Treatments to Help Relieve the Torture of Chronic Pain by Megan Augustine - October 30, 2010

Chronic pain affects an estimated 76.2 million Americans according to the National Centers for Health Statistics - more than the number of cancer, diabetes, stroke and heart disease patients combined. 

Chronic pain is different and debilitating.  Chronic pain persists.  Pain signals keep firing in the nervous system for weeks, months, even years.

Yolanda Vilches, an active 51-year-old from Kileen, had a job she enjoyed and four grandchildren that she spent time caring for when chronic back pain changed her life.  In 2006, she was diagnosed with a bulging disc and began a four-year journey to find relief from what became debilitating pain.

"I was in so much pain.  I couldn't sit.  I couldn't stand.  My legs would fall asleep.  It was no way to live," said Vilches.  Her doctor prescribed pain medication that gave her temporary relief but as time went by Vilches' pain grew worse and the medication helped less and less. 

Like many who suffer from chronic pain, Vilches began to miss work on a regular basis.  Prolonged absence from work, with a high likelihood of unemployment, is a common experience for people with chronic pain.  In addition to the negative impact it has on the patient's life, absence from work contributes to the high cost of chronic pain on the country's economy.  Even conservative estimates put this cost at over $100 billion per year.

Vilches was referred to Dennis Karasek, M.D., a fellowship-trained physician at the Spine and Pain Center of San Antonio.  Dr. Karasek has more than 13 years of exclusive practice in the treatment of pain.

"By the time a patient comes to me for help, they have often been in pain for many months or even years," said Karasek.  "Chronic pain can greatly reduce a person's quality of life.  My patients deserve my full attention and they deserve relief from their pain."

Dr. Karasek treated Vilches with a procedure known as Spinal Cord Stimulation. 

"He told me that this device would be my best bet for my back pain," said Vilches.  "I was afraid to have the surgery but I'm so glad that I did.  I should have done it years ago."  

Spinal Cord Stimulation was first used in 1971 and after several technical and clinical developments it has become a popular treatment for chronic back pain.  A small wire connected to a power source is surgically implanted under the skin.  Then low-level electrical signals are transmitted through the wire to the spinal cord or to specific nerves to block pain signals from reaching the brain.  Using a magnetic remote control, patients can turn the current on and off or adjust the intensity. 

The effects of SCS for Vilches were immediate.  Within 24 hours her pain was greatly reduced. Since then she has significantly reduced the amount of pain medication she takes and is looking forward to a day in the near future when she is completely drug-free. 

Julia Peterson, a former ballerina who suffered many injuries to her back, has also endured years of chronic pain.  Ten years ago, at 38, she underwent surgery in which discs were removed from her spine to relieve pressure on her nerves.  The surgery was successful and she soon returned to her active life.

In recent years, however, Peterson developed a compressive neuropathy (pinched nerve) in which the nerves in her spine were compressed and causing her extreme pain.  Like Vilches, Peterson went to see several physicians and specialists, most of whom prescribed pain medication as treatment. 

"Pain medication was OK for me temporarily, but I didn't want to stay on it," said Peterson.  "I want to live a long time and I want to have my own kidneys and my own liver."

The most commonly prescribed medications for the treatment of back pain are non-steroidal anti-inflammatory drugs (NSAIDs). These agents block prostaglandins, the substances that dilate blood vessels and cause inflammation and pain.  While short-term use of NSAIDs is often effective, studies show that regular use can be hazardous.  The two main adverse reactions relate to gastrointestinal effects and renal effects. 

"It is very possible that Julia will remain pain free with the use of spinal cord stimulation," said Karasek.  "Because the amount of stimulation is controlled by the patient, these devices can provide long term relief even for patients with degenerative conditions."

Although she is still recovering from the implantation, Peterson says that she already feels significant relief from her back pain.  She plans to continue her physical therapy program and looks forward to using less pain medication to control her symptoms.  

These are just two examples of patients seeking alternatives to traditional therapy and show great promise for ever-improving technology and advances for dealing with chronic pain and keeping up with everyday life.