SEATTLE — About 20 million Americans suffer from chronic pain and managing it can be a long and aggravating process. Many jump from doctor to doctor or frequently change treatment plans in hopes of finding something that works for them.
Dr. Steven Stanos, Medical Director of Pain Services at Swedish, says that to create a gameplan for managing pain, we first need to understand how it affects our bodies. That we first feel pain physically, but it also affects our emotional well-being.
"Chronic pain is really a biopsychosocial problem,” explains Dr. Stanos, “So patients may develop pain from an injury, say, to their back and then over time their nervous system can actually change."
He says that people with chronic pain experience a change in their brains that can lead to increased stress, anxiety or depression. It can also affect sleeping patterns and keep them from performing everyday activities like working and socializing, "That's why it's really important for people to get assessed the correct way and understand that there's a lot of options."
The team at Swedish Pain Services treat more than 1,000 patients a month, utilizing the latest research and techniques. The first step is for a pain management specialist to perform a complete assessment of each patient. Sometimes many issues combine to create chronic pain. Once those issues are discovered an individualized treatment plan is created that can include medication or alternative treatments.
Some patients are hesitant to take medications to manage pain because it can lead to more problems. Dr. Stanos outlines two major public health challenges: 1) trying to decrease the number of overdose deaths from prescription and illicit opioids and 2) providing care for the patients who need it. That's why patient-centered treatment plans are necessary.
Non-opioid medicines are available to help treat pain. "Antidepressants and seizure medicines can help kind of quiet down the nervous system," as well as interventional procedures like epidurals or injections for lower back or leg pain, "We inject steroids and numbing medicine along the nerve and many times that can quiet down their symptoms and that can also help them if they're in a physical therapy program to get more out of their program."
The frequency of injections varies from patient to patient. Some patients undergo a series of injections, while others only do it once. "We base it on what their physical exam shows and there's usually other treatments as well -- physical therapy, medications. So, we kind of tie it all together for what the patient needs."
Patients also rely on a variety of rehabilitation approaches to manage pain. "Those include psychology, relaxation training, physical therapy, occupational therapy,” explains Dr. Stanos, “A physical therapist works on strengthening but also showing patients other stretching and aerobic exercises. Occupational therapy works on function and getting patients with a pain problem to function better and to pace better."
Some occupational therapists teach patients Tai Chi to lessen pain. "It’s kind of balanced gentle movements. And those movements, besides improving your balance and your strength, can help quiet down the nervous system."
Self-management is crucial for patients to feel as comfortable as possible. "We'll teach patients basic ways to breathe for a relaxation response to decrease their pain or other ways to do some other stretches that they may have been doing wrong in the past. So just that education, many times, can help patients so much more."
Swedish Pain Services has comprehensive programs for patients to learn about available interventions and to acquire skills to better manage their pain.