Pain Management
|
The mission at Vital Health Institute is to effect a change in your body to get rid of disease and promote health. For patients in chronic pain, our goal is to find the source of the pain and remove or treat it. Patients with chronic pain often need pain management. But until we can reduce the pain, narcotic pain management is often needed. Unfortunately, the vast majority of pain management physicians do not see patients for narcotic management. Local community physicians are expected to provide this service to patients. The reality is that all too often, pelvic pain patients receive inadequate relief from their pain. While Vital Health Institute is not a pain management center, and I am not a board-certified pain management physician, I have received additional training in pain management. I have also created a very detailed, state-of-the-art pain management program, which includes random drug screening. This program has been reviewed by a regulatory agency, and it has been deemed to be a model program that should be taught to other doctors. The severity, timing and duration of pain are different for all patients. We use the standard Numeric Intensity Pain Scale, having the patient rate their pain from 0 to 10, with 10 being the worst possible pain. The goal of pain management is not necessarily to get rid of the pain. Instead, we attempt to reduce it to acceptable levels that result in an increase in the ability of the patient to function, and have a more normal life. The degree and timing of the pain will determine what type of pain relief treatment is provided to any given individual patient. Although narcotics are used as a last resort, we do believe in treating chronic, non-malignant pain with narcotics. For patients with 24/7 pain, we use a combination of long-acting narcotics for basal pain relief, and short-acting narcotics for breakthrough pain. Narcotic pain relief is only part of the overall pain management treatment plan. In addition to removal of the pain generator surgically (e.g. excision of endometriosis, removal of adhesions, ligation of varicose veins, hernia repair, removal of bowel restriction, etc), we use a wide variety of modalities, including nerve medications (e.g., Neurontin, Lyrica), nerve blocks, radiofrequency nerve ablation, topical treatment with a variety of compounded medications, medical treatment of underlying conditions (e.g., Elmiron for Interstitial Cystitis), and Botox for muscle spasms, In appropriate cases we may also recommend physical therapy, acupuncture, cranio-sacral therapy, chiropractic and other supportive therapies. Patients who need more specialized treatment will be sent to a board-certified pain management physician for evaluation and a second opinion of their treatment plan. These health care providers can offer more specialized treatments, such as nerve stimulators or pain pumps to help resolve severe refractory pain. Those who are in our pain management program for more than a year must see a board-certified pain management physician annually for evaluation and a second opinion of their treatment plan. |
