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January 8, 2016 | by The Polyclinic


The following is part two of our two-part series on pain management without the use of opioids. Part one covered what chronic pain is and the importance of managing pain in a variety of ways.

Pain is multidimensional and caused by many factors. The below treatments are part of 10 ways to reduce pain without opioids (read the first five here), and can yield successful pain reduction. It may be a combination of several therapies that will ultimately provide relief.

  1. Acupuncture. Acupuncture is a form of traditional Chinese medicine that is commonly used for treatment of pain by inserting ultra-thin, flexible needles into the skin in places where nerves enter muscle, at the midpoint of a muscle, or where muscle connects to bone. “Acupuncture can play a complementary role in reducing pain symptoms,” says Diana Ferdana, nurse practitioner, who treats patients with acupuncture at The Polyclinic.

  2. Trigger point injections. Another form of pain management is an injection into a specific site if the pain source is concentrated in the muscle or a set of muscles containing tender trigger points. Called a trigger point injection, it may contain a numbing agent such as lidocaine, and renders the trigger point inactive, relieving the pain. Trigger point injections can resolve pain permanently or require ongoing therapy with repeated injections.

  3. Ultrasound-guided injections. After determining the most likely cause of pain, your provider may suggest an ultrasound-guided injection. This treatment is an injection into the sac-like cavity between tissue where friction takes place with corticosteroid. It can often relieve the pain caused by inflammation resulting from muscle weaknesses or osteoarthritis. If your pain is caused by an unhealthy tendon, your provider may recommend treating your pain with Platelet Rich Plasma (PRP) or Dry Needling. These procedures direct your body’s own growth factors and inflammatory mediators to the poorly functioning tendon.

  4. Epidural steroid injections.Epidural steroid injections are often effective treating radiating pain, such as neck pain that radiates to arms or lower back pain extending into the legs. A steroid injection goes into joint space or between vertebrate, and reduces the inflammation causing the pain. A single injection can result in long-term—sometimes permanent—relief.

  5. Radiofrequency nerve ablation (RFA). Another effective treatment for localized neck and lower back pain is radiofrequency nerve ablation. This non-surgical treatment can target pain originating from the facet joints by using electrical current. Dr. Pearl Ren uses electrical currents produced by radio waves to burn off branches of targeted spinal nerves causing pain in the neck or low back. The nerves grow back after the procedure but patients are often pain free for up to three years.

The Polyclinic’s Muskuloskeletal Department on the fourth floor of Madison Center includes providers from related specialties in Orthopedics, Sports Medicine, Physical Medicine, Physical Therapy, Podiatry, and Rheumatology, who often work together to help patients better manage pain.

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