Presentation is loading. Please wait.

Presentation is loading. Please wait.

TREATMENT OF NEUROPATHIC PAIN GARY A. MELLICK, D.O. American Specialists, Inc. American PAIN Specialists, Inc. American Disorders Clinic American SLEEP.

Similar presentations


Presentation on theme: "TREATMENT OF NEUROPATHIC PAIN GARY A. MELLICK, D.O. American Specialists, Inc. American PAIN Specialists, Inc. American Disorders Clinic American SLEEP."— Presentation transcript:

1 TREATMENT OF NEUROPATHIC PAIN GARY A. MELLICK, D.O. American Specialists, Inc. American PAIN Specialists, Inc. American Disorders Clinic American SLEEP Disorders Clinic

2 Dr. Gary Mellick & Staff

3 Chronic Pain n Understanding Chronic Pain n What Causes Chronic Pain n Chronic Pain Treatments

4 Chronic Pain Pain -- has an Element of Blank -- It cannot recollect When it begun -- or if there were A time when it was not Emily Dickinson New England Poet

5 CHRONIC PAIN n The Terrible Triad u Suffering, Sadness & Sleeplessness n Chronic Pain is the most costly health problem in America. u Headache u Lower back pain u Cancer pain u Arthritis pain

6 Understanding Chronic Pain n Sounding The Alarm n Broadcasting The News n Censoring The News

7 Understanding Chronic Pain n Sounding The Pain Alarm u Nociceptors F Nerve fibers in the skin, muscles, or joints F Excited exclusively by intense, potentially harmful stimulation PinprickPinprick Painful heatPainful heat Irritating chemicalsIrritating chemicals

8 Degree/Type of Noxious Stimuli & Pain Perception Nociceptors Sound The Pain Alarm

9 Ascending Pain Pathways

10 Understanding Chronic Pain n Broadcasting The News u Higher brain centers are alerted by spinal pathways F Different pathways carry different information Where it hurts; how bad it is; whether the pain is sharp or burning Fear, anger, anxiety Change in pulse rate, blood pressure, dilating the pupils

11 Pain Transmission Broadcasting The News Higher brain centers are alerted by spinal pathways. Different pathways carry different information.

12 Understanding Chronic Pain n Censoring The News u Built-in nervous system mechanisms can block pain messages F Pathways come down from the brain to prevent pain signals from coming through F Endorphins - natural opiates

13 Descending Pain Control Pathways Censoring The News Built-in nervous system mechanisms can block pain messages.

14 What Causes Chronic Pain n Gate Theory of Pain u A hypothetical gate opens up and allows pain to travel to the brain u Chronic pain results in many opened gates and broken fences n Pain Wind-up n Centralization

15 Peripheral Nervous system TouchPain Touch-evoked pain Pain & hypersensitivity Sensitized C-fibers Sensitized A-Beta fibers Wind-up (Central Sensitization) Wind-up Normal Sensory Processing Normal A-Beta fibers Normal C-fibers Central Nervous System

16 Pain Neurochemistry Pain Wind-up Central Spinal Sensitization Gate Theory of Pain

17 Images of Acute Pain

18 Images of Chronic Pain

19 Chronic Pain Treatments n Pain Medications u Opiates (morphine, Darvocet, etc.) u Adjuvant pain medicines (all the others combined ) n TENS (local electrical pain blocks) n Anesthetic and Cortisone Injections n Spinal Cord Stimulation and Pumps n Alternative Medicine Treatments (Acupuncture, Chiropractic, etc.)

20 Physician Responsibilities

21


Download ppt "TREATMENT OF NEUROPATHIC PAIN GARY A. MELLICK, D.O. American Specialists, Inc. American PAIN Specialists, Inc. American Disorders Clinic American SLEEP."

Similar presentations


Ads by Google