The Metro Pain Clinic Group

Pain Management

Pain management essentially revolves around control. Successful pain management means that a person in pain can control his or her own pain: unsuccessful pain management means that the pain is in control of the person.

 Pain management incorporates a range of techniques and strategies including:

AUTHOR: Dr. David Vivian

Low back pain (LBP) is a big problem for health systems especially in industrialized countries,¹⁶ affecting approximately 60-80% of the adult population at some stage^14;24;39 and about 6% of people each day.²⁴ LBP affects up to 80% of the working population during their lifetime and is the second most common reason for physician visits,²⁵ and for work disability.³⁸ Although LBP is typically self-limiting,³⁷ it is still associated with substantial health care costs and absenteeism from work.^16;27;35

LBP is often associated with pain in other sites. For example, in a study of kitchen-hand workers, generalized musculoskeletal pain was present in 87%; including neck pain in 71%, LBP in 50% and forearm/hand pain in 49%.²¹ Also, 73% had pain in at least two sites, 36% in four or more, and 10% in 6-7.²¹ In another study of 4006 workers only 7.7% were free of regional pain of any description.²

AUTHOR: Dr. David Vivian

Pain, although usually a profoundly unpleasant experience, is a necessary part of our physiology. Those humans who are born without a pain system die prematurely, and at the end of their life, have substantial disfigurement. This is because they do not get the protection from tissue injury that pain provides, and also because the diagnosis of serious pathology, such as cardiac events and cancers, which typically present to doctors with pain, is delayed.

The pain system provides protection from tissue damage initially via the spinal reflex withdrawal system and subsequently from cognitive processes in which other controlled actions can be taken to avoid further tissue damage. For example, imagine you are walking along in bare feet and you stand on a sharp thorn. As the tip of the thorn touches the skin, sensitive receptors detect this information, and send nerve impulses up nerves in the leg to the spinal cord.

AUTHOR: Dr. David Vivian

Internal disc disruption (IDD) is a possible diagnosis in a patient presenting with chronic disabling low back pain (with or without referred pain). The search for the source and cause of low back pain (LBP) is often unsatisfactory. If the source is unknown the best labels for the diagnosis are either "non-specific low back pain" or "low back pain of unknown origin".