What’s New in Pain Treatments

Easing back, head and cancer pain

older woman holding neck

Treatment of pain, particularly headaches and back and cancer pain, has always been a challenge. Recent technological developments in pain management, as well as new variations on ancient methods, can help to eliminate or ease tough pain.

Here are a few of these treatments that have shown success in pain management.

Headache pain

  • Occipital nerve stimulator is implanted directly. The stimulator is about the size of a credit card and can be activated by patients at the first sign of a headache. The device stimulates the brain to make a morphine-like substance that helps alleviate the pain.
  • IMATCH is a three-week intensive outpatient program. Patients who experience severe headaches several days per week need intensive therapy. Cleveland Clinic’s IMATCH program focuses on improving a patient’s ability to function, rather than on completely eliminating pain.
  • Botox and nerve blocks treat migraine, tension or chronic headaches. For tough headaches that don’t respond to other medications, physicians use Botox®, the popular anti-wrinkle agent. Botox injections offer temporary pain relief for up to four months. Nerve blocks, which require a minimally invasive procedure, can offer relief for up to nine months.
  • Clinical studies might be an option. A clinical study for chronic migraine sufferers is under way to evaluate peripheral nerve stimulation.

Back pain

  • Transdiscal biacuplasty reduces low back pain. Radiofrequency waves have shown success in significantly reducing back pain and improving functionality for patients with chronic low back pain.
  • Cooled radiofrequency ablation offers long-term relief. This new minimally invasive procedure, using radiofrequency currents through a cooled electrode, treats sacroiliac joint pain and may offer long-term relief.
  • Balloon kyphoplasty relieves back fractures. This minimally invasive procedure can offer pain relief for patients with vertebral compression fractures. Orthopaedic balloons are inserted to lift the fractured bone and return it to the correct position.
  • Clinical trials might be an option. If you have lower back pain but have not had any previous back surgeries, you may be eligible to participate in a clinical trial to evaluate transdiscal biacuplasty.
  • Acupuncture, diet and exercise reduce low back pain. “Complementary therapy acupuncture can work very well for back pain, headache and many other types of pain,” says Hong Shen, MD, a Cleveland Clinic physical medicine and rehabilitation specialist and acupuncturist.

In addition to body acupuncture, practiced in China for more than 2,000 years, Dr. Shen uses auricular and scalp acupuncture.

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“Auricular and scalp acupuncture work faster than traditional body acupuncture,” Dr. Shen says. But a patient’s response is individual: Some respond better to just one type; others respond better to a combination. Modifying treatment based on a patient’s unique needs and responses is part of Dr. Shen’s patient-centered approach.

Cancer pain

  • Nerve blocks provide relief for months. Local anesthetics are injected near the nerves involved in transmitting pain signals and may help temporarily block the pain. Neurolysis, a longer-acting technique that uses alcohol or phenol to block pain signals, may provide pain relief for three to six months.
  • Intraspinal drug infusion systems deliver medication directly. Implantable pumps deliver a small amount of pain medication directly to the spinal fluid that bathes the spinal cord. Other treatment options include pain medication delivered through external pumps.
  • Radiation therapy helps manage pain. Although radiation therapy may not cure the cancer, it can be a pain management tool when used to shrink the tumor and reduce pain.
  • Adjuvant drug therapies can offer relief. Traditionally not considered first-line cancer pain therapies, drugs such as antidepressants, anticonvulsants, corticosteroids and others may offer pain relief.

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  • Tom

    I have arthritus pain, right side of neck. PT and chiro never helped. Any advice?

    • Health Hub Team

      Facet injections are an effective treatment for neck arthritis. When anti-inflammatory steroids are injected directly into osteoarthritic spinal joints, it can rapidly decrease pain and restore function. They are generally combined with an anesthetic, which also helps reduce the patient’s pain. Since repetitive cortisone injections can be harmful to the tissue and bones, they are reserved for patients with more pronounced symptoms.

      Alternative treatments include:
      Acupuncture, which aims to stimulate specific points on the body to restore and maintain health or control pain or stress. The most thoroughly studied mechanism employs penetration of the skin by thin, solid, metallic needles, which are manipulated manually or by electrical stimulation. Clinical studies add evidence that acupuncture may benefit chronic pain. Some private insurance plans already cover acupuncture; Medicare does not.

      Yoga exercise, which involves stretches, poses, and meditation. Yoga is not only a great exercise but also relieves stress and neck pain by reducing tension.

      Cognitive behavioral therapy, which is a type of talk therapy that may help if pain is having a serious impact on your life. Examples of proven techniques that help to manage stress and relaxation include controlled breathing, meditation, biofeedback and self-hypnosis. — Hong Shen, MD

  • http://www.facebook.com/violet.sanford.35 Violet Sanford

    How do I find out about clinical trials?

    • Health Hub Team

      I recommend searching the NIH clinical trials website for trials that are related to conditions you have. — Hong Shen, MD

      • Daniel Betz

        No mention of PRP or CRP which work better than cortisone and could be done easily and are inexpensive or manual therapy. Well, manual therapy is a lost art in PT so it would not matter.
        Sadly, this is all our health care system can provide to avoid back pain and spine issues. Even acupuncture is being proven to have a huge implications of Placebo effect. And , to train Western Medicine Doctors “Medical Acupuncture” it is quite a joke from my experiences in comparison to traditional CMT and Acupuncture.

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  • Marti

    Is there any treatment for RSD?

    • Dee

      I have a friend who was treated for RSD by the Pain Management team at CCF in the Walker (WOW) building off E. 105 on the second floor.

    • http://www.facebook.com/liz.brown.39982 Liz Brown

      Yes. I was treated by Dr Michael Stanton-Hicks and his amazing team for my RSD in my lower legs. They can help you get off a lot of not all of your meds so you can get back to your life. Good luck!

      • http://www.facebook.com/liz.brown.39982 Liz Brown

        I went with the spinal cord stimulator – if this is an option that can help you, please consider it.

      • Jeff

        What did he do to help? I’m searching for help. I have been to doctor after doctor but no one offers any help other than meds. I need to find the right doc. I’m in tears every day!

        • Klaracica .

          Me to Jeff.
          Did U find any help??I care

  • Jeanna

    Funny you don”‘t mention the invisible pain disease, fibromyalgia. I could write a book on the research I have done and how it has devalued my life. I have found some things that help physically and mentally, but mention the Fibtomyalgia and Drs act like you said the F word. Until a Dr. truly looses his life to this “syndrome’,not disease, nothing will be done. It is sad for the pain outcasts. Who are you to say how bad fibromyalgia pain is, if you don’t feel it. I have asked for a fibromyalgia Dr at Cleveland and 5 of the excellemt physicians say there really isn’t one. Why?

    • Peggy Mathews

      Jeanna, I’ve never replied to a message from a Cleveland Clinic email blast but I wondered if you came across Craniosacral Therapy as a way to decrease pain with fibromyalgia? I started studying it 2 years ago to use with patients in physical therapy who have pain. Peggy Mathews PT alternativesforhealth@gmail.com

      • jeanna

        Peggy, no I haven’t but I appreciate your response and I will look into it. I have tried all the Lyrics, Cymbalta, and Savella out there. Fibromyalgia sufferers often have intense reactions to medications. Savella worked amazing but I lost my vision on it and never regained it. I have tried the anti inflammatories, muscle relaxants, pain medication,nerve meds out there. I have done therapy, water exercise, moved 1000 miles for a new climate, yoga and changed my diet to foods closest to natural state and juicing. Some of the above works but I have also been unresponsive and almost dead from medication reaction, ground my teeth until all the roots were killed and my teeth were broken. Even after all this a Dr. In intensive care told me fibro is not real and all in my head and then took me off of every medication which sent me into 72 hours of terror from hallucinations, taking that many hours for other doctors to figure out what was wrong with me. There are a lot of horror stories out there and a lot of real people, in genuine pain who want to be treated with respect and have their medical condition treated as serious as it is.

        • Klaracica .

          So sorry !I have fibro also and took all the med U did.Only Savelle helped.Was pain free almost but had to stop because off side effect.Major sweetting,gas, was falling a s;eep anywhere anytime.. chills, felt like I have a flue.
          Have told do execise, but have AO also and its so painful a 2 togheter.After gym sometimes spend a day in bed.
          Did helped Ut to move? Where did u go ????
          So here I,am with my pain and nothing is helping.I do take Oxicodone, but its not help much, just feel the pain a little less.
          One thing I do not undestand why Drs not giving us something else.Why we have to suffer a rest of ur life ?
          I want morphine.Maybe for like list 10 days of the mont I want to be normal.
          I took one pill once ! and ( was by the ocen ) was running !!!!!!!! Wanted to, felt free no pain at all.Oh well I,am going to get it when I will be on my dearhbed.Addictive well I dont care.I,am not hook on Oxy ether, dont like it,only taking it when its very bad.

    • just a thought

      a dear friend of mine suffers from fibromyalgia and is currently seeing Doctor

      Jason Komitau at the Cleveland Clinic Jacobs Health Center. He has prescribed Lyrica for her and she has been experiencing good results from having been on it for over 2 years now. Dr. Komitau is a family practitioner, a good man, listens carefully and is a very good doctor. Give him a call. I think you’ll be pleasantly surprised.

  • Carol

    Who can I contact about the radio frequency ablation for SI joint pain?

  • Gregg

    I had an occipital nerve stimulator implanted several years ago to help with constant pain that followed brain surgery. Although it ddi not eliminate the pain, it is much more tolerable. It saved my life. Thank you Cleveland Clinic.

  • lindpe01

    I have headache like pain but worse and back pain

  • Kat Gist

    What about RSD pain when you have rejected both medicine and spinal cord stimulators and sympathetic nerve block shots? I’m currently waiting until the end of Septemper for a week ketamine infusions since nothing else has worked. RSD has spread from right foot and is in both legs, hips, stomach and ribs. It even effects my hands and fingers from time to time. Not to mention the lack of sleep that I have going on since I only get 2-3 hours of sleep a night if even that.

  • La Fina

    I recently was diagnosed with gluten sensitive enteropathy(celiac disease). Since I have been on the new diet(gluten free) I have very few migraine headaches. Prior to that I was dealing with them nearly every day.