| Headache & Pain Management Center of | | | | Physical therapists and chiropractors, |
| Palm Beach | | | | psychologists, massage therapists and |
| Medical conditions manifesting as pain account for | | | | acupuncturists may be involved in treatment as |
| 80 % of physician visits and pain costs Americans | | | | well. |
| $120 billion in expenditures yearly. With this in | | | | A persisting myth about patients in chronic pain is |
| mind, it is astonishing that only recently has pain | | | | that it's "all in their heads." For reasons mentioned |
| management entered the medical school | | | | above, severe pain may indeed persist without |
| curriculum and gained status as a legitimate | | | | any visible signs of injury or disease. There are |
| medical specialty. Despite great strides in medical | | | | intimate connections between the pain pathways |
| research and technology, the mechanisms which | | | | in the brain and spinal cord, and the portions of |
| make pain a problem in the human body are just | | | | the brain involved in mood and emotions. As a |
| now being explained. | | | | result, many victims of chronic pain suffer |
| The nervous system consists of nerve circuits or | | | | depression as well. This may give a false |
| pathways, some of which exist to warn of injury | | | | impression that depression is the primary problem |
| or damage to the body and to enable one to | | | | and the pain is imagined. This approach has been |
| react to prevent further trauma. The warning sign | | | | an obstacle to many chronic pain patients. In any |
| that we are all familiar with is the pain message. | | | | case, treatment for depression or anxiety is |
| Acute pain is often a useful sign of underlying | | | | sometimes required, whether it is a result of |
| injury or disease that needs to be treated. | | | | chronic pain or it was preexisting. Interestingly, |
| However, recent research shows that with | | | | many of the older antidepressant medications help |
| continued activation of "pain nerves" come | | | | chronic pain in non-depressed patients, particularly |
| abnormal changes in nerve connections and | | | | in cases due to nerve injury. Thus, it is important |
| braispinal cord chemical messengers which allow | | | | to recognize that pain is not just a physical |
| the pain message to persist, even if the initial | | | | phenomenon, that it affects multiple brain areas. |
| trauma has healed. This results in chronic pain, | | | | This idea creates the framework for a |
| which is much more difficult to treat than pain | | | | multidimensional approach to pain treatment. |
| from acute injury. As opposed to most instances | | | | Other barriers to the effective treatment of pain |
| of acute pain, chronic pain is not useful and can be | | | | stem from outdated attitudes about pain |
| considered a disease in and of itself. In fact, | | | | medications and their tendency to cause addiction |
| recent studies show that the effective treatment | | | | (psychological dependence). All opioid medications |
| of acute pain can prevent chronic pain from | | | | ("pain killers" related to morphine or codeine) have |
| developing. Thus, measures to prevent | | | | the potential to result in physical dependence with |
| post-operative pain are being taken even before | | | | long-term use. But studies have shown that very |
| a patient goes to surgery. Physicians are learning | | | | few patients with chronic or cancer pain actually |
| that it is more effective to treat painful conditions | | | | become addicted. Better education of physicians |
| early on, rather than waiting until the chronic pain | | | | and patients, as well as guidelines issued by |
| becomes a disease in and of itself. This is | | | | governmental agencies, have led to more |
| particularly true for conditions such as reflex | | | | effective treatment of cancer pain in particular. |
| sympathetic dystrophy, nerve injury, fibromyalgia, | | | | Managed care has not adequately addressed the |
| and post-traumatic pain states. | | | | treatment of chronic pain. Limitations are set on |
| Chronic headaches afflict a large proportion of the | | | | utilization of certain treatments, but there is no |
| population. New, very effective medications are | | | | consensus on what types of programs are |
| available to treat migraines. However, in many | | | | effective (as well as cost-effective) for treating |
| patients with very frequent headaches, medication | | | | patients with these conditions. In some settings, |
| may actually be the problem. The regular use of | | | | the multi-disciplinary approach has been shown to |
| medication to relieve the pain of headache can | | | | provide better outcomes (better functioning, less |
| result in "rebound headache" with increasing | | | | long-term reliance on the medical system, less |
| frequency of headache episodes. In such cases, | | | | pain medication required) but most insurance |
| the answer may lie in modification of lifestyle and | | | | companies do not cover such comprehensive |
| dietary habits as well as other preventative | | | | care. |
| measures. | | | | Whether you suffer from headaches, back pain, |
| The effective relief of many pain conditions | | | | neuralgia, neuropathy, fibromyalgia, RSD or |
| requires an accurate diagnosis in order to find the | | | | abdominal or pelvic pain, no single treatment is |
| most appropriate treatments. Depending on the | | | | effective for all conditions. Some types of pain do |
| exact symptoms, this may involve examination | | | | not even respond to strong pain medications. |
| by various specialty physicians, x-rays or MRI, or | | | | Depending on your diagnosis, other medical |
| electrical nerve and muscle tests, among others. | | | | conditions, age, and personal preferences, |
| Then patients can enter a treatment program | | | | treatment may include medications, physical |
| customized for their particular needs. This usually | | | | treatment, electrical nerve stimulation, nerve |
| requires a multidisciplinary approach, meaning there | | | | blocks (injections of numbing medication or |
| must be a team of medical professionals from | | | | cortisone), counseling, or other modalities. The |
| various specialties who work together to provide | | | | effect of a healthy lifestyle on chronic pain is well |
| whatever treatment is necessary. | | | | known. A fit body and good attitude can affect |
| Anesthesiologists, neurologists and neurosurgeons, | | | | the endorphin/enkephalin brain chemical systems |
| orthopedic physicians, psychiatrists, | | | | which can act as natural pain killers. A good diet, |
| rheumatologists, and rehabilitation physicians are | | | | regular exercise, and an active life are useful |
| among the specialists who have become | | | | adjuncts to other modalities of pain treatment. |
| advocates for patients suffering from pain. | | | | |