In the previous class,
we reviewed the pharmacological treatment of pain,
acknowledging that it is a cornerstone in the treatment of pain.
Yet many other treatments are frequently employed, mostly for
patients with chronic pain.
By non-pharmacological treatments,
we refer to a wide range of therapies starting from physical therapies,
pharmacological interventions, invasive procedures and complementary medicine.
Non-pharmacological treatments have to be aimed at specific targets
like pain reduction, improved function, better control of anxiety,
anger and depression, and even reduced drug consumption.
So if a patient with chronic pain is referred to physical therapy, for
example, specific goals have to be set.
These goals include not only pain reduction but also decreased muscle spasm,
improved body mechanics, posture, endurance, and muscle spasm.
The same is true for
psychological interventions which consist of individual and group therapies,
social counseling, relaxation techniques, biofeedback, hypnosis and so on.
These interventions can diminish negative feelings of anxiety,
anger, helplessness, and enhance positive emotions,
improving coping skills, and strengthen social activities and family relationship.
A growing emphasis is put on the employment of
self-administered physical and psychological.
Invasive procedures are directed mainly at pain control.
[SOUND] Among them, one can find various types of injections aimed at a trigger
points in muscles, ligaments, joints and the spine, as well as nerve blocks.
If pain becomes intractable, ablation of nerves is proposed.
Various techniques of electrical stimulation of peripheral nerves,
the spinal cord and even specific targets in the brain are employed for
difficult to treat neuropathic and ischemic pain.
Ischemic pain, which we haven't yet touched on,
is pain caused by reduced blood flow to specific organs like the heart or
other body parts, commonly the legs.
So intractable angina pectoris
is treated with electrical stimulation of the spinal cord.