Pain Medicine

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Chronic Pain

Chronic pain syndrome is complex and poorly defined. Most doctors consider pain that lasts longer than six months as diagnostic of chronic pain syndrome. In addition to pain, which can also be defined as pain that lasts “longer than it should,” patients are affected by many other symptoms. These symptoms are often a result of the pain, and include depression, reduced activity, fatigue, and reduction of libido, dependent behavior, and drug and alcohol abuse, with disability that is disproportionate to their impairment.

Your doctor will take a complete medical and psychosocial history, and will perform a thorough examination, including radiologic studies, if indicated. You will be asked the location of your pain, the triggers for the pain, how you obtain relief, the quality of the pain, severity, and radiation, if any, of the pain. Focus carefully upon your answers, as this will help your physician with his treatment plan for you.

With respect to the physical factors that contribute to chronic pain, they include osteoarthritis and rheumatoid arthritis, and a large variety of other conditions including Lyme disease, Reiter syndrome, back problems, fibromyalgia, polymyalgia rheumatic, muscular strains and sprains, hernias, chronic overuse syndromes, and other ailments. Chronic pain can also be initiated by brachial plexus traction injury, cervical or lumbar radiculopathies, spinal stenosis, cutaneous nerve entrapment, post herpetic neuralgia (shingles), chronic headaches, including muscle tension headaches and migraines, and many other neurologic complaints. Other significant sources of chronic pain include urologic and gynecologic disorders, gastrointestinal disorders, psychiatric diseases, cardiovascular disease, peripheral vascular disease, and complications of chemotherapy, radiation, or surgery.

Treatment

Chronic pain syndrome is complex and poorly defined. Most doctors consider pain that lasts longer than six months as diagnostic of chronic pain syndrome. In addition to pain, which can also be defined as pain that lasts “longer than it should,” patients are affected by many other symptoms. These symptoms are often a result of the pain, and include depression, reduced activity, fatigue, and reduction of libido, dependent behavior, and drug and alcohol abuse, with disability that is disproportionate to their impairment.

Psychological treatment to develop coping strategies, while treating concurrent depression and anxiety are an integral part of treatment in many patients. Biofeedback may help modulate the pain response. Changing the system of reinforcement has been shown to be effective in management of chronic pain patients.

The Cornell Pain Medicine Center is proud to include two specialists that are here to help patients with coping strategies for chronic pain: Dr. Amanda Sacks and Dr. Robert Allan.

Some nonsurgical treatments that will help with chronic pain syndrome include physical therapy, and occupational therapy will often help the patient with activities of daily living. Physical therapies that are directed to the patient’s needs build strength and flexibility. This is done gradually, so the patient does not have a fear of exercising. Other physical therapy techniques may include application of heat or cold, massage, ultrasonographic therapy, stretching, traction, manipulations, and transcutaneous electrical nerve stimulation, which has been shown to have a benefit in treatment of both rheumatoid and osteoarthritis.

Nerve blocks can be used for diagnosis, prognosis, and therapeutics. Spinal cord stimulation is used to treat neuropathic pain and is also used to help patients with failed back syndrome and radicular pain.

Contact Information

Center for Comprehensive Spine Care 
240 East 59th Street
Second Floor 
New York, NY 10022
Tel: 888-WC-BACKS
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Westside Office
2315 Broadway
Second Floor
New York, NY 10024
Tel: (646) 962-7246
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Downtown Office
156 William Street
Eleventh Floor
New York, NY 10038
Tel: (646) 962-7246
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