"Discover the Myths and Truths of Pain Management" FAQs

Public and Patient Education Department Program, November 29, 2005


Philip J. Wagner, MD

Assistant Attending Anesthesiologist, Hospital for Special Surgery

Is it possible that pain can be only a psychological issue?
Chronic pain is not “in your head.” Chronic pain is a legitimate medical condition that can and should be treated. Sometimes an exact cause cannot always be found. Be careful, because not all doctors have the specialized training to recognize and treat common and unusual conditions that cause ongoing pain.
Can an epidural paralyze me?
Permanent or long lasting paralysis from epidurals is exceedingly rare. In order to reduce the risk of paralysis (which is already very remote), special care is taken in the selection of the placement site for these anesthetics, the sterility of the procedure, and avoidance of certain medicines and medical conditions that increase bleeding risk.
What does the Hospital for Special Surgery’s Pain Management Center do?
Directed by an anesthesiologist with subspecialty training in pain management, the Division of Pain Medicine offers comprehensive evaluation and treatment to patients with acute and chronic pain syndromes, including pain from orthopedic and rheumatologic conditions. The division is skilled in treating pain related to conditions that include:
  • Spinal disorders
  • Nerve injuries
  • Arthritis
  • Peripheral neuropathies
  • Reflex sympathetic dystrophy
In addition, the division addresses post-operative pain and pain associated with cancer, shingles, and other medical conditions.
Can doing exercise really help manage my pain?
Regular to moderate exercise can benefit people suffering from chronic pain. Exercise can:
  • Keep joints moving
  • Keep the muscles around joints strong
  • Keep bones strong and healthy
  • Help you do daily activities more easily; and
  • Improve your overall health and fitness, including increasing your energy, improving your sleep, controlling your weight, strengthening your heart, and improving your self-esteem and sense of well-being.
What are some treatment options for acute low back pain?
Most low back pain can be treated without surgery. To treat the pain, medications such as acetaminophen (Tylenol), non-steroidal anti-inflammatory agents (such as aspirin, naproxen, and ibuprofen), and opioids can be used. NSAIDs suppress inflammation, pain, and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Opioids (such as codeine) provide pain relief only and are often prescribed to manage severe acute and chronic back pain. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
What are some non-surgical approaches to pain management?
  • Exercise programs
  • Meditation and Relaxation Techniques
  • Psychotherapy (especially Cognitive and Behavioral)
  • Physical Therapy and Rehabilitation
  • Medications
  • Injection procedures (epidural, facet, sacroiliac)
  • Nerve Blocks
  • Acupuncture
  • Spinal Cord Stimulation
  • Intraspinal opioid analgesia (implantable pumps)
  • Neurodestructive procedures (heat, cold, chemical)

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