Having trained as an Emergency Physician, I developed an early interest in chronic pain, given the number of patients I was seeing suffering as the result of motor vehicle trauma and other life-threatening and critical injuries. What I witnessed then, and what I continue to witness now in my role as Department Chief and Medical Director at the new Humber River Hospital, were chronic pain sufferers for whom regular mainstream treatments were ineffective.
With one in three Canadians suffering from chronic pain (and as many as 50 percent), pain management is a leading factor in overall health and wellness.
Patients are also better educated than ever before, having done their research before they visit their GP, looking for answers and bringing to the table new and improved solutions.
A simple Google search under chronic pain turns up over 50 million results. Talk about an overwhelming abundance of information and misinformation directed at a group of people who suffer day in and day out!
Even the volume of books being written about the subject turn up so many it would be hard to choose what to read first: Experiencing Chronic Pain in Society by Lous Heshusius as a follow up to his previous memoir, Inside Chronic Pain. Additional tomes include How Does It Hurt, The Pain Chronicles and even Chronic Pain for Dummies*.
All this to say that while there is definitely more awareness of — and support for — chronic pain, the truth is that patients are desperate for solutions that truly work and will get them back to “normal” with limited side effects.
Through my clinical practice, we seek solutions rooted in evidence-based medicine. The treatment we are currently recommending to most of our patients suffering from chronic pain (whether lower back, a result of heavy labour, migraines or spinal, to name just a few) is nerve blocks, whereby we aim to stop the pain via the delivery of an anesthetic agent directly in the proximity of the affected nerves. Think of it as temporarily hitting the “off switch,” which may no longer be working in the damaged nerve territory. Results have been excellent, with patients seeing 50 to 100 percent relief in the first 48 hours, with many experiencing up to 30 percent relief in the week following.
Nerve blocks may be used in conjunction with a pain management program including medication, rehabilitation such as exercise, physiotherapy, chiropractic therapy and/or cognitive therapies such as cognitive behavioural therapy and mindfulness. The good news is that most people are good candidates for nerve blocks, which deliver anesthetic directly to the source of the pain without the side effects other medications may cause. This treatment is covered by OHIP, making it accessible to all.
While we continue to see the number of chronic pain cases increase year-over-year, our goal is to see the level of relief keeping par (or better), and the use of nerve blocks is certainly a positive step forward in that direction.
Dr. Leon Rivlin
*books not reviewed nor endorsed by Dr. Rivlin.