Pain management for chronic back pain

Introduction to pain management for chronic back pain
Pain, especially intractable or chronic pain, used to be something many patients simply had to learn to “live” with. In recent years, however, researchers have learned a great deal about pain and its physiological and psychological basis, leading to pain management treatments that can provide complete or partial pain relief.

Untreated pain can interfere with the healing process by affecting the immune system and leading to other undesirable results. In cases of back pain, discomfort can impede the rehabilitation process by interfering with exercise and increasing the risk of psychological distress.

Patient reports of continuing pain in the absence of a definitive pathology have all too often been dismissed by health professionals who traditionally expected to find an organic cause for pain. Even in the absence of such a cause, however, chronic back pain can lead to neurological feedback processes that only serve to worsen the pain and make it more difficult to treat.

Pain is inherently subjective, and a greater awareness of the need for taking pain seriously is growing among the health community as well as the public at large. This is particularly true for chronic neck and back pain sufferers. While the great majority of cases are self-limiting and resolve on their own, the risk of recurrence and development of chronic disease is significant. Chronic back pain tends to be very difficult to treat, especially in cases involving failed back surgery or neuropathic pain (“nerve pain”).

These considerations have led to a proliferation of services available to patients seeking both medical and alternative treatment for neck and back pain. Pain management is rapidly becoming the preferred approach in many professional communities.

What is pain management?
Pain management, also known as pain medicine, draws on many disciplines in science and the healing arts to systematically study pain, its prevention, evaluation, diagnosis and treatment, as well as the rehabilitation of painful disorders. The pain may be the result of an injury, surgical intervention, cancer or other particular cause, or may constitute the primary problem, as in neuropathic pain and headache.

In spine and musculoskeletal cases, pain management is usually distinguished from surgical treatment, and is employed as an alternative to surgery as part of an aggressive conservative care program, or after surgery to cope with residual or recalcitrant pain. Pain management and the techniques it uses also help to identify the source of neck and back pain, determine the areas to be addressed surgically, and rehabilitate the patient after surgery.

Pain management uses a wide variety of techniques to address pain and painful disorders. The scientific basis for these approaches varies from those that are completely without experimental support to those whose effectiveness has been well demonstrated in clinical trials. In view of the diverse uses and methods of pain management and pain medicine, an overview of this fast-developing field is needed. This article highlights certain aspects of this diverse area.