Pills Aren't Always the Answer to Chronic Pain Relief

Many people see pain doctors as nothing more than pill pushers, overeager to prescribe medications to quiet patients quickly. Enough narcotics or opiates were prescribed in 2010 to medicate each American adult every four hours for a month, according to the Centers for Disease Control and Prevention.

Statistics like those and a mistrust of the medical profession often prevent chronic pain sufferers from seeking treatment.

They are skittish about narcotics because of the side effects, which include constipation, nausea and dizziness, and the fear they can become addicted. Prescription pain abuse is epidemic.

Doctors, however, have a variety of pain relief methods at their disposal that don't include popping Vicodin.

My specialty is interventional pain, so I use injections frequently in my practice. I assess whether patients are good candidates by looking at diagnostic imaging studies, conducting a physical exam and talking with the doctor who referred them.

The most common injections we perform are cervical (neck) and lumbar epidural (lower back) steroid injections, which are used to treat pain involving the spine. We also use nerve blocks, trigger point injections, spinal cord stimulators and joint and facet injections.

For cervical and lumbar epidural steroid injections, we use a topical or local anesthetic, if required, before placing a small needle in the epidural space. We then inject a steroid or local anesthetic to relieve the pain and to reduce the inflammation of the nerve. The procedure takes only 15 minutes and many feel relief immediately. They may feel some light soreness in the area but that goes away quickly.

We tell patients to take it easy for the rest of the day, but many return to work right after the procedure.

The number of times you need injections varies depending on your medical condition. You can only get three injections in a six-month interval. But we have seen the effects of one injection last between six to 12 months. Often by the time it wears off, the underlying cause has been resolved with other treatment.

If you have any qualms about medications, ask your physician about other options like injections. It’s not all about pills.

About Dr. Scott Gottlieb: Dr. Scott Gottlieb is a pain management expert and the founder of Gramercy Pain Management. He is the director of Pain Management at New York Eye and Ear Infirmary (NYEE) and has treated over 3,000 patients. Dr. Gottlieb is board certified in both pain management and anesthesiology. He has offices in both Manhattan and Montebello, N.Y. in Rockland County.