What Causes Pain?

Pain may have many causes, including disease, injuries, surgery, and nerve damage. The most common types of pain are:

Back pain with or without leg pain, Neck pain with or without arm pain. – Also treating spine arthritis resulting in pain limitations of range of motion and walking.
Chronic back pain is often felt in the lower back, but can also extend into your legs or feet. it can also start in the neck and radiates down to the arms. A number of spinal diseases or injuries can trigger chronic back and leg pain, including degenerative disc disease, lumbar or surgical disc herniation, failed back syndrome, epidural fibrosis, and arachnoiditis. Symptoms range from mildly uncomfortable to completely disabling. You may feel a sharp or knife-like pain, a burning sensation, or a dull muscular ache. Affected areas may feel tender or sore to the touch and the pain may increase with movement.

Back Pain

Complex Regional Pain Syndrome (CRPS) – CRPS, also known as reflex sympathetic dystrophy or causalgia, is a chronic pain condition that most often affects the arms, legs, hands, or feet. CRPS usually develops in a limb after an injury (such as a broken bone) or surgery that may have involved nerve damage. The overriding symptom is extreme pain, frequently described as burning. Other symptoms can include sensitivity to touch, skin changes, swelling, weakness, and decreased function of the hand/foot.

Painful Neuropathy – Painful neuropathy is a neurological disorder where you experience severe chronic pain due to nerve damage to the nerves that connect the spinal cord to the body and help the brain communicate with skin, muscles, and internal organs. Damage may be a result of nutritional imbalances, alcoholism, toxins, infections, autoimmunity, and illnesses, such as kidney failure or cancer, and nerve trauma. Symptoms include stabbing or sharp pain, burning and numbness in the hands or feet.

Cancer Pain – Cancer and cancer treatments sometimes cause moderate to severe pain. Cancer pain may be caused by surgery, radiation, and chemotherapy; scar tissue resulting from surgery or cancer treatment; or a tumor that has grown into – or crowded out – organs, nerves, or other parts of the body. Cancer pain usually falls into one of two categories:

  • Nociceptive Pain – Caused by damage to tissue; described as sharp, aching, or throbbing.

  • Neuropathic Pain – Caused by actual nerve damage; described as a burning or heavy sensation, or numbness.

  • Abdominal or Pelvic Pain – That can result from variety of reasons including pancreatitis and endometriosis.

  • Nerve Pain – Due to shingles or trigeminal neuralgia.

  • Headache – Including migraine and cluster headache.

How is Pain Treated?

A variety of pain management techniques are available to Dr. Emad Mikhail Bishai at The Woodlands Pain Institute to help ease your suffering. The choice of treatment depends on your specific needs: the type and severity of pain, as well as how you respond to different pain treatments. Not all treatments may be applicable to your type of pain. Treatments include:

Non-Drug Treatments – Techniques such as relaxation, biofeedback, imagery, hypnosis, acupuncture, exercise, and counseling help many people use less pain medication.

Physical Therapy – Physical therapy builds or reconditions muscles – allowing you to move more normally and with less pain. We may recommend passive physical therapy, such as massage and applying heat/cold, or active treatments, such as exercise.

Psychological Therapy – Chronic pain can result in stress that impacts you, your relationships, and your body. Psychologists are available to work with you on relaxation techniques, coping and self-monitoring skills.

Nonopioid Oral Medications (Pills) – If non-drug techniques have not had the desired effect, we will try onopioid oral medications. They include mild pain relievers such as acetaminophen and non-steroidal anti-inflammatory drugs like ibuprofen.

Opioids – If nonopioid medications are not effective in controlling your pain, the next step is opioids, such as morphine or an analgesic patch. Opioids are similar to natural substances (endorphins) produced by the body to control pain.

Neurostimulators – Neurostimlators are surgically implanted in the body to send mild electrical impulses to the spine, masking the perception of pain messages to the brain. Unlike some surgeries, you can try a neurostimulators in advance of surgery to be sure it will be effective. It is also reversible; we can turn it off or remove it.

Intrathecal drug delivery system: A Pain pump implanted for pain or stiffness using an innovative technique with micro dosing to improve function under the skin.

Corrective Surgery – In doing tests, such as MRI or CT scans, to look for the cause of your pain, we may discover a problem that can be corrected by surgery. If so, we would recommend this treatment.

Therapeutic Nerve Blocks – Therapeutic nerve blocks are local anesthetic and/or steroid injections given at the origin of pain. Nerve blocks usually provide temporary pain relief. If your pain is not managed after multiple injections, we may consider other treatments.

Neuroablation – With neuroablation, the nerves that serve as pathways to the brain are destroyed (usually with heat). Neuroblation is usually a last resort when other treatments have failed.

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