Long Island Neurosurgical & Spinal Associates (LINSA)

Pain Alleviation

Many procedures are available to mitigate chronic pain caused by a variety of conditions. Most procedures attempt to diminish the pain perception, or abolish it entirely, by modifying or blocking the transmission of the pain signal through the nervous system. Other procedures may reduce the degree of inflammation or reactive changes caused by processes such as chronic disk herniations or epidural scarring from past operations. Certain painfull muscle spasms and rigidity associated with neurological conditions such as Multiple Sclerosis, Cerebral Palsy or Spastic Paraplegia can be helped with the infusion of drugs into the spinal fluid (Baclofen). Any degree of pain alleviation often results in functional improvement. Brain stimulation procedures to help patients with disabling conditions such as Parkinson Disease are under development  [Tremor Control Therapy - Metronic]

The following measures are used most commonly:

• Rehabilitation -- physical therapy, back hardening, massage, acupuncture.

• Medication -- analgesics (usually narcotics), muscle relaxants, anti-depressants or various anti-inflammatory compounds.

• Injections -- trigger points, paraspinal, facet blocks, epidural steroids (ESIs), peripheral nerves (usually with "cocktails" of local anesthetics and cortisone)

• Corrective surgery -- removing or modifying the condition causing the pain.

• Implantable therapies: spinal cord stimulation, intraspinal drug infusion -- these are two site-specific treatments that block pain signals from reaching the brain.

• Nerve-destroying surgery -- destruction of the actual nerves (alcohol nerve blocks and avulsions), or, in some cases, tracts within the spinal cord (cordotomy). This non-reversible treatment is usually a measure of the "last resort.

                                          See also: [Advanced Pain Therapies - Medtronic]