Diseases & Conditions
The Neurosurgery Pain Group at the Boston Medical Center offers a variety of treatments to patients whose pain cannot be controlled through standard medical pain management.
For example, a surgical procedure known as a decompressive laminectomy can provide relief from pain due to a “pinched nerve” or sciatica. Similarly, open or endoscopic decompression surgery can help alleviate pain from carpal tunnel syndrome and a procedure called microvascular decompression can help relieve the pain of trigeminal neuralgia, an inflammation of the trigeminal nerve in the face. In addition, an implantable spinal infusion morphine pump or an implantable spinal cord stimulator can bring relief from some types of pain.
What is Pain?
Pain is a sensation of physical discomfort that can range from a minor nuisance to extreme and usually results from tissue damage. Most acute pain goes away after the tissue has healed. Pain is considered chronic when it continues after the tissue has healed and persists for more than six months. Inadequate treatment of pain can cause unnecessary suffering, disruption of life style, loss of income and loss of self-esteem.
Pain can be divided into two categories:
Mixed pain consists of a combination of neuropathic and nociceptive pain. This may be seen in migraine or cancer. About 70% of patients with advanced cancer have pain and about 25% die without adequate relief.
What is the standard treatment for Pain?
Most nociceptive pain is opioid-responsive, but effective doses may produce intolerable side effects. Neuropathic pain is usually opioid-resistant. Many patients require the addition of adjuvant analgesics such as antidepressants and anticonvulsants.
Patients who do not respond to the three-step analgesic ladder should be considered for treatment in a comprehensive multi-disciplinary pain clinic. Transcutaneous electrical nerve stimulation (TENS), nerve blocks and epidural steroid injections are commonly used, depending on the cause of the pain.
The Neurosurgery Pain Group offers a variety of treatments to patients who have failed standard medical pain management.