes side effects occur when you begin therapy and go away after your body gets used to the medication. Certain types of pain medicine can also cause physical dependence.
Do pain medications cause seizures?
Although uncommon, there is a risk of seizure associated with some pain medications. It is important to tell your health care professional if you previously have had a seizure and if you are taking opioid analgesics or medications commonly used to treat depression (e.g., amitriptyline, fluoxetine). Also, taking pain medications above the recommended dosage increases the risk of seizures.
Should I take other medication to manage the side effects of my pain therapy?
We do not recommend doing this. While taking medications to relieve the side effects of pain therapy may offer temporary relief, it could also disguise a serious medical problem. Many patients, for example, take antacids or acid blockers to ease stomach distress caused by NSAIDs. However, masking gastrointestinal symptoms can lead to critical delays in detection and treatment of emergency complications, such as ulcers.
Will I become addicted to pain medication?
Unfortunately, addiction to pain medication is a real and dangerous concern. 15,000 to 18,000 U.S. deaths per year are attributable to prescription opioid overdose. Certain pain medications can cause physical dependence, which means the patient may feel flu-like symptoms or have other withdrawal symptoms when medication is stopped. In most cases, these symptoms can be avoided through gradual weaning based on increasingly smaller doses.
It's important to understand that physical dependence does not mean abuse or addiction. Certain pain medications can be abused in order to get high or for effects other than pain relief. Addiction is a psychological problem that compels people to abuse pain drugs are requires treatment with addictionologist and substance abuse centers. If you have concerns of addiction, please discuss with your provider.
Do you recommend chronic opioid therapy?
Unfortunately, the evidence for long term chronic opioid therapy is poor in most situations due to well-established side effects, including immunosuppression, endocrine abnormalities, constipation, sedation depression, and worsening pain from opioid-induced hyperalgesia. While we will prescribe opioids in certain situations when clinically indicated, we extensively evaluate our patients, keep dosages low, and seek other ways to control pain.
We do not recommend opioid therapy for fibromyalgia, headache, self-limited illness, uncomplicated back and neck pain, uncomplicated musculoskeletal pain, or abdominal and pelvic pain.
Can I take nonprescription pain relievers in addition to prescription pain drugs?
Sometimes, people have intensified bouts of pain that are not controlled by otherwise effective pain therapy. If this happens, you may be tempted to take nonprescription drugs for added relief. But first ask your doctor or pharmacist if it's safe. Combinations of certain pain relievers could cause serious problems.