Managing pain is an important part of your treatment and recovery from an orthopedic disorder or injury. Pain can cause sleeplessness, depression and limitations on your ability to move – all of which can slow down your recovery.
It is important to manage your pain before it becomes too intense. Be sure to tell your doctor when you have pain and discuss ways to deal with the pain. The sooner you treat pain, the less likely it is to get worse or cause other complications.
Pain can be:
- Acute, lasting up to three months. It usually gets better after four to six weeks of home treatment. This type of pain is usually the result of an injury or a disorder such as arthritis. It can range from a muscle ache to s shooting or stabbing pain. Sometimes it limits your ability to move or stand up properly.
- Recurrent, a repeat episode of acute symptoms. Most people have at least one episode of recurrent low back pain.
- Chronic, lasting longer than three months. This type of pain often gets worse over time. Its cause can be difficult to identify.
Call your doctor if:
- Your pain has gone on for more than three months
- Your pain is interfering with your usual daily activities
- You can’t sleep because of pain
- Your orthopedic disorder or condition has healed, but pain is still thereUsually, pain is treated beginning with the least invasive and less potent measures first. If these don’t work, your doctor will then try stronger approaches
At Trinity Hospital, a team of experts in orthopedics and pain management carefully monitors each patient throughout his or her treatment. Some treatments for pain include:
This includes the use of tools to add strength, stability or support to a joint or bone to relieve painful pressure. Assistive devices are any tools, such as back or wrist braces or canes that aid the body in managing activities of daily living following injury, disease or surgery. Some devices, such as braces, hold a joint in place to aid the healing process. Other types of devices give strength or stability to a joint. Still other assistive devices, such as canes or walkers, help a person redistribute their weight to favor a weakened or injured joint.
Usually the first approach to treating back pain involves using pain relievers, reducing any swelling, restoring proper movement and strength and preventing a return of the pain. Conservative care that can be done at home include:
- Applying ice and heat. This can reduce the pain and swelling for some people, improving their ability to move. As soon as possible after an injury, you should apply a cold compress (a bag of ice or a bag of frozen vegetables wrapped in a towel) to the painful area several times a day for up to 20 minutes each time. After two to three days, you should begin to apply heat to the area using a heating lamp or hot pad for brief periods to relax the muscles and increase the blood flow. Warm baths may also help relax muscles. (Avoid falling asleep with the heating pad in place. This can cause burns.)
- Bed rest. Do this for one to two days at most. You should resume activity as soon as possible to avoid loss of muscle strength or blood clots in the legs. At night or when you are resting, you should lie on one side with a pillow between the knees. Another option is to lie on the back with a pillow under your knees.
- Exercise. This may be the best way to recover from back pain because it strengthens the back and stomach muscles. This is particularly important if you have irregularities in your spine. Consult your doctor or a physical therapist for a list of gentle exercises to keep your muscles moving without making your condition worse. Examples of good exercises for the back include stretching, swimming, walking or yoga. Most mild discomfort that you may feel when you begin to exercise should disappear as your muscles warm up. If the pain is more than mild and lasts for 15 minutes or more during exercise, you should stop exercising and speak to your doctor before doing more exercise.
A number of prescription and over-the-counter drugs help relieve the pain, swelling and other symptoms that come with fractured bones, injured ligaments, disease, aging and degeneration of joints and bones. Managing pain is important for your recovery. Severe pain or pain that doesn’t go away can lead to depression, difficulty sleeping, limitations on your ability to move around and changes to your daily activities. All of these can slow down your healing and prolong a painful bone condition. You should always consult with your doctor about how best to deal with your pain. Be careful about taking drugs you haven’t had before. Be sure to tell your doctor about all drugs that you are taking, including over-the-counter medicines. Also, be sure to take any drugs your doctor prescribes the way that he or she tells you and for as long as you are asked to take them.
Avoid using alcohol to relax or relieve pain. While it may relax muscles, it is not a pain reliever. Many doctors believe alcohol may cause more problems than it solves. Alcohol is a major depressant and can be habit-forming. In addition, it can have serious side effects with pain-relieving drugs. Alcohol is also fattening and tends to slow your recovery.
The information provided here about each category of drugs is general in nature. It does not cover all the possible drugs that could be given for orthopedic conditions, nor does it describe all the possible uses, side effects, interactions with other drugs or vitamins and herbal supplements. Please talk to your doctor or pharmacist for full information about the drugs that are prescribed. This information should not be used as medical advice for individual health problems. If your doctor thinks that a drug therapy program can benefit you, he or she will develop a program that is specific to your condition, age, general health and other drugs you may be taking. Drugs should be taken as prescribed. Tell your doctor all drugs and supplements are taking and any side effects you may have.
Below is an overview of the main categories of drugs that may be recommended for orthopedic conditions:
- Anti- depressants
- Anti-seizure drugs
- Muscle relaxants
- Narcotic pain relievers
- Non-steroidal anti-inflammatory drugs (NSAIDS)
- Osteoporosis drugs
- Pain relievers
Interventional Pain Management
Interventional pain management uses injections of drugs to reduce pain. Besides its therapeutic benefit, interventional pain management can play a role in identify the source of the pain.
Often, an X-Ray or MRI shows more than one area that the pain could be coming from. By selectively injecting each separate area or spine structure with anesthetic, your doctor can begin to pinpoint the problem.
Interventional pain management doctors are skilled in performing pain injections. An orthopaedic surgeon may perform the injection or refer you to another specialist:
- Epidural Steroid Injection. This is the most commonly done procedure to relieve pain. The injection delivers a powerful cortisone solution directly to the spine, which reduces the swelling and irritation around a nerve or part of the spinal cord. Most patients who receive epidurals will have less pain for a number of weeks or months. This allows them to participate in a rehabilitation program. Epidural injections are usually repeated when severe symptoms flare-up.
- Selective Nerve Root Injection. In this procedure, the doctor uses X-ray guidance (fluoroscopy) to locate a particular nerve root. The drug is injected into the troubled nerve root, rather than into the entire spine. The injection can be even more tightly focused if it is being done to diagnose the source of the pain.
- Facet Joint Injection. The bones (vertebrae) of our spines are linked to each other by facet joints. The facet joints are paired (one on the right and one on the left side of the spine) on every vertebra. Injecting medication directly into the facet joint with the aide of x-ray guidance (fluoroscopy) helps to locate and relieve the source of the pain.
- Sacroiliac Joint Injection. At the base of the spine is the tailbone (the sacrum). The sacroiliac joint connects the sacrum to the pelvis. It can become a source of lower back and leg pain. An injection into the sacroiliac joint can provide relief from pain.
- Joint and Soft Tissue Injections. The doctor injects a corticosteroid or pain reliever directly into the affected joint or soft tissue space (the space between the muscle and bone) to provide relief for weeks or months, or longer. The injection also may be used to remove fluid build-up in an inflamed joint.
Trinity Hospital offers physical therapy for individuals with orthopedic diseases, disorders or injuries and those recovering from orthopedic surgery. This comprehensive program includes a rehabilitation gym and equipment for Pilates-based exercise.
The Clinical Staff: All rehabilitation services are provided by licensed physical therapists. Our staff includes certified clinical specialists as well as therapists experienced in treating sports injuries, spinal disorders (surgical and nonsurgical), chronic pain and arthritis.
Services Provided: After being referred for physical therapy, each Orthopaedic Center patient receives an evaluation by a licensed physical therapist. A treatment plan is developed based upon the recommendations from the referring doctor and the findings of the evaluation. The therapist maintains communication with the referring doctor on the patient’s continued progress.
Treatment Goals: The program’s goal is to help patients reach optimal levels of function and independence, helping them to return to everyday activities. Our goals are to:
- Decrease pain
- Improve functional mobility
- Improve posture
- Increase range of motion
- Improve tolerance to work
- Increase strength and endurance
Treatment Procedures: Our orthopedic experts use a wide variety of treatment procedures to help optimize function and help patients reach their personal goals. Treatment procedures may include:
- Gait training
- Pilates-based exercise
- Proper posture and instruction in body mechanics
- Range of motion and stretching
- Soft tissue and joint mobilization
- Therapeutic exercise
- Trunk stabilization
- Motion Analysis
Home Program: Patients are trained to carry on a therapeutic program at home. This physical therapy program is designed for patients individually by our licensed physical therapists.