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    Chronic Pain and the Deaconess Comprehensive Pain Center

    Brittney Fulcher, NP NP from the Deaconess Comprehensive Pain Center​​ 06/10/2014

    Tens of millions of Americans suffer from chronic pain. This pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating.
    At the Deaconess Comprehensive Pain Center (DCPC), we serve patients with chronic pain caused by a wide variety of medical issues:

    • Headaches
    • Cancer-related pain
    • Peripheral neuropathy
    • Myofascial pain syndrome
    • Complex regional pain syndrome
    • Spinal spasticity
    • Traumatic/Sports Injuries
    • Post herpetic neuralgia

    Sports Injuries
    Sports Injuries, both new and old, are one of the most common conditions we treat. We offer a combination of services to help control your pain and address the underlying cause of that pain. Your physician will work with you to determine which of the follow approaches will have the best results.

    • Oral medications (pain control and for nerve stabilization to help address tingling or other unwanted sensations)
    • Topic anesthetics (creams, ointments, etc. for numbing and muscle relaxation)
    • Nerve blocks (to stop pain and feeling in a particular nerve)
    • Physical and occupational therapy, which is offered on site.

    Back Pain
    Back pain is a common condition we treat and will affect 90% of all Americans at some point in their lives.

    Causes of back pain are varied, and include:

    • Mild to significant muscle strain
    • Degenerative disc disease as a result of aging
    • Injury/trauma
    • Post-surgical pain from previous back surgery
    • Cancer spreading to bone
    • Other disease processes, such as scoliosis or osteoporosis
    • Poor posture, which can lead to weakened muscles that don’t support the back

    We utilize a variety of treatment options in the treatment of back pain. They include:

    • Oral medications, for pain control and for nerve stabilization to help address tingling or other unwanted sensations
    • Topic anesthetics, such as creams, ointments, etc. for numbing and muscle relaxation.
    • Nerve blocks (to stop the sense of any feeling in a particular nerve)
    • Physical therapy is a huge component of back pain treatment. Stretching, core strengthening, and exercises specifically to strengthen back muscles are all part of the comprehensive P.T. plan.

    Other options for back pain involve specialized procedures and surgery.

    • Spinal cord stimulation - The insertion of an electrode that replaces a painful sensation with a pleasant sensation.
    • Epidurals - An epidural for back pain works in a similar way to epidurals used during childbirth. Numbing medication is delivered near the source of the pain. Steroids are part of this process as well, as they help reduce the swelling and inflammation around the nerve.
    • The MILD procedure - Minimally-Invasive Lumbar Decompression (MILD). This procedure is for people suffering from pain related to spinal stenosis (a change in the structure that narrows the spinal column). The MILD procedure helps reduce narrowing and relieves pressure on the nerves. Patients who have had trouble walking or standing for any length of time (due to their spinal stenosis) have reported less pain and a return of mobility.

    Pain at the Site of a Healed Incision
    This kind of pain can often be a result of either nerve damage, or from the development of scar tissue.

    It can also be diagnosed as complex regional pain syndrome, which means that while the body has healed, nerves are still sending out abnormal pain signals.

    This pain is often addressed via topical treatment, as well as nerve stabilizing and numbing treatments. (If these treatments don’t work, there are other procedures to consider.)

    This pain can get worse if not treated, so anyone with pain after surgery or pain after an injury has healed, should speak to their physician.

    Possible Treatment for Shingles
    Shingles is a very common cause of pain. Many people develop shingles from the chickenpox virus which has been dormant in their body for years after having it earlier in life.

    Shingles is a flare of a particular nerve or set of nerves together, where the nerve’s inflammation causes a painful rash. Prior to the rash showing up, the feeling can be a burning, tingling, “creepy-crawly” sensation. Many people say they can’t stand clothing or anything else touching the area.

    Treatment for shingles includes topical anesthetic creams, nerve blocks, steroid injections, and other options for reducing the sensation of pain.

    Most of the time, when a patient develops shingles, they first see their primary care doctor for treatment, and he/she will prescribe antiviral medication and an anesthetic patch to apply to the site of the shingles.

    This is often all that is needed. But sometimes, those painful sensations continue even after the rash is gone. That ongoing pain is called post-herpetic neuralgia. At that point, a person’s primary care doctor can provide a referral (such as to DCPC) for more in-depth treatment options.

    Headaches have a variety of causes, and therefore, a variety of treatments.

    Depending on the cause, the following treatment can be provided:

    • Occipital nerve blocks, to numb the nerve that often causes headaches
    • Cervical medial nerve blocks, which numb nerves in the neck--and reduce inflammation--that can be causing headaches
    • Oral medications
    • Physical therapy is always part of the treatment of headaches. It helps to strengthen the neck muscles, helping to reduce pressure and muscle spasms

    Finally, pain is a combination of physical and emotional factors. Ongoing, chronic pain can take its toll on patients both physically and mentally. A social worker may be an essential part of your care plan and help you develop personal strategies to deal with your pain.  A dietitian may also have a role in your care plan if weight reduction is necessary. Many times, pain can be caused or aggravated by too much body weight causing stress on joints.

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