Suffering from Chronic Pain? There’s Hope!
By Michael P. Basista, M.D., Director, ImmediCenter Family Practice

Most pain is fleeting, but unfortunately, some pain continues for extended periods of time. Some physicians specialize in reducing or even eliminating chronic pain.

Chronic Pain
Pain is an unpleasant feeling associated with actual or potential tissue damage. Chronic pain refers to pain that lasts for more than three months. It has no protective role, and is not necessarily associated with tissue damage.
Chronic pain can affect all areas of a person’s life- functional, psychological, and social. It can affect family and friends, and keep one from enjoying a full life.

Types of Pain
1] Somatic Pain is caused by the activation of pain receptors in the skin, muscle, or skeletal tissues- usually as a result of surgery or laceration. Skin pain is usually sharp, with a burning or pricking quality. Musculoskeletal pain is dull or aching.
2] Visceral Pain is pressure-like and deep. It is usually related to cancer, bone fracture, or bone cancer.
3] Neuropathic Pain is caused by damage to nerves that carry pain information. “Shooting,” “electric,” or “burning”, it may travel from the spine into the arms and hands, or into the buttocks, legs, or feet.

When the resources of conventional medical pain treatment have been exhausted, there are pain management specialists who can lessen and sometimes even eliminate chronic pain.

Narcotics (morphine or codeine) and anti-inflammatories (ibuprofen or naproxen) are usually not effective for neuropathic pain. Treatments include nerve “block” injections, and a variety of medical interventions.
4] Disc Pain: Discogenic back and neck pain can result from injury or irritation. It can spread away from the source, usually along the back or neck or down the arm or leg, and can be accompanied by weakness or tingling.
The pain might feel like it is coming from the buttock area down into the upper thighs. Feeling pain in an area away from the real source is called radiation of the pain. It is common for spine and disc problems.
5] Joint Pain: Inflammation of the joints and ligaments is very common, especially for women following pregnancy. This is because the hormone relaxin is released, which relaxes the ligaments in preparation for childbirth. In most cases, the causes of joint inflammation are mechanical.

Symptoms include:
• Pain either to the left or the right of your lower back. The pain can range from an ache to a sharp pain that can restrict movement.
• The pain may radiate out into your buttocks and lower back and will often radiate to the front into the groin. Occasionally, there is testicular pain.
• Occasionally there may be pain into the thigh, leg, or foot that can be mistaken for sciatica.
Classic symptoms are:
• Difficulty turning over in bed
• Struggling to put on shoes and socks
• Pain getting your legs in and out of the car.
• Stiffness in the lower back when getting up after sitting or lying down for a long period of time.
• Aching on one side of your lower back when driving.
6] Facet Joint Pain: Facet joints are the joints of the spine that contain joint fluid and are lined by cartilage. Facet joints can become diseased, most commonly by arthritis, which results in loss of joint cartilage, bone overgrowth, erosion, and joint instability. As the disease progresses, nerve endings become irritated and inflamed, causing pain.

Treatment

See your doctor. He or she will take a history, examine you, order tests such as X-rays, MRI’s, nerve conduction studies, and then prescribe proper treatment including rest, medication and physical therapy.

Sometimes, these steps fail, and this can be frustrating for both the doctor and the patient. The doctor can then refer the patient to a pain management specialist who has access to a greater variety of treatments including:
• Neck and Lower Back injections
• Spinal Nerve Steroid Injections
• Facet Joint Anesthetic Injections
• Anesthetic/Steroid Nerve Blocks for the Sacroiliac Joint (where the pelvis joins the spine)
• Radio Frequency Ablation (damaged tissue is internally electrically burned away non-invasively without surgery).
• Discography- a diagnostic tool used to determine which spinal disk is causing pain.

If your primary physician has exhausted his or her treatment methods, and you are still suffering with pain, they may refer you to pain management specialists.

The ImmediCenters, with locations in Clifton, Bloomfield and Totowa, have primary care physicians who can help with the first stage of diagnosing and treating chronic pain syndromes.

If this first stage treatment does not relieve the patient’s chronic pain, they refer the patient to Dr. Allan Weissman and Dr. Eugene Gorman, our pain management specialists. They offer a team approach that is optimal for dealing with chronic pain at the Clifton ImmediCenter, which is located at 1355 Broad Street. The phone number is 973-778-5566.

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