Chronic pain can wear you down, and you may not realize how much it is affecting you until you finally find relief. At Tulane Health System Neuroscience Center, our specialists are experienced in advanced treatment and management options to relieve your pain, from medication pumps to minimally invasive surgery.
Chronic pain is a very real, unique experience. No two people will feel or show pain the same way. We’ll work with you to create an individual treatment and management plan, so you can live as pain-free as possible. Your team may include specialists in neurology, neurosurgery, physiatry, palliative care, anesthesiology, psychiatry, oncology and other fields, depending on your type and the location of the pain.
What is Chronic Pain?
Acute, temporary pain has a purpose. It can warn us of health problems that need attention or tell us if we’re using our body the wrong way. But chronic pain persists and doesn’t serve a good purpose. It could be from an old injury, illness, infection or chronic condition such as arthritis or fibromyalgia. Nerve damage to specific nerves or to the nervous system itself can also cause chronic pain.
Some people have chronic pain without any known cause. As we grow older, we’re more likely to have chronic pain — and though greeting cards and old jokes may make light of aches and pains, any pain that interferes with your life is no joke.
Common locations of chronic pain, due to a variety of causes, include:
- Back and neck. Chronic pain in the back and neck can be due to conditions such as spinal stenosis, herniated (ruptured) disk or degenerative disk disease.
- Head. Migraines, cluster headaches and tension headaches may be the cause of head pain, as can neurological conditions such as Chiari malformation.
- Face. Occipital neuralgia, atypical facial pain, trigeminal neuralgia or a complication of shingles can all cause face pain.
- Arms and hands. Chronic pain in the arms and hands can be caused by cervical radiculopathy, ulnar nerve neuropathy, complex regional pain syndrome or peripheral neuropathies.
- Chest and torso. Surgery, chronic angina or a complication of shingles can cause chest and torso pain.
- Abdomen. Pain in the stomach can be caused by chronic pancreatitis, visceral pain or post-surgery pain.
When Should I Seek Help for Chronic Pain?
Any time you have pain that can’t be explained, you should tell your doctor. Any kind of pain can be a sign that something is wrong and needs to be addressed.
When pain becomes chronic and you can’t find lasting relief, you’re at higher risk for depression. You may not rest well, and you may have a hard time focusing on the things you need to do or enjoy doing. Your pain can even affect those you love.
If you’ve had pain for three months or longer, you owe it to yourself to explore options for controlling it so you can live the way you want.
How is Chronic Pain Treated and Managed?
Just as pain isn’t the same for everyone, neither is pain management. Today’s treatment options are diverse — and are helping millions of people live more fully and comfortably.
Treatment depends on the type and location of the pain, and other factors such as your age, general health and personal preferences. Some common treatments for chronic pain include:
- Medication. Medicines can be oral or injected. They can include anti-depressants, non-steroidal anti-inflammatory drugs (NSAIDs), opioids and other medicines for specific conditions.
- Pain pumps. These small devices can be implanted to continuously deliver a precise dose of pain medicine to a targeted area. It can often provide better pain control than medicines taken orally. You may be able to stop taking oral medicines or take less of them.
- Spinal cord stimulators. Also called a dorsal column stimulator, this device is implanted under your skin to send a mild electric current to your spinal cord through a small wire. It can often help decrease pain so that you can take less pain medicine or stop taking it completely.
- Nerve blocks. This involves injections of pain-numbing medicine into nerves that cause pain to a specific area of the body. The site of the injection depends on the location of the pain.
- Surgery. Surgery can repair or reduce problems that can cause chronic pain, particularly in the neck or back. Most procedures are minimally invasive, preventing the need for large cuts and long recovery times.
- Microvascular decompression. This surgical procedure relieves symptoms caused by compression of a nerve by an artery or vein.
- Percutaneous trigeminal rhizotomy. This stereotactic surgery can relieve nerve pain by destroying the part of the nerve that’s causing distress and by suppressing the pain signal to your brain.
- Physical therapy. This can improve function and flexibility. Many people benefit from therapy in combination with other care.
Below are treatments for some common pain locations:
- Back and neck problems, such as a herniated (ruptured) disc, are among the most common reasons for seeking help for chronic pain. Our specialists are leaders in treating back and neck pain nonsurgically or through minimally invasive procedures. Medication, nerve blocks and physical therapy can often help dramatically. If surgery is needed, most procedures are minimally invasive, meaning the surgery is completed through tiny incisions. For instance, doctors can use advanced techniques to remove part of a herniated disk, or replace the entire disc to keep it from pressing on nerves and other structures.
- For abdominal pain, medication may be the best answer. In some cases, a celiac plexus block can help control pain from chronic pancreatitis and other painful conditions. A celiac plexus block is a nerve block injected around the nerves surrounding the aorta (the main artery in the abdomen). The effect can last for hours or days, and usually lasts longer each time.
- Hand and arm pain is often treated with steroid injections or other medications. In some cases, surgery can provide lasting relief.
- Chronic chest pain can be treated with a variety of medicines or surgery, depending on the cause.
For almost any kind of pain, alternative treatments and techniques, such as yoga and acupuncture, might reduce your perception of pain and help you feel more comfortable and at ease. Many alternative treatments can be safely combined with more conventional pain care.
Whatever the source of your pain, we’ll work with you to find the right mix of treatment options to eliminate or manage it safely and effectively.
Many resources are available to help you learn more about your chronic pain, treatment options and self-care. You may also benefit from connecting with others who are dealing with chronic pain. Here are some places to start:
- Medline Plus from the National Institutes of Health and the National Library of Medicine
- National Institute of Neurological Disorders and Stroke chronic pain information page
- American Chronic Pain Association