“Chronic pain is treatable in many cases. Pain is not a mystery. The important thing is to find the ‘pain generator’ and fix it,” said Interventional Pain Specialist, Dr. Ronald Kloc. “Pain Medicine has progressed so that we can treat a large percentage of patients who are in pain and improve their lives markedly.”
Watch Dr. Kloc in this video speak to the different non surgical treatments he employs to help relieve arthritis, spinal stenosis, and other chronic pain for many of his patients. (Transcript below)
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I tell people the garden variety causes of chronic pain are typically something’s pressing on or irritating nerves chronically, or it’s a bone and joint problem.
Physical exam, that’s the old standard for finding out what’s wrong, but the modern methods we add to that by looking at MRIs, CAT scans, we want to see what it is that’s causing their pain.
We’re talking about nerves getting compressed or irritated chronically, so a lot of times a targeted steroid injection will be helpful.
Seeing if a targeted steroid injection can shrink down those, basically, angry areas in your body and help to relieve the pain. We can commonly get a pain reduction of anywhere from 50 to 100%.
Another common cause for chronic pain is the arthritis and you’ll have arthritis commonly in the neck that could be causing chronic neck pain, pain in the back, the lumbar spine, causing chronic back pain. You have these small nerves that will go to the joints. So the joints are the things that are hurting you, but we want to focus on those joints and the way we do is to find the nerve that goes to the joints, block those with a test, to see if the pain goes away. That’s a very important procedure because if you have very good results with that, then we have the diagnosis. We know that we can go one step further then and do what they call a radio-frequency. It’s a needle tip that has a very directed and small tip that will burn just a millimeter or two of tissue, right where that nerve is.
One of the causes of pain caused by pressure to the nerves is spinal stenosis. We find that there’s an area in the lumbar spine that’s very common in our seniors where that spinal cord has been narrowed and in the lumbar spine, we see a ligament that’s called ligamentum flavum, which often starts to buckle in patients. But patients will have difficulty walking, they can’t walk very far. They’ll say, “I walk a block or two, when I used to walk two miles.” We can go in and debulk that ligamentum flavum, which you see on the MRI. You’ll do that with a special tool that has a blunt tip on it, actually. It’s a procedure that uses x-ray guidance and not an open view. This is a more minimally invasive type of surgery. We can shave down that ligamentum flavum and it’s done as an outpatient, the patients go home within a half hour afterwards, and they should notice some improvement right away.
We see that a lot of our seniors will get a vertebral compression fracture. You’ll get a loss of calcium in their vertebrae and eventually you can have a spontaneous fracture. You don’t even have to do anything. Many of my patients will say, “I just got up in the morning and I had this sudden sharp pain in the back.” So we have a procedure called a kyphoplasty, where we can go in there, with x-ray guidance, we look for the exact spot to put our trocars or needles, and we can fill it up with bone cement and stabilize the fracture. That often gets near total pain relief.
It’s impossible to take away 100% of patient’s pain from 100% of people, but we can make great inroads and when I can get people more functional, up and doing the things that they love to do, that really makes my day.