Well Being — 06 October 2017
New treatments emerge for chronic pain

By Jana Soeldner Danger

City & Shore Magazine 

Chronic pain is a debilitating and discouraging problem that can drastically reduce quality of life. It’s also surprisingly common.

“It’s endemic,” says Dr. Joseph Alshon, DO, an interventional physiatrist at Anesthesia Pain Care Consultants, a practice with offices in Tamarac and Boca Raton.

Many people suffer needlessly, he says, because pain specialists now have a variety of weapons in their arsenal.

Finding the target

Diagnosing the exact cause of the pain is the first step. “The key to treating a chronic pain condition is to properly identify the source,” Dr. Alshon says. “Our focus is not on masking symptoms, but on effectively treating the cause. It’s easy to give someone a pill, but much harder to find the reason for the pain.”

Joint pain

Joints in the shoulder, knee, elbow and back are common sources of pain that can cause people to restrict or even give up activities they enjoy. Some of today’s treatments: “Steroid injections, radio frequency interventions, stem cells or plasma-rich protein injections,” Dr. Alshon says.

Depending on the diagnosis, injecting anesthetic into joints in the neck, thorax and low back, often done with the aid of fluoroscopy, may be a first step. The patient’s response helps the doctor determine the exact source of the pain.

A person who responds favorably might be a candidate for radio frequency ablation. This treatment uses radio waves to create an electrical current that heats a small amount of nerve tissue, blocking pain signals from nerve to joint. It can be effective for joints that have deteriorated due to arthritis, among other conditions; and relief can last for months.

When inflammation is the source of joint pain, steroid injections may help with healing. For pain resulting from ligament and tendon strains or injuries rather than inflammation, however, the doctor may choose plasma-rich protein injections.

In this treatment, the patient’s blood is drawn and spun in a centrifuge, which separates it into layers. The plasma layer is removed and injected into the affected area, where increased circulation may promote and speed healing. “PRP can be effective for rotator-cuff injuries or tennis or golfer’s elbow,”  Dr. Alshon says.

Stem-cell injections are another treatment that may help repair injured cartilage, tendons or ligaments. Fat extracted from the patient is spun in a centrifuge to isolate stem cells, which are then injected into the affected area.

Not Just for Wrinkles

Botox isn’t just for wrinkles. It can also help reduce or eliminate muscle spasms caused by overuse or injuries, or as a response to underlying arthritis. “If the patient has persistent muscle spasms, resistant to medication and steroid action, then Botox may be a great option,” Dr. Alshon says.

Prevention

Prevention is better than treatment, so it’s important to incorporate healthy lifestyle practices that may help stave off common kinds of pain, Dr. Alshon says. Managing weight, as well as exercises that improve flexibility and increase core muscle strength, can be helpful.

So can changing the way you move or execute simple daily activities. Bend at the knees when doing activities that require you to bend forward, says Dr. Alshon. “Getting in and out of the car, vacuuming and brushing your teeth all need to be done in ways that are best for your back.”

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