Chronic pain is an experience that affects the body and mind, and negatively impacts a person's relationships with their surroundings, family, and career. Untreated pain becomes a disease in itself. We currently have many methods that effectively treat chronic pain. Therapy encompasses both the body and mind – a challenge for an interdisciplinary team of specialists.
Given the specific nature of chronic pain, the appropriate place for the treatment of these ailments is a pain management clinic. A pain clinic is a place where patients not only receive prescriptions for painkillers. Here, the patient can also talk to a doctor about their suffering. They will also receive advice on how to cope with the pain.
The treatment of chronic pain should be approached comprehensively, meaning not only alleviating the pain itself but also easing accompanying symptoms. The aim of therapy is to improve the patient's quality of life through the use of non-invasive and invasive methods. It is crucial to determine the severity of the pain and its cause in order to achieve success. Only based on this information can pain medication or therapeutic procedures be accurately selected.
Pharmacotherapy – medications can be administered orally (painkillers) or transdermally (pain relief ointments, pain relief patches). If necessary, for example in the treatment of neuropathic pain (resulting from nerve damage), painkillers are supplemented with antidepressants, anticonvulsants, or drugs that modify inflammatory responses. This method also influences the mechanisms of pain occurrence and perception: physical and psychological. Indications include chronic headaches, back pain before or after surgery, and advanced cancer causing, for example, bone pain.
Treatments that cause a temporary or permanent interruption in the transmission of pain signals to the central nervous system, such as:
Barricades (diagnostic, prognostic, therapeutic), i.e. anaesthesia of peripheral nerves by administering a local anaesthetic in the immediate vicinity of nerve trunks, plexuses and nerves. This not only eliminates local pain sensation, but also reduces inflammation and removes post-traumatic spasms, muscle contractures and vasomotor dysfunction, which facilitates physiotherapy.
Thermoablation – involves the destruction of nerve structures by thermocoagulation using high-frequency electric current. Indications for its use include, for example, chronic back pain caused by degeneration, trigeminal neuralgia, or sciatica.
Neurectomy – involves the destruction of nerve fibres by the local administration of, for example, ethyl alcohol, glycerol, or phenol. The method is used to relieve pain that cannot be reduced by any other means in cancer patients or in cases of limb ischaemia.
Neuromodulation – involves the implantation of systems that affect the nervous system by electrical stimulation or continuous drug delivery. Indications for the use of this method include, among others, pain after unsuccessful spinal surgery.
Botulinum toxin treatment involves subcutaneous or intramuscular injections, which cause temporary paralysis of the muscle in the area where it is administered. Indications for using botulinum toxin include torticollis and migraines, among others. Symptoms gradually subside 1-3 days after application and last for several months.
Alternative methods such as local cryotherapy, acupuncture, massage, TENS (transcutaneous electrical nerve stimulation), PENS (percutaneous electrical nerve stimulation), magnetotherapy, osteopathy, ultrasound, and kinesitherapy (gymnastic exercises).
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