For many patients, initial efforts to relive pain involve home remedies such as the application of heat or ice or the use of over-the-counter medications. If these attempts at managing pain aren't cutting it, other conservative (non-surgical) and surgical pain management techniques may be worth considering. The goal with any type of pain control or management is to bring discomfort down to a level where it has less of an impact on quality of life. Here are some forms of pain management that may be right for you.
Platelet Rich Plasma Injection
Using a patient's own blood, PRP injections are sometimes given around joints to speed up the body's natural healing process after an injury. It's believed that the extra concentration of platelets helps with tissue regeneration.
Often recommended for the management of pain from knee osteoarthritis, visco supplementation involves the injection of a lubricating fluid directly into the affected joint. The shots include hyaluronic acid, a lubricating fluid naturally found around joints. The injection helps by making it easier to move the affected joint.
Nerve Blocks and Joint Injections
Pain management may involve several different injections directly into the affected area in a mix that usually includes a local anesthetic to ease discomfort from the shot. Cervical and lumbar epidural blocks are placed into the epidural space where small blood vessels are located in the neck or lower back. Injections to ease spine pain or radiating nerve pain may also include:
Sympathetic Nerve Blocks
Sympathetic nerve blocks specifically target nerves within the sympathetic nervous system, which controls involuntary body functions. Like most nerve blocks, sympathetic nerve blocks may be used to accurately determine a patient's source of pain or for therapeutic purposes to ease pain caused by some type of nerve irritation.
Dorsal Column Stimulators
Controlled by the patient with a remote control, a dorsal column spinal cord stimulator is an implantable device that uses electrical impulses to manage back pain. It may be suggested as a pain management tool when a patient doesn't have the desired results from spine surgery (failed back surgery syndrome).
With a percutaneous discectomy, small instruments are inserted between the vertebrae and the middle part of a disc to remove material that's pressing on nearby nerve roots. This procedure is meant to manage pain from a herniated disc in the lower (lumbar) spine).
Also referred to as a discogram, a discography is a diagnostic procedure done to determine which disc is causing a patient's back pain. A sterile liquid is injected into one or more discs suspected of being a source of pain.
Surgery for Pain Management
If other attempts at pain relief aren't successful or effective enough to improve quality of life, surgery may be recommended. Minimally invasive spine surgery involving smaller incisions may be performed to remove a disc that's damaged (herniated), fix a spinal fracture with a balloon and a special type of cement (kyphoplasty), or perform a fusion of two adjacent vertebrae to improve or maintain spinal stability (cervical and lumbar disc fusions). Specific procedures may include:
The specific type of pain management that's right for you will depend on several factors, including the identified or likely source of your discomfort and the severity of the symptoms experienced. Surgery is rarely a first consideration for any type of pain relief unless the pain is severe and debilitating or not responding well to other management attempts. Increase your odds of seeing meaningful results by having realistic expectations and discussing your goals with your doctor.