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Why we care about pain part 2: Does pain management make a difference?

December 14, 2020 | Kevin Wininger, RT(R)

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Last week I discussed what pain is and a few benefits of staying as mobile as possible. For my final installment in this series, I shed light on the role of pain management.

Part 2: Does a pain management plan make a difference?

Medical imaging is closely utilized for developing an appropriate pain management plan. For instance, MRI exams assist doctors in making determinations about the reasons for and the severity of your pain, especially if the pain is located in your spine, hips, shoulders, or knees. In some cases, however, a short course of a non-steroidal anti-inflammatory drug as well as several physical therapy sessions may be recommended before the MRI exam is suggested. In other cases, CAT scans might be a better alternative as well as basic x-ray films.

What’s more, image-guided pain management is a branch of medicine unto itself. In fact, treatment plans initiated by an image-guided pain management doctor can cover multiple medical disciplines in an interconnected and comprehensive way. The goals are aimed at 1.) reducing your pain complaints; 2.) offering non-surgical interventions; and 3.) improving mobility. A referral to a doctor who specializes in this field is important as early as possible to tackle pain-related issues as soon as possible. Yet, consultations are beneficial during any period in the subacute to chronic phase timeline (from 6 weeks to beyond 3 months).

Doctors utilizing image-guidance, such as x-ray or ultrasound technologies, for injections that treat pain will specifically target the source of pain with a precise dose of drug for diagnostic or therapeutic purposes. The imaging technologies make delivery of medications more accurate. Small doses of anesthetics as well as anti-inflammatory steroids are typically used. The steroids calm down the targeted nerves and tissues.

Following an injection, pain management plans may include referrals to exercise specialists and physical therapists to help patients desensitize from their pain and promote mobility. Here again, the information from MRI findings can have important consequences for guiding care. For example, for many people with localized low back pain, the multifidus is a particular muscle that therapists focus on. Pronounced “mul-tif-ə-dus,” this small muscle of the spinal column is responsible for both mobility and support between the column’s bony segments. Here the physical therapy outcome is linked to giving patients time to strengthen their core muscles across the waistline and low back. Simple flexion and flexibility exercises are important.

There are any number of factors that can cause pain for a wide variety of reasons, yet there are also many image-guided, non-surgical procedures that are well-suited for a great treatment plan. Here examples include minimally invasive lumbar decompression and spinal cord stimulation. Even treatments aimed at reducing facial pain, headaches, or the continuance of pain after back surgery as well as joint replacement surgery are possible. Referral to the appropriate image-guided pain physician starts with a visit to your family doctor.

About Kevin

Kevin Wininger, RT(R) is as a radiology technologist and exercise physiologist at Fisher-Titus Medical Center. This editorial is based on several articles he’s written on the treatment of pain. MRI exams, CAT scans, and x-ray films can be useful in helping your doctors and physical therapists develop a treatment plan aimed at reducing your pain and improving your mobility.