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Breakthroughs in Pain Management

Breakthroughs in Pain Management


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Imagine suddenly losing the use of your hands. You're unable to comb your own hair or brush your teeth. Picture how it would be to never pick up a cup, or a flower--or your own child. Simple acts we take for granted every day, like answering a phone, would be an enormous challenge.

Dr. Shane Brogan, Medical Director of the University of Utah Health Care Pain Management Center, doesn't have to imagine this. Two years ago, he first saw a patient who suffered from a crippling work-related injury that left her disabled. Not only did she lose function in her hands, she suffered from intense chronic pain for eight years.

Teamwork for Pain Management
University of Utah's Pain Management Center provides an interdisciplinary team approach to the diagnosis and treatment of pain. It's one of only a dozen such clinics in the United States offering this holistic approach to care. Anesthesiologists specializing in pain management, and other specialists, work with nurses, psychologists and physical therapists to develop treatment plans that make it possible not only to reduce pain, but to improve overall quality of life.

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Lisa Cannon has been a writer and editor for nearly 20 years. She writes about everything from the health benefits of journal writing to the best ways to recycle computer hardware. She lives in beautiful Portland, Ore.

"We work together to try to deemphasize medication management, because it's not satisfactory in the long term," says Dr. Brogan, "especially for this patient, because she was experiencing complex regional pain syndrome." Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by continuous, intense pain that's often out of proportion to the severity of the injury. And it gets worse rather than better over time.

"When we see the patients, we all work together," says Dr. Brogan. "So the doctor, physical therapist, psychologist and pharmacologist are involved." The holistic approach to this patient's condition was a combination of spinal cord stimulation, behavior modification and functional therapy.

Spinal cord stimulation delivers low-voltage electrical stimuli to the dorsal columns of the spinal cord to block the sensation of pain. It means implanting a small system, which looks and works a lot like a pacemaker, into your body. "After we put in a spinal cord stimulation device, the patient got almost total pain relief," says Brogan. "Spinal cord stimulation has been around for about fifteen years, but in the last three years there have been a lot of advances in the technology."

Functional physical therapy (physical therapy with an emphasis on practicing day-to-day activities) can help patients regain their range of motion, strength and motor control. Physical and occupational therapists use treatments such as stretching, strengthening and hydrotherapy. And behavior modification helps patients retrain their patterns of thinking--to stop automatically responding to expected pain.

According to Dr. Brogan, just two years after treatment started, the patient has almost completely recovered the full use of her hands.

Other Pain-Blocking Techniques
All too often, pain sufferers fail to seek help in the first place because they think chronic pain is just a part of their lives, or they've been told they can't be helped. But there have been other breakthroughs in pain management.

Nerve blocks, for example, can help people with pain after surgery. Certain procedures, such as total shoulder or knee replacements and ACL reconstruction, are often extremely painful during post-operative recovery. But a nerve block can make them virtually pain-free. An injection of a nerve-numbing shot is delivered, often using ultrasound, to a group of nerves causing pain to a specific part of the body.

Intrathecal pumps make it possible for pain medications to be delivered directly into the sheath surrounding the spinal cord. The medications are more effective when administered this way because they don't circulate through the system in order to reach the cerebrospinal fluid. As a result, pain relief can be achieved using much smaller doses than are used in orally administered drugs, which reduces the frequency of side effects.

"I recently had one patient with pancreatic cancer, and he had horrible, horrible pain," says Dr. Brogan. "He needed so much pain medication, he couldn't even communicate." This patient only had a few months to live, and he desperately wanted to be able to spend the time he had left with his family, including his 6-year old son. Thanks to the intrathecal pump, he was able to dramatically reduce the amount of pain medication he needed.

"He was so improved, it became possible for him to travel," says Dr. Brogan. "He was even able to go to Sea World with his son."

To learn more about breakthroughs in dealing with chronic pain, visit the University of Utah Health Care Pain Management Center. (http://healthcare.utah.edu/paincenter/ )

Reprinted with permission from myRegence.com

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Lisa Cannon, myRegence.com Editor

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