- Treating Pain
- What We Do
- Your First Visit
- What To Expect
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- Patient
- Caregiver
- Medical Professional
Unfortunately most cases of chronic pain cannot be cured for life. A small percentage can be cured. However, most patients end up needing a combination of medication, psychological support, and in some cases nerve blocks to control their pain and improve their quality of life.
Chronic pain may be treated with medications, psychological support such as therapy, physical rehabilitation such as stretching exercises, and palliation, which is defined as making a disease or its symptoms less severe or unpleasant without removing the cause. Palliation is usually performed by administering pain medication. If the chronic pain is beyond our capability to diagnose or treat we may give the patient a referral to another specialist for treatment or surgery.
Remember that most medical illnesses are not curable. For example, insulin is not a curative treatment; it is a palliative treatment. It must be given on an ongoing basis. The same applies to medication for high blood pressure.
Palliation is defined as making a disease or its symptoms less severe or unpleasant without removing the cause. When a patient is not a candidate for surgery, or when surgery fails to relieve the patient’s chronic pain, we perform palliation. Nerve blocks and medications can be used for the purposes of palliation. Our primary method of pain management is the nerve block. Other pain medications may be used to perform palliation.
Twenty percent of chronic pain patients diagnosed at our clinic have been candidates for surgical treatment. Our experience indicates that surgery may significantly reduce pain, and in some cases totally relieves it.
We do not have the facilities at our clinic to perform surgery. Patients are referred to a surgeon or neurosurgeon in their area.
When surgery is not an option, or when surgery provides incomplete relief of chronic pain, medications may be prescribed.
The types of medications prescribed may include anti-inflammatory medications, antidepressants, and anticonvulsants. When necessary analgesics may be prescribed under strict monitoring and control.
Certain types of antidepressants may decrease various types of pain as well as improving the patient’s mood. They also may be helpful in improving a patient’s sleep.
Anticonvulsants have been useful in treating various neuropathic pain conditions. Neuropathy is disease or dysfunction of one of more peripheral nerves, typically causing numbness or weakness.
These are medications that relieve pain. Powerful analgesics must be administered under strict monitoring and control. Many doctors at the Rothbart Centre do not prescribe analgesics. The patient’s family doctor will remain in charge of all currently prescribed analgesics, as the Rothbart Centre does not offer medication management.
Some patients who are currently taking narcotics seek referrals to our clinic in hopes of obtaining a new source of narcotics prescriptions. If the patient is currently being prescribed narcotics by their physician, their current doctor will remain in charge of those prescriptions, as the Rothbart Centre does not offer medication management.
Our main modality of treatment is nerve blocks. These consist of local injections of steroids or anesthetics that are non-addictive and in a separate category from narcotics that the patient may currently be taking. They will not create a “high” and are not opioid-based. If the patient is already taking narcotics they may be treated with nerve blocks but will not receive prescriptions for any additional narcotics.
If you suspect that the patient is addicted to narcotics and requires assistance, please contact Addiction Centre Toronto. They are a drug addiction clinic with several locations in Ontario. Their services are covered by OHIP and they accept self-referrals from patents. If you have any additional questions about referrals to Addiction Centre Toronto please contact them directly.
We have found that Cognitive Behavioral Therapy is very effective in helping patients deal with their chronic pain symptoms.
A preferred more of treatment is to eliminate the source of the pain. Studies have shown that when pain is relieved patients revert to their normal psychological profile.
Since complete pain relief is not always possible psychotherapy is an important part of helping patients deal with their chronic pain symptoms.
Cognitive Behavioral Therapy or CBT is a therapy based upon self-motivation. The patient does a mental self-examination and determines the course of their actions based upon their inner thoughts, feelings, and intuitions.
Patients learn about focusing on positive ideas and behaviors. They set and reach their own goals. They learn how to recognize and deal with bad thought patterns and habits. They learn practical problem solving skills. They learn to challenge themselves and cast doubts on their current behaviors. They learn that being open is valued and highly constructive.
Reduction of emotional stress, reinforcement of co-operation, adaptation to changing situations, and reduction of pain-related anxiety.
If the patient is suitable for mild stretching, strengthening, and fitness exercises, these will be recommended for the patient.
Continue reading › What Are Nerve Blocks?
