Taking Away the Pain
Dr. Pavan Dalal, Pain Management Specialist
April 26, 2021
Patients today have options for finding relief to back and joint pain
Getting to the source of pain can be complicated. The pain near your hip could be caused by a nerve in your back. The pain in your neck could be from a problem with your muscles, joints, or nerves or a combination of areas. That’s why the most effective treatment often involves a combination of different therapies, especially for chronic pain that lasts longer than 12 weeks and doesn’t resolve on its own or with conservative treatments. The good news is that doctors are constantly refining approaches to treating pain, whether in the lower back, knee, hips or other parts of the body that affect most people at some point in their lives.
Here are some of the ways we address pain:
Targeted steroids. Steroids like prednisone help to reduce inflammation but may produce undesirable side effects and aren’t designed to be taken long-term. In targeted steroid injections, we inject a steroid locally around inflamed tissues, using guided imaging to target the exact spot of pain. In some cases, relief will last for months. Other times, particularly when a patient partakes in physical therapy or an exercise program, there is no need for another injection.
Radiofrequency Ablation. In this procedure, effective for spine-related joint pain, we remove sections of small nerves that sense pain in the joints causing the trouble by using heat to reduce or stop the transmission of pain. The radiofrequency waves ablate, or "burn," the nerve that is causing the pain.
Medication. In light of the opioid epidemic which has deeply hurt communities across America, there’s a big movement toward non-narcotic options for pain management. Certain medications may target nerves that transmit pain while others can take aim at specific causes such as muscular pain and inflammatory pain. Some anti-depressants, which target the pathways of the brain that control mood and arousal, have also been shown to be particularly effective for many forms of pain. In addition, prescribed non-steroidal anti-inflammatories are effective in treating pain caused by inflammatory conditions like rheumatoid and osteoarthritis, or even sciatica type pain. There are prescription forms of these medications that are stronger and have a different timing for release in the body than ibuprofen or naproxen, allowing patients to take fewer pills each day and sometimes with fewer side effects.
Lifestyle modification is probably the single most important thing that patients can do to prevent certain common conditions such as back pain and neck pain. There’s a lot of core muscle weakness in today’s population due to work and lifestyle habits, for example spending lots of time in front of a computer. What’s more is that many people who exercise routinely often miss some of these major muscle groups in their exercise routines. When these muscle groups are appropriately strengthened, they help prevent abnormalities in spine and joint loading that over time can lead to debilitating, chronic pain issues.
For patients who have these chronic pain causes, I often suggest developing of an exercise regimen supervised by a trainer or physical therapist to ensure that these muscle groups are engaged correctly and without causing harm—this is something that can go a long way in preventing back, neck and joint pain as well as treating it.
Dr. Pavan Dalal is the Director of Pain Management at White Plains Hospital and treats patients at several of our White Plains Hospital Physician Associates locations around Westchester. To make an appointment, call (914) 235-8224.
Tags: back pain
, physical therapy