Managing Chronic Pain-This Patient's Prospective

No matter how many commercials you are exposed to by the media, chronic pain cannot be controlled by over the counter drugs. Chronic pain requires a combination of oral medications (commonly called a "medical cocktail") as well as, pain medication injected directly into the inflamed area. Once your pain gets to the level where ordinary pain medication cannot stop the sharp, stabbing, grinding never ending but constantly increasing pain, you are most likely searching for, or have been referred to, a "Pain Management Doctor".

Pain Management is not an easy or quick fix. It may, as it has with me, take years for you and your doctor to find the right combination of medication. My pain is managed by a team of doctors at Tennessee Valley Pain Management.

At first the amount of medication can be overwhelming, especially if you are still in pain. But you must be be involved. An uninvolved patient creates an ineffective doctor. Every patient is different. Maybe that needs repeating. Every patient is different. Waiting until your next appointment thirty days into the future to notify your doctor that the last prescription is not helping you is unacceptable. There is no pain medication that takes that long to work. It helps or it dose not.

When pain block injections are used. These injections are performed in doctor's offices or "Out Patient Medical Centers". Surgeons perform surgery in these out patient centers daily. With the continued reduction of what insurance companies will pay for their policy holders medical care, these medical facilities are becoming more abundant. As a result, doctors are opting to use them instead of hospitals.

One of the major causes of pain in aging adults is the degeneration of the disc of the lumbar spine. As we age, the disk gradually drys out losing strength and resiliency.





As shown above, degenerative disc disease can cause the disc to lose height resulting in the narrowing of nerve pathways and causing nerve impingement, inflammation and pain. Says Doctor Darryle Antonacci, MD F.A.C.S





Epidural Steroid Injections

Epidural Steroid injections are commonly used to relieve chronic pain. For the proper placement of the medication into the damaged area, the use of fluoroscopy or live x-ray is used. The doctor monitors his direction by watching a screen showing the x-ray of your spine as you lay on the operating table. Usually a solution of cortisone, local anesthetic and saline is injected into the inflamed area.



The type of anesthetic is called twilight. I usually find myself going in and out of consciousness. Sometimes I can feel and hear what is taking place and sometimes I am completely out of it.



Once the procedure is completed, you are taken to a recovery area where you remain until the staff is sure you are not having an adverse reaction to the medication. This takes about an hour. You are then wheeled out to who ever has accompanied you to the procedure. You must have a driver or no anesthetic can be used.





Side Effects that have affected me are

• Localized increase in pain - usually last a few days following the injection



• Anxiety



• Sleeplessness



• High blood sugar - my blood sugar levels are elevated for about a week following a procedure



• Decrease in the immune system. I have suffered with staph infections twice



• Cataracts were recently diagnosed by Dr. John E. Miller , my ophthalmologist. He sees no reason for concern at this time. The cataracts could be from normal aging or from prolonged use of steroid medication.

The purpose of this blog is to inform you of the help that is available for you. Of course, there are others and they will be discussed in future blogs. The important thing is that you are as informed as possible. When you walk into that office, go in with the confidence and knowledge that you are making an educated decision. Make it your decision and not just an agreement to a suggestion that your doctor has made to you. You always have the right to refuse a procedure.