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Palliser Primary Care Network


​Welcome to the Palliser Primary Care Network


Did You Know?

Palliser PCN health home teams provide service to approximately 105,000 patients.

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Treating your Chronic Pain

Chronic pain is a medical condition that largely impacts our community and is one of the most common reasons people seek medical attention from primary care. The most commonly diagnosed causes of chronic pain are neuropathic (diabetic neuropathy), musculoskeletal, mechanical (joint pain) and inflammatory (arthritis), although these primary diagnoses are not mutually exclusive. (uptodate.com; June 25, 2018).

Prior to treating a patient for chronic pain a physician will complete a comprehensive evaluation to formulate a customized plan of care. This may include an ongoing pain assessment that explores individual symptoms, social and occupational function, sleep patterns, activities of daily living, exercise, previous trials and investigations. During this planning, discussions about the patient's perceptions of chronic pain, their stress responses, pre-existing coping skills and educational gaps will allow the care team to ensure the patient has access to the needed tools to manage the illness. (Chronic pain, where the body meets the brain. Transactions of the American Clinical and Climatological Association. 2015: 126: 167-183).

Some of the primary treatment options available for chronic pain include medication management (over the counter medications, NSAIDS, muscle relaxants, antidepressants and opioids), physical therapy, neuromodulation devices (TENS), behavior modification and in some cases surgical treatments. (uptodate.com; June 25, 2018).

I would like to review one option that has been used more frequently for patients experiencing chronic joint, muscle, or back pain. This intervention involves the administration of pain management injections and is performed primarily under radiographic surveillance by a trained professional. The treatment tends to have very promising outcomes and can provide patients with a decrease in pain. Three different types of cortisone (steroid) injections may be used for back and neck pain.

1.       Facet joint injection - administered into a facet joint (situated on either side of the spine where each vertebrae overlap). This treatment is effective when the tissues around the spine are inflamed.

2.       Nerve root block injection - administered in the area near the spinal nerve roots to reduce pain, particularly in the lower back region.

3.       Epidural steroid Injection - administered directly into the space surrounding the nerves with in the spinal cord. This in turn will help decrease pain in back, neck, shoulders and other associated symptoms like tingling and numbness. (uptodate.com; July 15, 2018).

If you would like further information on chronic pain options contact your health home care team. 

Article Submitted by Melanie Neilson, RN with Riverside Medical Clinic

References:

1.       www.uptodate.com; Accessed June 25, 2018 and July 15, 2018

2.       "Chronic pain, where the body meets the brain." Transactions of the American Clinical and Climatological Association. 2015: 126: 167-183

3.       www.thecurbsiders.com

4.       "What you need to know about pain management", patient handout.  BGSA Radiology Inc.