Other Pain Sources

There many other sources of pain, such as:

  1. Neuropathic Pain
    • Complex Regional Pain Syndrome (CRPS), also called Reflex Sympathetic Dystrophy
    • Sympathetically Maintained Pain
    • Fibromyalgia
    • Interstial Cystitis
    • Irritable Bowel Syndrome.

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  2. Treatment of Neuropathic Pain
    The various neuropathic pains are a complex collection of disorders that can be difficult to treat. However, with careful diagnosis and the marshalling of diverse resources, we stand an excellent chance of improving your life. Our favorite phrase here is, “you have given me my life back.”

    One of the most powerful tools in treating neuropathic pain is the spinal cord stimulator, which delivers tiny amounts of electrical energy directly onto the spine. The effect of this stimulation of the spinal cord is to allow, via a variety of mechanisms, the spinal cord to function normally and to stop sending inappropriate pain information up to the brain.

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  3. Other Pain Sources

    1. The many types of cancer pain
      Cancer pain can arise from many different causes, including the cancer itself, compression of a nerve or other body part, fractures or treatment of the cancer. We have multiple techniques to assist with treating the various pains from cancer, including medications and injections. In particular, we offer ablative therapies and the use of pumps to deliver pain medication to the subarachnoid space, so that the medication is targeted to pain receptors on the spinal cord. The advantage to the cancer patient is better pain control with decreased side effects.

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    2. Headaches and facial pain, including atypical facial pain and trigeminal neuralgia
      Headaches are a major source of discomfort and lost productivity. Multiple effective treatments exist for refractory headaches, including medication, biofeedback, injections, and implants, depending upon the precise type of headache.

      Botox also provides a useful means of effectively and safely treating headaches.

      Atypical facial pain can be debilitating. Often times it can be treated by injections of the sphenopalatine ganglion.

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    3. Peripheral nerve pain
      Peripheral nerve pain is an underappreciated source of pain that is often misdiagnosed and under treated. While not common, they can be debilitating. They can respond well to simple treatments such a trigger point injections and cryoablation, an office-based procedure that involves freezing the nerves.

      Examples of peripheral nerve pain include intercostal neuralgia, ilioinguinal neuroma, hypogastric neuroma, lateral femoral cutaneous nerve entrapment, interdigital neuroma and related nerve entrapments.

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    4. Post-herpetic neuralgia
      Post herpetic neuralgia (PHN) is a painful condition occurring after a bout of shingles. When we are young, we are almost all exposed to chicken pox, caused by the Herpes Zoster virus. Our immune system controls the virus, but it goes to live in the spinal cord. When we get old, sick or stressed, the virus can again attack us. However, in this second attack, the body usually recognizes the Herpes Zoster virus and contains the pain to a localized area, along the course of one nerve root (cervical, lumbar). You have the characteristic blisters, which normally heal. Sometimes, however, the Herpes Zoster virus damages the nerve, causing ongoing neuropathic pain that persists after the lesions from the shingles have healed.

      The best way to treat the PHN is to treat it before it sets in. Medications such as Acyclovir (Zovirax), steroids and injections, such as sympathetic injections, can help prevent the onset of PHN.

      After the pain is present, injections, local anesthetics, and pain medications can be useful.

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    5. Compression fractures
      Compression fractures of the vertebral bodies are common in the elderly and commonly arise as a result of osteoporosis, or loss of calcium in the bone. With less calcium, the bone becomes weak and can break. Like any fracture, compression fractures hurt. Like any fracture, they are treated by stabilization, in this case, by injecting cement into the bone in a procedure known as a vertebroplasty. Vertebroplasty is an effective way to treat the pain of compression fractures.

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    6. Piriformis syndrome
      The Piriformis muscle goes from the hip to sacrum (tailbone). It is important in that the sciatic nerve passes through it.

      Piriformis syndrome is a spasm of the Piriformis muscle. When the muscle goes into spasm, it can squeeze the sciatic nerve, causing pain going down the leg.

      Piriformis syndrome will usually respond to physical therapy. In persistent cases, one can inject local anesthetic and steroid into the muscle. If the pain persists, injecting Botox or Myobloc, which are both botulinium toxins, into the muscle provides effective, safe treatment.

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    7. Coccyxdynia
      Coccyxdynia is simply pain in the region on the tailbone, or coccyx. It can result from trauma or arise without apparent cause.

      The initial treatment is conservative, with oral analgesics. Oftentimes, the pain is sympathetically mediated and can respond to either a local anesthetic injection of the Ganglion Impar, which is located by the coccyx or by ablating the Ganglion Impar, usually using radiofrequency.

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    8. Myofasciitis and torticollis
      Myofasciitis (pain in the muscles, whether in the neck or back) often responds to conservative physical therapy treatments, massage and exercise. If the pain persists, trigger points can be used. If the trigger points provide temporary relief, our preference is to proceed to Botox injections. Botox, which is botulinium toxin, can relax the muscles for six or more months, with long-term relief of pain. It provides a safe, effective treatment for what can otherwise be a difficult, ongoing problem.

      Torticollis is spasm of the muscles in the neck, forcing the sufferer to hold his or her neck tilted or rotated to the side. Botox is approved by the Federal Drug Administration for treatment of this problem.

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    9. Plantar fasciitis and Lateral epicondylitis
      Plantar fasciitis (heel pain) and lateral epicondylitis (tennis elbow) are two common pain problems. Treatment starts with conservative options, such as rest, non-steroidal anti-inflammatory medications, steroid injections, over-the counter pain medications, physical therapy and, for heel pain, shoe inserts.

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At Pacific Coast Pain Management Center, Dr. Helm, and associates will use contemporary techniques to diagnose and treat your pain. If you live in the Laguna Hills or greater Orange County area, call today to schedule your consultation with one of our specialists.

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