As the premier pain-management practice in the Lehigh Valley, we offer the most diverse treatment options in the area. These include traditional medical therapies and innovative advanced surgical techniques.
Comprehensive Pain Centers offers help and hope to those who experience one or more of the following conditions:
Back Pain – Acute or Chronic
Back pain is the second leading, medically related reason for missing work. While clinical trials are difficult to perform, due to the multiple factors that can influence a patient’s perception of pain, evidence is proving that early imaging and intervention result in better patient outcomes.
Degenerative back and neck pain is generally classified into three broad categories: disc degeneration, disc protrusions/herniations, and facet degeneration. The primary role of imaging is to exclude causes of nondegenerative pain (e.g., compression fractures, tumors, neural disorders, and traumatic injuries) and indicate which of the above three categories may be the primary pain factor.
Cancer Pain– Cancer is usually not painful in its early stages. When the cancer becomes recurrent or spreads to other parts of the body, such as the bones, many patients experience pain that becomes more severe with the progression of the disease.
With advanced disease, 60 to 90% of cancer patients report pain of different intensity. Among those, 25% die without relief from their severe pain. The pain is usually accompanied by a feeling of helplessness, hopelessness, and despair. These patients are not afraid to die, instead they are afraid of the pain that remains with them daily – that they suffer from an incurable disease. Pain has become the central focus of their lives. It also leads to nausea, vomiting, insomnia, weight loss, and weakness.
With advances made in understanding the physiology and pathophysiology of cancer and its symptoms, The World Health Organization has developed guidelines for better pain management for advanced cancer patients. The guideline involves starting with weak pain killers, such as anti-inflammatory medications and advancing to Opioid therapy, nerve blocks followed by nerve destruction, if necessary.
The management of cancer pain uses three different approaches. The first one deals with treating the cancer itself with the appropriate measure, such as surgery, chemotherapy, radiation therapy, and hormonal therapy. The second approach deals with treating the patient itself since pain is the most common complaint of patients with advanced diseases. About 80% of cancer pain is due to direct tumor involvement. This means that the cancer has spread to your bones, nerves, or other organs to cause pain directly. About 15% of cancer pain is due to cancer therapy, such as surgery, chemotherapy, and radiation therapy. The last category of pain seen in cancer patients is not related to the cancer or the therapy; instead is due to myofascial pain, joint pain, or other common causes of acute or chronic pain found in the general population.
A comprehensive approach is used to treat cancer pain. It encompasses behavioral therapy, physical therapy, medications, nerve blocks, rhizotomy, and the implantable devices, such as spinal cord stimulators and intrathecal Morphine pumps If your oncologist or family physician has exhausted their pain treatment options then you may suggest being referred to a comprehensive pain center where the above-mentioned treatment modalities are available and effective in controlling your pain.
Complex Regional Pain Syndrome (CRPS) – Formerly called Reflex Sympathetic Dystrophy (RSD). This is a chronic condition that usually affects the arm or leg in which the patient may experience sensations of intense burning or aches combined with swelling, skin discoloration, altered temperature, abnormal sweating and hypersensitivity in the area that is affected.
Degenerative Disc Disease – This is a term used to describe the normal changes in the spinal discs as a person ages where the discs between the vertebrae can become stiff and rigid resulting in pain and other symptoms.
Fibromyalgia – Treatment of symptoms or associated pain
Headaches & Migraines
Low Back Pain
Multiple Sclerosis – Treatment of symptoms or associated pain
Neck Pain – Acute or Chronic. The neck represents a small area in the body; however, it contains many pain-sensitive structures making neck pain a very common complaint. The cervical spine is located between the weighty head and the immobile thorax. Because the cervical spine is mobile, it is subject to varying degrees of trauma. While the complex structure in the neck can cause direct or referred neck pain, only the most common causes of neck pain will be mentioned here.
Whiplash Injury – This refers to the injury caused by an abrupt hyper-extension of the neck from an indirect force. For example, during a rear end motor vehicle collision, the body is propelled forward and the head backward until it hits the posterior upper thorax – a position that is not within the physiologic range of motion. With severe impact, various cervical muscles are overstretched with consequent lacerations of the muscles to varying degrees, the posterior fibers of the intervertebral discs, and the capsule of the facet joints. The esophagus and temporomandibular joints are among other structures that can be stretched leading to hoarseness and difficulty in opening the mouth. Patients usually complain of neck pain aggravated by movements of the head. Treatments consists of NSAIDs (medication), physical therapy, TENS unit, ice or heat therapy, and cervical facet joint therapy.
Neck Sprain – This is the most common painful neck injury; it involves the ligaments, tendons, and muscles in the cervical spine. The causative factors include accidental trauma, microtrauma resulting from incorrect posture or persistent abnormal use of the head and cervical spine at home or at work. It is manifested by neck pain, low occipital headache and limitation of movement. Treatment consists of anti-inflammatory drugs, massage, ultrasound, short term neck collar, exercises, traction, trigger point injections, and cervical facet injections when appropriate.
Neuralgia – This is a sharp, severe, and shooting pain that travels along a nerve or group of nerves. The pain is usually caused by irritation or damage in the area of the body where the nerve is irritated.
Osteoporosis – Related Back Pain
Pelvic Pain & Urogenital Pain
Phantom Limb Pain – This is a pain that people experience after the amputation of a limb. Although the limb in no longer present, the patient can continue to have an awareness of it and to experience sensations from it.
Radiculopathy – Pain, numbness, tingling, and weakness in the patient’s arms or legs that are caused by a problem with one or more nerve roots.
Recurring Discomfort – From Industrial or Accidental Injuries
Sciatica – A type of radiculopathy that travels from the patient’s lower back through the buttock and down the large sciatic nerve in the back of the leg.
Shingles (Post-Herpetic Neuralgia) – An infection that arises from the reactivation of the same virus that causes chickenpox (the varicella virus). It can cause a painful rash of blisters that is isolated in a broad band on one side, or one area, of the face or body. Although the triggering factor is unknown in most cases, the disease occurs mainly in older patients who had chickenpox and who have become immune-compromised as a result of chronic infections, malignancy, and medications.
Following an attack of chicken pox, the virus moves to the dorsal root ganglion where it becomes dormant. The dorsal root ganglion is the part of the nerve that connects to the spinal cord. During the disease process the virus undergoes reactivation, multiplication and transportation from the dorsal root ganglion to the sensory nerve endings to the skin. The incidence in the general population is 125 cases per 100,000 per year.
Clinically, 50% of the patient population presents with a vesicular rash in their chest area; 20% experience the painful rash in their face. The infection is usually limited to the distribution of a single spiral or cranial sensory nerve. These patients complain of a sharp shooting pain and hypersensitivity or numbness in the involved area. Occasionally they have accompanying fever, malaise, and headache. Pain usually precedes the rash by four to five days. The lesions begin as a swollen red papule that progresses to clear vesicles and pustules that crust over in two to three weeks. Usually as the vesicles begin to dry and scale, the intense pain subsides.
The goal in treating herpes zoster is to promote healing of the rash and to prevent progression to the intensely painful and disabling post-herpetic neuralgia. Various medication including anti-depressants, anti-virals, and pain killers are used successfully. Nerve blocks and epidural steroid injections mixed with local anesthetic are also helpful in the treatment of herpes zoster. Sympathetic nerve block, when performed within the first two to three weeks after onset of symptoms, has been shown to be nearly 100% successful in controlling the pain and promote healing.
Post-herpetic neuralgia is an excruciating and debilitating pain that occurs in 20% of herpes zoster sufferers after the lesion has healed. It is characterized by a constant burning and aching pain superimposed by episodes of sharp lancinating pain. The lightest touch becomes intolerable. It is felt to be secondary to the damage that occurs in the dorsal root ganglion during herpes zoster. The goal of therapy is to improve the quality of life of those patients by controlling their pain. Usually no one treatment can achieve that goal. An aggressive multidisciplinary approach is necessary involving different classes of medications, including NSAIDs, weak to strong Opioids, diagnostic and therapeutic nerve blocks, spinal cord stimulators, and implantable Morphine pump for patients who develop side effects from oral narcotics.
Spinal Stenosis – A narrowing of areas of the spine which is caused by degenerative changes of the vertebrae. Spinal stenosis can result in sensations of cramping, pain or numbness in the patient’s legs, back, neck, shoulders or arms. It can also cause a loss of sensation in the extremities and sometimes problems with bladder or bowel function.
TemporoMandibular Joint Syndrome (TMJ)
Work Related Injury
Traditional Pain Treatments Include:
- Medication Management
- Nerve Blocks
- Patient-controlled Analgesia
- TENS Units (these provide nerve stimulation to decrease pain)
- Surgical Procedures
- Biofeedback & Relaxation Techniques
- Psychological Intervention
- Support Groups