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.

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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.

“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.

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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.