Radio Frequency Lesioning

What Is Radiofrequency Lesioning?

Millions of adults in the United States suffer from various types of chronic pain conditions. The pain associated with these conditions can be severe and can have a detrimental impact to an individual’s personal and professional lives. Additionally, chronic pain has a significant impact on the U.S. economy, resulting in increased healthcare utilization, including rehabilitation and decreased worker productivity.Pain-Doctor-Epidural-Steroid-Injection-Procedure-5Patients suffering with chronic pain are often treated with a combination of medication, physical therapy, as well as epidural steroid injections and other conservative treatment options. However, not all patients experience pain relief from these treatment methods. Radiofrequency lesioning is a minimally invasive procedure that may be used to treat chronic pain that has been unresponsive to conservative measures. Radiofrequency lesioning uses heat to effectively destroy the sensory nerve endings that are believed to be the source of pain. By destroying the nerve endings, pain and other related symptoms are reduced following treatment.Before recommending radiofrequency ablation, diagnostic local anesthetic nerve blocks need to be performed to ensure that the patient is an ideal candidate. A diagnostic nerve block involves injecting a local anesthetic into the area of the nerve that is believed to be causing the patient’s pain. The local anesthetic essentially temporarily numbs the area and should result in reduced pain symptoms. The effectiveness of radiofrequency lesioning can be predicted from a patient’s response to the temporary nerve block procedure.

How Is Radiofrequency Lesioning Performed?

Cervical-Radiofrequency-Ablation-Procedure-6A radiofrequency lesioning procedure is performed in an outpatient setting. Generally, radiofrequency lesioning procedures take approximately 30 to 60 minutes to complete.The nerve supply to the painful structure is targeted during a radiofrequency lesioning procedure. A small needle or radiofrequency cannula is positioned next to the targeted nerves using fluoroscopic guidance. Once the needle is in place, small currents are applied to ensure proper needle placement. Once the proper placement of the needle or cannula is confirmed, a local anesthetic is injected to numb the area. The radiofrequency generator is then utilized which delivers an electrical current that produces radiowaves. These radiowaves heat the targeted nerve ending for up to 90 seconds, which results in destruction of the targeted nerve. The needle is then removed and the procedure is complete.

Pain-Doctor-Radiofrequency-Ablation-Procedure-8After the procedure, patients may experience discomfort around the needle placement site, which usually subsides within a few days. Occasionally, patients may experience temporary burning or numbness, which usually subsides within a few weeks.The risks associated with radiofrequency lesioning include: bleeding, infection, or allergic reaction to the local anesthetic used during the procedure. Rare side effects include: nerve damage, which may lead to permanent altered sensations including numbness, burning, tingling, and possibly extremity weakness.

Radiofrequency lesioning procedures generally provide long-term pain relief; however, the pain pathways may regenerate over time. Therefore, it is possible that the procedure may need to be repeated.

Conditions Related To Radiofrequency Lesioning

There are various conditions that may be successfully treated with radiofrequency lesioning, including:

  • Facet joint pain
  • Discogenic pain
  • Coccydodynia
  • Sympathetically mediated pain

facet joint syndromeFacet joint pain is one of the most common causes of chronic spinal pain.  Radiofrequency lesioning of the medial branch of the posterior primary ramus can denervate the facet joint and effectively provide long-term pain relief for some patients. Successful radiofrequency lesioning for patients suffering with facet joint pain typically lasts for more than a year.Spinal pain that is arising from the intervertebral discs of the spine is another common source of pain, commonly referred to as discogenic pain. Once the painful disc is identified radiofrequency lesioning can be used to partially denervate the intervertebral disc, by either lesioning the rami communicans, or by using intradiscal denervation techniques. The use of radiofrequency lesioning is contraindicated if there is a disc herniation that is causing nerve impingement, if there is disc disease at multiple spinal levels, or if there is advanced degenerative disc disease.

Coccydodynia (tailbone pain) that is the result of organic causes can be treated by radiofrequency lesioning of the coccygeal nerve or the ganglion impar. Prior to using radiofrequency lesioning, a minimum of two blocks are performed to confirm that the pain is organic in nature.

Pain that is transmitted by the sympathetic nerves may be treated using radiofrequency lesioning by lesioning the sympathetic chain at the spinal level or at the stellate ganglion. This results in an interruption of nerve signal transmission.

Additional radiofrequency lesioning can be used to treat trigeminal neuralgia by thermocoagulation of the Gasserian ganglion. It can also be used to treat nociceptive radicular pain by partial rhizotomy of the dorsal root ganglion. Furthermore, it can be utilized to treat cancer pain by lesioning the sphenopalatine ganglion and stereotactic cordotomy.

Conclusion

Cervical-Radiofrequency-Ablation-Procedure-3Millions of adults suffer from chronic pain conditions in the United States. Patients suffering from these conditions not only experience physical symptoms, they often also suffer emotionally and physically if their pain cannot be effectively managed. Radiofrequency lesioning is a minimally invasive method that can be used to effectively treat pain that has been unresponsive to conservative treatment options.The nerves that are believed to be responsible for causing pain are targeted during a radiofrequency lesioning procedure.

The targeted nerves are destroyed by the application of heat. Radiofrequency lesioning can be used to treat a variety of conditions including facet joint pain, discogenic pain, tailbone pain, and sympathetically mediated pain.

Radiofrequency lesioning is generally safe; however, as with any surgical procedure, there are minimal risks involved including mild injection site soreness, bleeding, infection, and temporary altered sensation in the extremities.

Serious side effects are very rare. Patients suffering from unresponsive spinal pain should discuss the possibly of radiofrequency lesioning with their physician, as it may provide effective, long-term relief of their symptoms.

References

  1. Principles and uses of radiofrequency nerve lesioning in chronic pain control – Cabell Huntington Hospital – Huntington, WV. 2015.
  2. Geurts JW, van Wijk RM, Stolker RJ, Groen GJ. Efficacy of radiofrequency procedures for the treatment of spinal pain: a systematic review of randomized clinical trials. Regional Anesthesia and Pain Medicine. 2001;26(5):394-400.
  3. Kawaguchi M, Hashizume K, Iwata T, Furuya H. Percutaneous radiofrequency lesioning of sensory branches of the obturator and femoral nerves for the treatment of hip joint pain. Regional Anesthesia & Pain Medicine. 2001;26(6):576-581.
  4. Kornick C, Kramarich S, Lamar TJ, Sitzman T. Complications of lumbar facet radiofrequency denervation. Spine. 2004;29(12):1352-1354.
  5. Nagda JV, Davis CW, Bajawa ZH, Simopoulos TT. Retrospective review of the efficacy and safety of repeated pulsed and continuous radiofrequency lesioning of the dorsal root ganglion/segmental nerve for lumbar radicular pain.Pain Physician. 2001;14(4):371-376.
  6. Oh WS, Shim JC. A randomized controlled trial of radiofrequency denervation of the ramus communicans nerve for chronic discogenic low back pain. Clinical Journal of Pain. 2004;20(1):55-60.
  7. org. American Academy of Pain Medicine – Get The Facts on Pain. 2015.

Sacroiliac Joint Injections

Sacroiliac Joint Injections

What Is A Sacroiliac Joint Injection?

The sacroiliac joint is a diarthrodial joint that is located lateral to the spine and connects the hip to the sacrum on both sides of the body. There is a sacroiliac joint located on the right and on the left and these joints bear the weight of a patient’s upper body and extremities. Due to the fact that the joint has to be very stable, movement of the joint is limited. A thin layer of cartilage covers the surface of the ileum and sacrum. Synovial fluid fills the space between these two structures, which is enclosed within a fibrous capsule. Sacroiliac joint inflammation and dysfunction can result in chronic low back or leg pain.Sacroiliac joint dysfunction can be difficult to diagnose as the symptoms often mimic other causes of back pain including disc herniation, facet syndrome, and radiculopathy. Sacroiliac joint injections serve two purposes: to diagnose the source of a patients’ pain and to provide pain relief. Various studies have shown that extra-articular and peri-articular steroid injections within the sacroiliac joint are more effective than placebo treatments for pain relief. Additionally, the studies have found that these pain relief benefits are sustained at a one-month follow-up appointment.

How Is A Sacroiliac Joint Injection Performed?

A diagnostic sacroiliac joint injection is performed when sacroiliac joint dysfunction is suspected. The area around the sacroiliac joint is numbed with a local anesthetic and a needle is then inserted using fluoroscopic guidance. Contrast dye is injected once the needle is in place to ensure proper needle placement and proper spread of medication. A numbing medication is then injected into the joint.After the numbing medication is injected, patients are asked to try and reproduce their pain by performing certain movements. If the patient reports a significant reduction in their pain, a diagnosis of sacroiliac joint dysfunction is tentatively made. In order to confirm the diagnosis, a second injection should be performed at a later date.

A therapeutic sacroiliac joint injection is performed when a diagnosis of sacroiliac joint dysfunction has been established and the patient requires pain relief. This procedure is performed in the same manner as the diagnostic sacroiliac joint injection with the exception that a corticosteroid is also injected into the affected joint.

Many patients that are treated with a sacroiliac joint injection are expected to experience immediate pain relief. After the procedure is completed, patients are monitored for pain relief and adverse reactions.

If a patient experiences prolonged pain relief after receiving a therapeutic sacroiliac joint injection, they may start a physical therapy program to further reduce their pain and to help them achieve normal functioning. If a patient experiences significant pain relief following a sacroiliac joint injection, it may be repeated up to three times per year.

As with all medical procedures, there are risks associated with sacroiliac joint injections, including bleeding, infection, and allergic reactions to the medications. Additionally, a patient may experience temporary numbness or weakness in the legs that is caused by the anesthetic that is injected. Some patients may have a temporary increase in pain and injection site tenderness for a couple of days after the injection. Diabetics may notice an increase in their blood sugar levels that is the result of the corticosteroid that is injected.

Conditions Related To Sacroiliac Joint Injections

Sacroiliac joint injections are often used for treating patients that suffer from chronic, non-specific back pain that is the result of irritation, inflammation, or injury of the sacroiliac joint. Sacroiliac joint dysfunction is tough to diagnose as the symptoms overlap with other injuries. Research has shown that up to 40-50% of patients with a confirmed diagnosis of sacroiliac joint pain are able to identify an event that likely contributed to their current episode of sacroiliac pain. These events may include a slip and fall, a motor vehicle accident, or repetitive stress on the joint.It should be noted that acute events are not responsible for all episodes of sacroiliac joint pain. Research has found that there are a number of traits that are associated with an increased risk of developing sacroiliac joint pain, including leg length discrepancy, gait and biomedical abnormalities, transitional anatomy, scoliosis, persistent strain, and pregnancy.

Patients who suffer from sacroiliac pain often describe the pain as diffuse, lower back pain. Of concern when evaluating a patient with sacroiliac joint pain is their current level of impairment (strength, flexibility, balance, etc.). The level of impairment will help the patients’ physician determine whether the patient will be able to engage in a rehabilitation program without experiencing significant pain. Additionally, depending on the current level of impairment, the physician may recommend a trial of conservative treatment options before initiating this type of treatment.

Conclusion

Sacroiliac joint injections are an effective procedure for patients suffering from chronic lumbar back pain that is the result of inflammation or dysfunction of the sacroiliac joint. Sacroiliac joint injections are minimally invasive and can provide pain relief almost immediately for many patients. It is hypothesized that these injections provide pain relief as the result of their anti-inflammatory characteristics; however, the literature remains unclear. Patients suffering from chronic low back pain that originates from the sacroiliac joint should discuss the option of sacroiliac joint injections with their physician to determine if it is an appropriate option for their case.

References

  1. Chou R, Atlas SJ, Stanos SP, Rosenquist RW. Nonsurgical interventional therapies for low back pain: A review of the evidence for an American Pain Society Clinical Practice Guideline. Spine. 2009;34(10):1078-1093.
  2. Cohen SP, Chen Y, Neufeld NJ. Sacroiliac joint pain: A comprehensive review of epidemiology, diagnosis and treatment. Expert Rev Neurother. 2013;13(1):99-116.
  3. Hansen H, Manchikanti L, Simopoulos TT, Christo PJ, Gupta S, Smith HS, Hameed H, Cohen SP. Pain Physician.2012;15(3):E247-78.
  4. Jee H, Lee JH, Park KD, Ahn J, Park Y. Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the non-inflammatory sacroiliac joint dysfunction: A prospective, randomized, and single blinded study. Arch Phys Med Rehabil. 2013;9:[Epub ahead of print].
  5. Manchikanti L, Hansen H, Pampati V, Falco FJ. Utilization and growth patterns of sacroiliac joint injections from 2000 to 2011 in the medicare population. Pain Physician. 2013;16(4):E379-90.
  6. Simopoulos TT, Manchikanti L, Singh V, Gupta S, Hameed H, Diwan S, Cohen SP. A systematic evaluation of prevalence and diagnostic accuracy of sacroiliac joint interventions. Pain Physician. 2012;15(3):E305-44.
  7. Spiker WR, Lawrence BD, Raich AL, Skelly AC, Brodke DS. Surgical versus injection treatment for injection-confirmed chronic sacroiliac joint pain. Evid Based Spine Care J. 2012;3(4):41-53.

Lumbar Epidural Steroid Injection

Lumbar Epidural Steroid Injection

What Is A Lumbar Epidural Steroid Injection?

Epidural injections for pain relief emerged in 1901. The first epidural injection performed used cocaine to relieve pain that was suspected to emerge from the lumbar nerve roots. Between the 1920s and 1940s, epidural injections contained mostly saline and a local anesthetic agent. The use of corticosteroids in epidural steroid injections began in 1952. The corticosteroid used during this procedure is a synthetic, man-made drug whose function is similar to that of cortisol.Currently, epidural steroid injections are widely used both in diagnosing and treating neuropathic pain. Lumbar epidural steroid injections, in particular, are performed in the lumbar region of the lower back in order to treat pain that occurs within the lower back and legs. More specifically, corticosteroids are injected into the epidural space surrounding the spinal nerves of the lumbar region. This medication functions to reduce pain and inflammation within the area. The procedure itself is minimally invasive and does not require surgery.

The short-term efficacy of lumbar epidural steroid injections has been well documented. Moreover, this procedure has been accepted as an effective treatment option for both radicular and back pain by the United States Department of Health and Human Services and the North American Spine Society. The long-term effectiveness of this procedure is not as clear, however, and more studies are warranted.

The lumbar epidural steroid injection provides some benefits over steroids that are administered orally or other orally dispensed analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs), as the medication is delivered directly to the affected area. Additionally, successfully completed lumbar epidural steroid injections may also reduce concomitant symptoms of numbness or tingling sensations.

Though quite rare, there is some risk for potential complications associated with the lumbar epidural steroid injection procedure. As with other epidural injections, there is a risk for minor bleeding at the site of the injection, infection, spinal headache, and temporary leg weakness.

In addition, there is a specific risk for additional complications with regard to the lumbar procedure. The more commonly occurring of these include:

  • Backache or a postural puncture headache (occurs in between 0.5 and 1% of patients receiving lumbar injections)
  • Dizziness, neurocardiogenic syncope, nausea, or even vomiting
  • Bleeding at the trajectory of the injection
  • Injury to the nerve root

How Is A Lumbar Epidural Steroid Injection Performed?

During the lumbar epidural steroid injection procedure, the patient is placed in the prone position on the X-ray table (i.e., lying face down flat on the table). Some physicians or pain specialists will have the patient place a small pillow under their stomach, which places a slight curve in the lower back. The surface of the skin in the area of the injection is thoroughly cleansed and sterilized. For most procedures, only a topical local anesthetic is required; however, a small portion of patients may feel too uncomfortable and request that they be sedated for the procedure.The physician will begin by inserting a fluoroscope device into the back, which transmits a video image of the internal structures on to a computer screen. This device is then used as a guide for the physician to ensure proper placement of the injection needle into the affected area. Contrast dye can also be injected in order to confirm placement, as well as to assess the degree of medication distribution.

When the physician has assured correct placement of the injection needle, the steroid solution is injected. In some instances, the patient will report sensations of pressure that are not painful, owing to the build-up of fluid. Once the procedure has been completed, the patient is held for observation for approximately 15 to 20 minutes and is then discharged home.

In terms of needle placement, there are three different methods for performing a lumbar epidural steroid injection, which include:

  • Interlaminar: Needle is placed between the lamina and vertebrae of the middle back and the corticosteroid solution is delivered on either side of the spine
  • Transforaminal: Needle is placed into the neural foramen on the side of the vertebrae and the corticosteroid solution is delivered only to one side of the spine
  • Caudal: Needle is placed in the area of the large sacral canal at the tailbone

Conditions Related To Lumbar Epidural Steroid Injections

The lumbar epidural steroid injection can be effective in managing many forms of acute and chronic pain that occur within the lower back or limbs. In particular, this procedure is most effective in conditions that arise as the result of damage or irritation and inflammation of the nerves within the lumbar region.Some common pain conditions that are treated using lumbar epidural steroid injections include:

  • Synovial cysts: This condition occurs as the result of cysts that form within the facet joint or in the area of the nerve root. These cysts may cause compression of the structures of the spine, which can lead to nerve pain.
  • Lumbar radiculopathy: This is a specific type of pain that emerges as the result of compression or inflammation of the spinal nerves. This pain is unique in that it radiates from the lower back region, down through the back of the leg, into the calf or foot.
  • Degenerative disc disease: This condition occurs when nerve bundles of the spine are impinged as the result of an irritated or damaged and inflamed intervertebral disc. This compression of the nerve tissue causes it to become irritated and transmit exaggerated signals of pain back to the spinal cord and brain.
  • Herniated disc: Similar to intervertebral disc degeneration, herniated discs occur when the intervertebral disc bulges or even ruptures and thereby places compression on the nearby spinal nerves, causing them to send exaggerated signals of pain to the spinal cord and brain.
  • Spinal stenosis: This condition occurs as the result of a narrowing of the spinal canal, which places pressure on the nerves inside the passageway.
  • Spondylosis: This condition occurs as the result of a defect in the link between the vertebrae that make up the spinal column. Over time, this defect can lead to degeneration of the structures that make up the spine and even stress fractures.

Conclusion

Epidural steroid injections have been used to effectively treat neuropathic pain since 1952. Lumbar epidural injections, in particular, can provide patients suffering from chronic or acute lower back and leg pain with some relief from their symptoms. The procedure is minimally invasive and does not require surgery. Previous studies have supported the short-term effectiveness of these injections; however, more work is necessary to examine the long-term benefits of the procedure.

References

  1. Coliman F, Villalobos F. Epidural steroid injections: Evidence and technical aspects. Techniques in Regional Anesthesia and Pain Management. 2010;14;113-119.
  2. Collighan N, Gupta E. Epidural steroids. Brit J Anaesth. 2010;109(1):1-5.
  3. Friedrich J, Hlumbar epidural arrast M. Lumbar epidural steroid injections: indications, contraindications, risks, and benefits. Current Sports Medicine Reports. 2010;9(1):43-49.
  4. Ghai B, Vadajae KS, Wig J, Dhillon MS. Lateral parasagittal veres midline interlaminar lumbar epidural steroid injection for management of low back pain with lumbosacral radicular pain: A double-blind randomized study.Anesth Analg. 2013;117(10):219-227.
  5. Manchikanti L, Cash K, McManus C, Damron K, Pampati V, falco F. Lumbar interlaminar epidural injections in central spinal stenosis: Preliminary results of a randomized, double-blind active control trial. Pain Physician. 2012;15:51-63.
  6. Sukdeb D, Ramsin M, Laxmaiah M. Evidence-based practice of lumbar epidural injections. Techniques in Regional Anesthesia and Pain Management. 2009;13:281-287.

10 Pain Conditions Treated By Regenerative Medicine

10 Pain Conditions Treated By Regenerative Medicine | PainDoctor.com

10 Pain Conditions Treated By Regenerative Medicine

Regenerative medicine is a branch of medical technology that includes platelet rich plasma therapy, stem cell injections, and amniotic membrane therapy. These three therapies are showing great promise in treating a number of different pain conditions.

What is regenerative medicine?

Regenerative medicine is the umbrella term for three specific therapies: platelet rich plasma therapy, stem cell injections, and amniotic membrane therapy. Instead of treating the symptoms of a pain condition, these therapies focus on healing damage in the body.

Platelet rich plasma therapy

Platelet rich plasma therapy use the patient’s own blood. Blood is taken from the patient and then placed in a centrifuge. Platelets are separated from some of the blood and then added to more of the patient’s blood before being injected into the area being treated. Platelets have a protein called growth factor. This growth factor encourages the healing and regrowth of tissue. Platelet rich plasma therapy injections have between five and ten times the amount of platelets normally present in blood.

Using a patient’s own blood eliminates the risk of disease transmission during treatment and is considered a minimally-invasive type of treatment.

Stem cell injections

Stem cell injections have been very controversial in the past but are beginning to gain more acceptance. Stem cells are present in all cells. Their job is to grow and heal whichever living structure they are part of (e.g., skin, tissue, organs, etc.). Injecting stem cells into a damaged area of the body can help to regenerate healthy tissue.

There are three types of stem cells.

  • Embryonic: Immature cells from an embryo that is four to five days old. Can be used to regrow any type of cell in the body.
  • Adult: Mature stem cells that can only be used for the organ from which they are harvested (i.e., liver stem cells can only be used to heal liver tissue).
  • Induced pluripotent: Created in a laboratory. These stem cells can be used in the same manner as embryonic stem cells.

The discovery of pluripotent stem cells has helped to ease the controversy of embryonic stem cells somewhat. Since these stem cells can be used for any tissue in the body, embryonic stem cells have been less necessary for research.

Amniotic membrane therapy

Amniotic membrane therapy uses cells from the amniotic membrane surrounding a baby in utero. There are two types of these cells: stromal and epithelial. As with embryonic stem cells, both types of cells are able to differentiate and become any type of cell needed.

Pain conditions treated by regenerative medicine

Although regenerative medicine is still being researched, here are ten pain conditions that these therapies can treat.

1. Knee pain

Knee pain can be caused by many different factors. Regenerative medicine can help with inflammation while encouraging the body to regrow any damaged soft tissues or tendons.

2. Arthritis

Inflammation and pain due to arthritis can be treated in the same manner as knee pain. A wear-and-tear condition may be especially responsive to regenerative medicine as it may be able to turn back damage and restore mobility.

3. Achilles tendinitis

Tendinitis occurs when tendons in any part of the body become inflamed and damaged. When this occurs in the Achilles tendon, walking may become nearly impossible. Regenerative medicine has been shown to be effective in repairing the tendon.

4. Tennis elbow

Tennis elbow is a condition of inflammation and pain that occurs when the repetitive motion of tennis wears down the tendons and muscles in this joint. Regenerative medicine addresses this and helps the body heal.

5. Cervical radiculopathy

This condition results in pain due to nerve damage in the cervical spine. Platelet rich plasma therapy or stem cell injections can help repair nerve damage to relieve pain.

6. Compression fracture

There is some evidence that regenerative medicine can help bones to heal faster and stronger, making the prospect of re-fracture in the same bone less likely.

7. Degenerative disc disease

Degenerative disc disease occurs over time as discs wear out. When this occurs, they provide less cushion between vertebrae, causing pain and inflammation. With regenerative medicine, discs repair themselves and are able to return to their normal function.

8. Herniated disc

Herniated discs can be a result of injury or disc degeneration. The disc ruptures, allowing the cushioning fluid to seep out. Instead of just removing the ruptured disc material, regenerative medicine allows the disc to repair and potentially restore the disc material.

9. Sciatica

Sciatic pain is pain that is felt anywhere along the sciatic nerve. This nerve is the longest and widest nerve in the body, running from the lumbar spine underneath the buttocks, along the hip, and down to the feet. Sciatica is the collection of pain symptoms caused by an underlying condition that regenerative medicine can help treat.

10. Osteoarthritis

Another wear-and-tear condition, the pain and inflammation of osteoarthritis can be addressed as the painful area regenerates and returns to normal functioning.

Regenerative medicine may seem like science fiction, but evidence is mounting that it really does work. The University of Alberta Glen Sather Sports Medicine Clinic found that platelet rich plasma therapy caused positive structural changes in the tissues of study participants with chronically sore shoulders. This means that not only did pain go away, but the shoulders began to heal on the tissue level.

Scientists at the University of Gothenburg in Sweden believe that stem cell injections may be able to help intervertebral discs to regenerate. This hypothesis is supported by their observations of regeneration of disc material in the lab. Regenerating disc material could not only eliminate back pain due to degenerative disc disease, but it could also cure the underlying condition.

Regenerative medicine may be the future of chronic pain treatment. For more on the exciting potential of this therapy, visit the Mayo Clinic’s website on regenerative medicine.

10 Reasons To Try Acceptance And Commitment Therapy For Pain

10 Reasons To Try Acceptance And Commitment Therapy For Pain | PainDoctor.com

10 Reasons To Try Acceptance And Commitment Therapy For Pain

For people living with chronic pain, having someone tell them that pain is “all in their head” can be the ultimate slap in the face. In recent years, there has been research that indicates that while pain is a physically experienced sensation, how we think about pain does, in fact, affect the way we experience it. This does not mean that pain is “made up” or manufactured where it doesn’t exist. It means that patients can have more control over the way they deal with and experience daily chronic pain without using drugs. One way to work towards pain management is acceptance and commitment therapy for pain. Here are ten reasons to give it a try.

Ten reasons to try acceptance and commitment therapy for pain

1. Acceptance and commitment therapy distinguishes between structural and neural pathway pain

Structural pain is that pain which is a result of a specific, traceable cause of pain. Neural pathway pain is pain that is learned. The difference between the two is significant. While structural pain (e.g., pain that is caused by a herniated disc pressing on the sciatic nerve) has a specific treatment that often results in resolution, neural pathway pain may not be traceable to a specific cause.

Why does this matter? Neural pathway pain is very real; the brain has recreated itself in such a way that it remembers pain. But these patterns can also be unlearned. Acceptance and commitment therapy works to change the way pain patients think about their pain. The focus is not just on accepting that the patient is in pain. Patients work towards physically changing the way they think to eliminate it altogether.

2. Acceptance and commitment therapy does not believe pain is permanent

Acceptance and commitment therapy is partially based on the tenets of mindfulness. Mindfulness acknowledges that everything – good and bad – is impermanent. Many chronic pain patients and their doctors believe that unless they can find and treat a structural cause, pain is a permanent feature of life. Acceptance and commitment therapy points out that nothing in life is permanent therefore everything is subject to change. This includes eliminating pain.

3. Acceptance and commitment therapy works with cognitive-based philosophies and mindfulness techniques to reduce or eliminate pain

Acceptance and commitment therapists believe that neural pain can be eliminated or greatly reduced. By reframing the way a person thinks about pain, acceptance and commitment therapists help patients to understand how their thoughts may undermine their ability to heal themselves.

4. Acceptance and commitment therapy for pain includes action

Changing the way a person thinks is not enough. Acceptance and commitment therapy for pain works to help patients change the way they act. It encourages patients to face their pain instead of fearing it and then to take positive action. This is not an easy task, especially if patients feel deeply that their pain is incurable. Taking action in spite of fear and pain is key to this therapy, as one patient noted:

“I was in quite a bit of pain but I was also super-determined to walk in the neighborhood. I said to my subconscious mind, ‘I am walking today despite the pain. You can make it easy for me or you can make it difficult. But I am doing it!’ I walked about a half an hour and my pain lessened considerably. This was a huge breakthrough for me and I can now see that this program is working! I am astonished. I cannot believe it.”

5. Acceptance and commitment therapy acknowledges the struggle and suffering of pain patients and helps them through it

Pain is a complex process that has roots in the brain and expression in the body. Every experience in a lifetime marks a person neurologically, for better or for worse. Acceptance and commitment therapy goes deep into the roots of physical pain, looking at a person’s experiences overall, not just in the painful present. Research has acknowledged the strong mind-body connection. This type of therapy explores that connection and unravels the knots of pain that life can create by exploring and expressing painful or difficult parts of the past.

6. Acceptance and commitment therapy for pain is a process, not a product

While not a quick fix for pain, acceptance and commitment therapy may help pain patients develop a deep and satisfying understanding of themselves as they work to change the way they think about their pain. Unlike taking a pill to relieve the symptoms of pain, acceptance and commitment therapy gets at the neurology of pain to heal and connect patients to themselves.

7. Acceptance and commitment therapy for pain has no side effects

Unlike experimental treatments, implanted devices, and pharmaceutical interventions, acceptance and commitment therapy is 100% side effect-free.

8. Acceptance and commitment therapy works in conjunction with other treatments

Insinuating that pain can be removed by simply changing the mind may seem to dismiss the reality that pain patients face, but that is not the goal of acceptance and commitment therapy. This therapy acknowledges that pain exists and works to help patients address it constructively and with an action plan that goes beyond symptom relief. While patients work to address physical or structural issues, they also begin to change their mind and the way they think about their pain. This can truly change their lives in more ways than one.

9. Acceptance and commitment therapy encourages participation in life

Chronic pain can be an isolating condition. Many patients find themselves withdrawing from their daily lives, even activities that they previously enjoyed. Acceptance and commitment therapy for pain encourages patients to re-engage and re-commit to doing the things they love and offers tools and techniques to help them do that.

10. Acceptance and commitment therapy believes changing behavior can change the mind

Changing behavior to change the mind is at the root of acceptance and commitment therapy. This approach requires work and is not easy, but there is a strong research basis that this technique of action can change how a person experiences pain.

Clef two-factor authentication