Overview of the Neurological Pain Management Program
Pain is a condition that affects millions of people worldwide. It is a complex, challenging problem requiring careful investigation of symptoms and specialized care. For individuals suffering from acute, chronic, or cancer-related pain, the Neurological Pain Management Program at Cleveland Clinic Abu Dhabi’s Neurological Institute offers a full range of outpatient evaluation and treatment techniques.
The program’s board-certified healthcare professionals have special training in the management of pain through an interdisciplinary, Patients First approach. The team is comprised of anesthesiologists, spine surgeons, physical medicine specialists, and psychiatrists who are dedicated to the goals of alleviating pain and improving each patient’s quality of life.
What we treat
The Neurological Pain Management Program treats patients with a wide range of conditions for related pain. Conditions that may require pain management include: The Neurological Pain Management Program treats patients with a wide range of conditions for related pain. Conditions that may require pain management include:
- Reflex sympathetic dystrophy: A disorder that may be caused by trauma or surgery, characterized by pain, swelling, tenderness, and vasomotor-related symptoms of the hands and feet (sweating, burning, or discoloration).
- Causalgia: A syndrome characterized by chronic, severe arm or leg pain after injury, surgery, stroke, or heart attack. The pain is much greater than it should be after these events and its cause is unknown.
- Disc disease: Low back or neck pain caused by the wearing down of a spinal disc. It can sometimes also cause hot, sharp pains in the hands and feet, along with weakness and numbness.
- Facet pain syndrome: Pain caused by injury to one of the facet joints (the joints between the vertebrae in the spine). This is one of the most common causes of back pain.
- Myofascial pain syndrome (MFP): A chronic pain disorder affecting fascia (connective tissue covering the muscles). Myofascial pain syndrome can happen after a muscle has been contracted repeatedly, causing pain in the specific muscle and seemingly random areas of the body.
- Peripheral neuropathy: Damage to the peripheral nerves (the nerves that carry messages from the brain, through the spinal cord, and to the rest of the body) that causes weakness, numbness, and pain. Pain is usually in the hands or feet, but can affect the rest of the body as well.
- Radiculopathy: Also called a pinched nerve, a condition in which a nerve is damaged or compressed. This can cause radiating pain, weakness, and/or numbness.
- Radicular pain: Pain that radiates (travels in waves) down the arm or leg.
- Sacroiliac pain syndrome: Chronic pain in one of the sacroiliac joints (the two joints in the lower back, positioned on each side of the spine). This pain resonates in the lower back and can feel either dull or sharp.
- Spinal pain: Pain that can occur anywhere between the bottom of the neck and the lower back. There are many different reasons for spinal pain, such as injury, bad posture, pressure on the spinal nerves, or a broken vertebra.
- Spinal stenosis: A condition in which the spaces between the vertebrae narrow, causing pain and other complications. It is mostly caused by arthritis, but can also be caused by a herniated disc (slipped disc), injury, or tumor.
- Abdominal pain: Pain that occurs anywhere in the stomach region. It can be caused by a broad variety of factors, such as indigestion, constipation, menstrual cramps, or gas. These causes of abdominal pain are usually not serious, but sometimes pain may indicate a problem with one of the organs in the abdomen.
- Arthritis: Inflammation of the joints. Symptoms are pain, swelling, and stiffness in the joints that can appear gradually or very suddenly. While there are many types of arthritis, the two most common types are osteoarthritis (caused by wear on the joints) and rheumatoid arthritis (an autoimmune condition).
- Post-surgical pain: After surgery, it is common to experience pain in the area that was operated on. How long this pain lasts depends heavily on what surgery was performed.
- Failed back surgery syndrome: A condition in which patients continue to have back or spinal pain after back or spine surgery that was intended to eliminate pain. The most common cause of this is that the area operated on was not in fact the actual cause of pain.
Diagnosis & treatment of pain
Diagnosis of pain
Neurological Pain Management Program physicians have access to the most advanced equipment for diagnosing the origin and causes of pain, enabling them to develop tailored treatment plans for patients. Diagnostic procedures may include:
- Laboratory testing: Specific blood or urine sample analyses that may be ordered, depending on the patient’s symptoms.
- X-ray: A non-invasive imaging study that creates pictures of the inside of the body. X-rays are usually able to identify the cause of pain when it is a broken bone or a skeletal defect.
- Computed tomography (CT) scan: A non-invasive imaging study that uses x-rays to create cross-sectional images. It can be used to detect a range of abnormalities, including problems with the vertebral discs.
- Magnetic resonance imaging (MRI): A non-invasive medical test that uses a large magnet and radio waves to make clear images of the body. MRIs can detect brain and spinal cord injury, cancer, multiple sclerosis, stroke, heart attack, damage from a heart attack, disc problems, and other conditions.
Treatment of pain
Based on the patient’s diagnosis, a specialized treatment plan is created by a multidisciplinary team of caregivers. Treatment plans are tailored to the unique needs of each patient and discussed with all physicians across Cleveland Clinic Abu Dhabi who are involved in the patient’s care.
Treatment may include a combination of several approaches, such as:
- Physical therapy
- Interventional pain procedures
One of several types of interventional pain procedures may be recommended, including:
- Nerve block: An injection of medication into a group of nerves. This medication numbs the nerves and blocks pain from reaching the specific part of the body.
- Joint injection: A non-surgical treatment for arthritis in which an anesthetic (to numb the area) or a steroid (to block the pain in the area) is injected directly into the joint.
- Trigger point injection: A pain medication injection into an area of muscles called a trigger point. This is a knot of muscle that does not relax. These injections usually contain an anesthetic (numbing medication).
- Spinal cord stimulation: A procedure that supplies nerves in the spinal column with mild electrical stimulation that suppresses nerve communication with the brain to block pain.
Psychiatric evaluation or assessment for surgical treatment may also be recommended.
Neurological Pain Management Program caregivers
The Neurological Pain Management Program at Cleveland Clinic Abu Dhabi’s Neurological Institute is comprised of experts who are specially trained in helping patients with a range of conditions that require pain management care.
Caregivers involved in patient care for this program are:
- Pain physicians
- Spine surgeons
- Interventional radiologists