For many people, managing chronic pain is a constant undertaking. It's hard to know which treatments to rely on—how much to depend on pain medication versus other options, when to turn to spine surgery, which type of spine specialist to see, and more.
Watch: Epidural Steroid Injections Video
Careful attention to pain management is a critical component of your recovery. Chronic back pain can lead to overwhelming problems in everyday life and in maintaining an active rehabilitation program, which in turn can make your pain worse.
Back pain problems are often complex
Compared to other medical conditions, there are relatively few standardized approaches to the diagnosis and treatment of back pain. While some diagnoses are relatively straightforward (such as spinal tumors, infections, or fractures), for many spine conditions there is little agreement among spine specialists about a diagnosis and treatment plan. Therefore, it's important for you to take a proactive role as much as possible in finding and maintaining a pain management approach that works for you.
Pain management is often a process of trial and error
Pain is experienced very differently for each individual, and the effectiveness of a particular treatment will often differ from person to person. For example, an epidural steroid injection for a herniated disc may provide instant pain relief for some people but not for others. While it can be frustrating at times, it's important to remember that it may be necessary to try several treatments before you find what works best for you.
The treatment of pain often boils down to a trial and error process.
Chronic pain is different from acute pain
Unlike acute pain, the level and extent of chronic pain does not reflect the extent of tissue damage.
For example, severely degenerated discs may not produce much pain at all and discs with little degeneration can produce severe pain. Therefore, your physician cannot merely rely on an imaging scan to see what is causing your pain; a clear description about the level and nature of your pain is essential for an accurate diagnosis and appropriate treatment plan.
Pain medicine is a medical specialty
Many types of physicians, like anesthesiologists, neurologists, and physiatrists, complete specialized fellowship training in pain management after their residency and other training is completed.
A pain medicine specialist who treats back pain may be a medical doctor or a doctor of osteopathic medicine and usually practices in a pain clinic or an integrated spine clinic.
Some spine surgeons also specialize in pain management. While the majority of spine surgery is performed to correct an anatomical lesion (which in turn should relieve pain), these surgeons also perform surgery focused just on treating chronic pain.
Typical surgeries may include implanting spinal cord stimulators or pain pumps to relieve chronic pain that has not responded to other treatments. Many patients who have this done have already had back surgery but it has not relieved their chronic pain (failed back surgery syndrome).
Some pain management treatment options include medications, different types of injections and prolotherapy for chronic back pain. For more information on these treatments, see below:
Don't forget to take good care of your emotional health
Chronic pain can interfere with all aspects of your life, including your emotional health.
Dealing with severe pain can naturally lead to depression, sleeplessness, feeling too overwhelmed to continue with treatments, etc., and it's often as important to seek appropriate treatment for these symptoms as it is for your symptoms of physical pain.
Psychologists who specialize in helping people cope with chronic pain can be an essential part of a comprehensive treatment program. Many integrated spine clinics have a psychologist who specializes in chronic pain on staff, and most physicians can refer you to one.
While dealing with severe pain is a difficult experience physically, emotionally, financially, practically, and in many other ways, it will help if you can try to proactively manage the process of seeking medical attention for your pain as much as possible. Ultimately, participating in the decision-making process about your medical care should help you find more effective pain relief and have a better experience overall.Visit our Pain Management Forums to connect online with people who know what you are going through.