What is Chronic Pain?

Pain is considered to be chronic when it persists beyond 3 months. The World Health Organization (WHO) in their 11th revision of the International Classification of Diseases (ICD-11) has classified chronic pain into two categories: primary and secondary. Chronic primary pain refers to either (a) persistent pain that extends past the complete healing of damaged tissues or (b) pain without an identifiable cause. Chronic secondary pain is pain associated with underlying diseases such as rheumatoid arthritis or fibromyalgia.

Common Causes for Chronic Pain

Biological, psychological, environmental, and social factors can all influence your experience with chronic pain. It is important to address the underlying causes of your chronic pain as soon as possible, as untreated pain can easily impact a person’s work, social, and family life, as well as their ability to perform everyday tasks.

Common causes of chronic pain include but are not limited to the following:

• Biochemical deficiencies and imbalances such as a lack of vitamin D, magnesium, or omega-3 fatty acid, to name a few, may influence proper pain processing and lead to increased chronic pain

• Any cause for excess inflammation such as lack of or poor sleep, poor nutrition, high stress, chronic inflammatory diseases, and some medications

• Neuromuscular deconditioning and imbalances can lead to muscle or joint dysfunction and pain

• Persistent emotional pain can overlap with your central nervous system’s processing of physical pain and lead to an increase of chronic pain. Stress, fear, anger, anxiety, panic, grief, and loss can all negatively affect your mind and body and manifest as chronic pain.

What is Therapeutic Injection and Intervention?

Therapeutic injection and intervention therapy are methods of pain management offered by Insight Medical Imaging in which our highly trained and experienced radiologists relieve various types of joint, back, and musculoskeletal pain through mechanical or surgical interventions. It is a safe and effective form of pain management and has been known to show its efficacy in treating orthopedic or neurological conditions or injuries. Injection therapy is also common as a treatment for neck pain following vehicular accidents.

How Can Injections Help With My Chronic Pain?

For patients suffering from chronic pain due to underlying conditions or neuromuscular issues, it can be hard sometimes to identify just where the pain is coming from. Injections can aid in both the diagnosis and treatment process by administering numbing or anesthetic agents straight to the source.

For patients with underlying conditions such as Myofascial Pain Syndrome (MPS), a common musculoskeletal pain syndrome, needle therapy or injections can help facilitate a rehabilitation program as the patient works to regain executive function. For patients with MPS or suffering from referred pain (which is pain felt in one part of the body that is actually caused by an injury or pain in another part of the body), the administering of a numbing agent or steroid can help break up muscle tension and give pain relief.

Epidural steroid injection (ESI) is one of the most common pain management injections. It is a minimally invasive medical procedure, and is used to relieve neck, arm, back, and leg pain when prescribed by a doctor. ESI is delivered into the epidural space around the patient’s spinal cord where the steroidal medication inside the needle reduces inflammation and pain.

Another form of injection treatment administered by our radiologists is nerve block treatment. Selective Nerve Root Block (SNRB) injection is used to diagnose and treat inflamed spinal nerves or pain in the arm or leg that can be traced down the path of a single nerve. Typically, an anesthetic agent is injected and administered near the spinal nerve to reduce inflammation and numb the pain transmitted by the nerve.

If your chronic pain originates around your hip area, bilateral hip injections can be used to treat hip-related pain by administering a numbing agent into the joint.

All the injections administered by Insight Medical Imaging are done under x-ray (fluoroscopy) or ultrasound to accurately see where the needle needs to be targeted in relation to the joint causing you pain.

What is Radiofrequency Ablation?

Radiofrequency Ablation is the process of using heat to intentionally damage tissue and encourage the formation of scar tissue in order to close up varicose veins. Our radiologists treat the pain associated with varicose veins by inserting a thin tube (catheter) into a small incision into the varicose vein where radiofrequency energy can heat and damage the wall inside the vein. The resultant scar tissue closes off the varicose vein, prevening further pain.

Insight Medical Imaging Clinics Are Here To Help

Be it chronic or emerging but persistent acute pain, we urge you to come in and see one of our specialists to get started with your treatment. Contact any of our locations in Alberta to book an appointment. Be sure to review our Exam Prep for Pain Management before your first appointment, including our informational video (available in seven languages), but also don’t forget to bring your requisition, Alberta Health Care Card (or any out-of-province health care card).

References

Singh, V., Trescot, A., & Nishio, I. (2015). Injections for Chronic Pain. Physical Medicine and Rehabilitation Clinics of North America, 26(2), 249-261. doi:10.1016/j.pmr.2015.01.004

Coffa D, & Mehling W. (2013). Management of chronic pain. LaDou J, & Harrison R.J.(Eds.), CURRENT Diagnosis & Treatment: Occupational & Environmental Medicine, 5e. McGraw Hill.

Funiciello, M., DO. (2019). Selective Nerve Root Block Injections. Retrieved from https://www.spine-health.com/treatment/injections/selective-nerve-root-block-injections

University of Maryland Rehabilitation & Orthopaedic Institute. Nerve Root Blocks. Retrieved from https://www.umms.org/rehab/health-services/pain-management/treatments/nerve-root-blocks?__cf_chl_jschl_tk__=pmd_8AC20ZroXLC9DunN0qWHPmw..xzayuKVmEeOYkq10mk-1630099966-0-gqNtZGzNAmWjcnBszQil

Healthwise Staff. (2020). Varicose Veins: Radiofrequency Ablation. Retrieved from https://myhealth.alberta.ca/health/pages/conditions.aspx?Hwid=tx4190

Pain Specialists of America. (2018). Different Types of Pain Management Injections And How They Can Help You. Retrieved from https://psadocs.com/different-types-of-pain-management-injections-and-how-they-can-help-you/

Remde A (2019). Chronic pain. Usatine R.P., & Smith M.A., & Mayeaux, Jr. E.J., & Chumley H.S.(Eds.), The Color Atlas and Synopsis of Family Medicine, 3e. McGraw Hill.

Health Canada. (2021, May 12). Canadian Pain Task Force Report: March 2021 – Canada.ca. Government of Canada. Retrieved from https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2021.html