Pain Management Solutions: More Options Help Chronic Sufferers Rely Less on Meds

At least 20 percent of U.S. adults live with chronic pain, which frequently limits leisure or work activities, according to the U.S. Centers for Disease Control and Prevention (CDC).

That represents about 50 million people with chronic pain, and about 8 percent of adults suffer from “high-impact chronic pain,” which can significantly affects a person’s quality of life. September marks Pain Awareness Month, an observation to help bring attention to the wide range of treatments available to help chronic pain sufferers lead normal lives.

There are many causes of chronic pain that requires thorough analysis by a primary care doctor and pain management specialists, such as those at Miami Neuroscience Institute and Marcus Neuroscience Institute, both part of Baptist Health. Disease can be the underlying cause of chronic pain, including rheumatoid arthritis, osteoarthritis and fibromyalgia. Persistent pain may also be due to serious health issues such as cancer, multiple sclerosis, stomach ulcers, and even gallbladder disease.

Types of Chronic Pain

Moises Lustgarten, M.D., director of pain management at Miami Neuroscience Institute.

Chronic back pain is one of the most common conditions requiring some type of treatment, said Moises Lustgarten, M.D., director of pain management at Miami Neuroscience Institute.

“But there are many other conditions that require pain management treatment,” Dr. Lustgarten explains. “Examples include acute neck and low back pain, Sickle Cell crisis, acute abdominal pain (pancreatitis), cancer pain and post trauma/injury pain.”

Seif M. Elbualy, M.D., director of interventional pain management at Marcus Neuroscience Institute, says chronic low back pain is one of the most common complaints nationwide. 

“It is one of the biggest causes of missed work days,” said Dr. Elbualy. “We also treat many people with chronic neck pain. Certainly, many people have sciatica or radicular types of pain as well. Radicular pain occurs when pain radiates from an inflamed or compressed nerve root. For example, pain from your back and hip that you can feel in your legs.”

The Pandemic’s Impact

The COVID-19 pandemic has fueled in an increase in chronic pain because of the pandemic as some patients have put off surgeries or visits to their doctors.

Seif M. Elbualy, M.D., director of interventional pain management at Marcus Neuroscience Institute.

“There are multiple reasons for this increase in chronic pain, including failure to seek medical care, increased rate of obesity and sedentary life, lack of outdoor activities, and gym closures,” said Dr. Lustgarten. “There is a significant correlation between obesity, sedentary life, lack of outdoor activities and chronic pain.”

Dr. Elbualy adds that there is reason for optimism as COVID vaccinations become more widespread.

“Initially we had many people reluctant to seek healthcare,” said Dr. Elbualy. “But as vaccines became common, we have had a reengagement of these patients.  Essentially, everything we do is outpatient, so that alleviates the fear of going into a hospital

Misconceptions

What are the biggest misconceptions about pain management among patients?

“There are many: That pain will become permanent, that there are no suitable options to treat pain, that all conditions would require medications, that all medications used are addictive,” said Dr. Lustgarten.

Dr. Elbualy adds that many patients believe “pain management equals narcotics,” or opioid medications. “In most cases, we don’t consider that pathway,” he said.

Treatment Options

Adding to the problem of chronic pain is the opioid epidemic that has swept across the nation for years and has put many prescribed painkillers under intense scrutiny and restrictions. As a result, more doctors are referring patients into physical therapy programs and other alternative pain management treatments.

“We provide multiple options including the use of non-steroidal. anti-inflammatory medications, muscle relaxants, physical therapy, nerve blocks, implantable devices, and opioids – if absolutely necessary,” explains Dr. Lustgarten.

The best approach will prevent or reduce medications, whether prescribed or over-the-counter, the pain management specialists say.

“We try to focus on interventional options as opposed to adding more medications to people’s regimen,” said Dr. Elbualy. “Certainly, there is a role for conservative care, including NSAIDs (non-steroidal anti-inflammatory drugs” and physical therapy modalities.”