At Mobile Physical Medicine & Wellness, persons with chronic pain syndromes are managed with a multimodality approach. After a thorough history and physical exam are performed, treatment is recommended.
Pain is divided into two types: acute and chronic. An example of acute pain might be a person who has suffered a fractured arm. The pain is sudden in onset and is severe. Another example is that caused by a muscle strain or ‘pulled muscle’, which results after someone moves too quickly and “throws his back out.” Most often, acute pain is self-limited and short lived. Acute pain usually subsides within days to weeks, and typically, resolves altogether.
The other type of pain is chronic pain. This type of pain does not typically improve. Most clinicians define chronic pain as any pain which persists for more than three months, and may remain for years. Typically, treatment such as rest, ice, heat, or over- the -counter anti-inflammatory medications do not completely alleviate the pain. The most common sources of pain in patients evaluated in our Clinic include neck, low back or other joints such as the shoulder or knee. There may also be a component of nerve (or neuropathic) pain involved in the syndrome. In addition, headache syndromes, such as chronic migraine headaches, are also treated.
In the majority of cases, the patients who have chronic pain are also deconditioned and have some degree of functional limitation (ie. inability to walk as far as before, or inability to perform normal daily activities in a satisfactory manner.) As a result, in many cases some form of exercise, usually through a referral to physical therapy, can be very beneficial in improving a person’s overall functional abilities as well as help to better control the pain. Other treatments, including muscle injections and/or referral for epidural injections may be indicated. Prescription medication is also a form of treatment. This may include anti-inflammatory medications, muscle relaxants, neuropathic pain meds, and narcotic analgesics. Which specific medications are prescribed depends on each patient’s unique situation. In addition, the medication regimen may change over time, based on the response of the patient to the medications prescribed. The expected therapeutic effects, as well as possible side effects and drug/drug interactions of the prescribed medications, are discussed in detail with the patients.