Chronic pain can be managed with several different methods including medicine and therapy. There are specialists that only practice pain management in Baltimore, but most general practitioners are able to prescribe sufficient treatment if the pain is due to an injury or illness that may resolve sometime in the near future. Each patient is different and will require a different level of treatment. It is up to the doctor to ensure that the patient receives the base amount of treatment without leaving the patient in constant pain.
The type of medications that a physician may prescribe depends on the length of time that you are projected to take it as well as the level of pain you are in. A mild pain will generally get over-the-counter acetaminophen or a non-steroidal anti-inflammatory. Mild to moderate pain will get a medication that is slightly stronger, such as a weak opioid like hydrocodone or a combination opioid and acetaminophen such as Vicodin. Moderate to severe pain warrants narcotics, which can be addicting and will need to be monitored closely by your physician. Narcotics that are most commonly prescribed include oxycodone, opiates, and amitriptyline.
Therapy is commonly used to treat chronic pain when the pain is due to an injury or surgery. Physical therapy can help to relieve pain with the use of thermal agents, electrotherapy, and exercise suited to build back muscle strength. It is common to have pain medications prescribed at the same time because the physical therapy may be painful in its beginning stages. A TENS unit can help with back pain by stimulating nerves using transcutaneous electrical currents. The psychological approach to pain management attempts to encourage helpful thought processes as well as create lifestyle changes that will increase sleep patterns and create better coping skills.
There are several procedures that can be performed to relieve pain. If the pain is chronic with no chance of relief in the near future, the patient and doctor may opt to implant an intrathecal pump which will deliver small quantities of medication directly into the spinal fluid. This can be implanted underneath the skin and allows for fewer systemic side effects. A spinal cord stimulator is a device that is implanted near the dorsal surface of the spine. The device creates an electric impulse that provides a tingling sensation, which alters the perception of pain in the patient. Hypnosis is not a proven method of pain management in Baltimore, but some patients believe that it can help them.