The stepwise approach to pain management

- Effective pain management doesn't work unless all bases are covered. Fact!

- There is no magic bullet injection or treatment that cures chronic pain. Fact!

- We're searching for the magic bullet but haven't found it. Fact!

Here's how good pain management works

The key is to combine pain reducing techniques with carefully selected and concomitant therapies like rehabilitation therapies &/or physical therapies &/or psychological therapies. And get this, these therapies need to be combined with effective pain education and patient empowerment.

Modern pain reduction techniques

Modern pain reduction techniques are pretty good. They include medications like non-opioid analgesic medications & interventional pain techniques. These treatment approaches can provide significant pain reduction. Interventional pain techniques might include: joint blocks, nerve blocks, radiofrequency and neurostimulation.

The key to effective pain management

They key to effective pain reduction techniques is to use modern pain reduction techniques in a step-wise fashion 'stepping up' to the next treatment if the current treatment fails. As you step up to the next treatment, it is more likely to help but carries more risk. Neurostimulation / neuromodulation carries the greatest success if the candidates are selected appropriately with a success rate, with 70-80% of patients receiving more than 50% pain reduction. It also carries the highest risk but generally the people that are offered neurostimulation have had pain for a significant length of time and are quite debilitated but it.

Here is a graph adapted from a research article. It explains how effective pain management techniques should be applied and how the use of allied health pain experts like, physiotherapists, psychologists, occupational therapists and nurses, should be combined with these pain reducing techniques.