April 24, 2024
Chronic Pain
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Developing an integrative treatment plan for chronic pain management requires a comprehensive approach tailored to the individual patient. Here is a general outline that Dr. Garen Gajian at PARCUS in New Brunswick [NJ] considers while creating a chronic pain management plan. Each patient’s needs and circumstances are unique, so the plan is customized accordingly.

Patient Assessment

  • Thorough medical history, physical examination, and pain assessment to understand the nature and severity of the pain.
  • Psychological evaluation to assess any potential emotional factors contributing to the pain.

Multidisciplinary Approach

Collaboration among pain specialists, physiatrists, psychologists, physical therapists, and other relevant healthcare providers is crucial.

Conservative Therapies

Before considering invasive procedures, non-invasive treatments are considered. It includes – 

  • Physical therapy
  • Occupational therapy
  • Cognitive-behavioural therapy
  • Medications.

Radiofrequency Procedures

  • Radiofrequency ablation of nerve endings to disrupt pain signals.
  • Typically used for conditions like facet joint pain or sacroiliac joint pain.

Sympathetic Nerve Blocks

  • Used to treat conditions like complex regional pain syndrome (CRPS) or sympathetically mediated pain.
  • Involves injecting an anesthetic near the sympathetic nerves to interrupt pain signals.

Major Joint Injections

  • Injections of corticosteroids and local anesthetics into large joints like knees, hips, or shoulders to reduce inflammation and pain.

Peripheral Joint Blocks

  • Similar to major joint injections but targeting smaller joints.
  • Used for conditions like arthritis or joint-related pain.

Epidural Injections

  • Injection of steroids into the epidural space to reduce inflammation around the spinal nerves.
  • It is commonly used for back and leg pain due to herniated discs or spinal stenosis.

Facet Joint Injections

Injection of medication into the facet joints of the spine to alleviate pain from conditions like facet joint arthritis.

Spinal Cord Stimulation (SCS)

  • Implantation of a device that delivers electrical impulses to the spinal cord, blocking pain signals.
  • Used for conditions like failed back surgery syndrome or neuropathic pain.

Peripheral Nerve Stimulation

  • Similar to SCS, peripheral nerves are targeted.
  • Useful for conditions like peripheral neuropathy.

Monitoring and Adjustments

  • Regular follow-up appointments to monitor the effectiveness of the treatments.
  • Adjustments to the treatment plan are based on the patient’s progress and any emerging issues.

Patient Education

  • Educate the patient about their condition, the chosen treatments, and self-management strategies.

Lifestyle Modifications

  • Encourage healthy lifestyle changes, including regular exercise, balanced nutrition, and stress management techniques.

Scale of Care

  • Plan for long-term pain management and periodic reassessment of the treatment plan.

The above-integrated pain management plan is a general outline. The doctors will tailor it based on the patient’s medical history, underlying conditions, pain severity, and treatment responses. Look for a pain management specialist in New Brunswick because they have experience and can create the most appropriate and effective integrative treatment plan for chronic pain management.

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