【Night Eye Care】Ultrasonic examination of nerve lines and injection of drugs to treat pain

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(Hong Kong News) According to the research data in 2017, nearly 30% of the population suffers from various chronic pains, and 10% of them suffer from severe pain. Surveys in recent years have also revealed that 9 adults have pain in two or more areas, the most common being the knees, back, and shoulders.

Diagnosis and treatment can be performed simultaneously

Dr. Tong Jiahui, a specialist in pain medicine at the Sanatorium and Hospital, said that common pain symptoms such as knee joint pain, shoulder pain, neck pain, and even some medical pain conditions including raw snakes and headaches can be treated not only by surgery, but also by pain medicine specialists. Injectable drug therapy and radiofrequency, another treatment option, can be performed in the clinic with lower risks than surgery.

He said that pain medicine specialists can use ultrasound or X-rays to accurately place extremely thin needles next to the nerves that cause pain, and relieve pain by heat or electricity.

“At present, it is also possible to use ultrasound to check whether there is swelling of the nerve cord that causes pain, and to inject painkillers directly, so that diagnosis and treatment can be carried out simultaneously; Nerve ablation of the joint blocks the nerve signal and helps relieve pain.”

He said that after treatment, the pain relief effect of individual patients with back pain or raw snakes can last for several years. Even if the pain recurs, the risk and effect of repeating the same treatment are the same; Risk and effect are not necessarily the same.

Elderly taking painkillers causes side effects

In particular, he pointed out that the pain has accumulated over the years, especially for the elderly. Apart from suffering from pain, they may also need to take multiple drugs due to high blood pressure, diabetes and heart disease.

“However, due to the weakening of their organ functions, the liver and kidney functions may not be able to decompose and excrete drugs as usual, resulting in a greater chance of side effects after taking painkillers for the elderly. Some drugs, such as anti-inflammatory drugs, will greatly increase gastric bleeding, kidney failure and heart disease. The risk of disease, long-term use is not recommended for the elderly.”

It is difficult for outsiders to understand the pain of suffering from pain disorders for many years. He shared that a patient once suffered from neuralgia in the hands for many years and felt that she had suffered from pain for many years. When she was found to have cholangiocarcinoma, she chose not to receive treatment because she thought that suffering from pain for a long time would make her feel Life is better than death, and I would rather be freed as soon as possible.

Chronic Pain Including Headache Raw Snake

Based on his years of experience in practicing medicine, he pointed out that he saw many pain patients who had only mild pain at the beginning, thought that rest and taking painkillers and anti-inflammatory drugs would relieve the pain, and ignored it until it worsened after a few years, so he had to visit different family doctors as a last resort Seek help from a specialist.

“Due to the lack of deep understanding of pain medicine specialists in the market, many chronic pain patients may not know that they can seek assistance from pain medicine specialists to prescribe the right medicine for the root cause of pain.”

He said, in fact, when the pain persists for one to two months, and different treatment methods are ineffective, it is recommended to seek help from a pain medicine specialist. In addition to the common “urban pain”, some chronic pain diseases such as pain caused by raw snakes , cancer pain, headache, etc., will generally improve after treatment, and the dose of medicine and acupuncture can be gradually reduced.

“Sometimes patients take different painkillers, but they may not be able to distinguish the effects and side effects of the drugs. Pain medicine specialists will evaluate and adjust the dosage of drugs according to the patient’s condition, and reduce the drugs with side effects to achieve the best curative effect. “

Don’t let the pain last for more than 3 months Chronic pain becomes more difficult to treat

Pain is the most common health problem among urbanites. It is usually triggered by illness, accident, or long-term poor posture.

Dr. Tong Jiahui, a specialist in pain medicine at Sanatorium and Hospital, said that the pain caused by general surgery or sprains and bruises will gradually subside as the body recovers. However, if the pain lasts for more than three months, it is classified as chronic pain and should be referred to a pain specialist for treatment as soon as possible, so as not to delay treatment for longer, and seriously affect the daily life of the patient.

Missed treatment opportunities lead to long-term pain

Studies have found that 20 to 30% of the population has chronic pain, the most common being headache, back pain and neck pain; about half of the elderly have pain in more than one location, such as knee pain, hip joint pain or raw snake pain wait.

“However, people generally lack awareness of pain departments, coupled with the shortage of public medical resources, resulting in many patients missing treatment opportunities and developing long-term pain.”

Pain is bothersome, but he bluntly said that if patients get referral as soon as possible, about 50% of the cases can be cured, and the pain of the remaining 50% will be greatly reduced.

“Because the pain doctors are all from the anesthesiology department and have a deep understanding of pharmacology, they can ensure that the prescribed painkillers are safe and effective and can be taken for a long time. They will also cooperate with some unique minimally invasive treatments, such as injections, radiofrequency or Brain magnetic therapy targeting the pain-sensing nerves of the brain, etc. Even if the patient has pain in more than one location, it can be treated together.”

He emphasized that the pain department does not just treat the head for headaches and the feet for feet.

“When facing a patient, our first step is to find out the source of the disease. If the patient is not referred by other specialists, we will conduct a comprehensive examination first. When other disease factors are excluded, we will further evaluate the impact of pain on the patient’s life. impact, and then formulate appropriate treatment.”

Multispecialty treatment can help speed up recovery

In addition to medications and interventional treatments, the pain department often adopts interdisciplinary treatment programs, including physical therapy, occupational therapy, and psychological therapy, to help speed up recovery.

“Because emotional factors can also aggravate pain, regulating emotions can help relieve pain to a certain extent and reduce dependence on drugs.”

He pointed out that because pain is a subjective feeling, it is difficult to measure it scientifically. Even for pain in the same location, the treatment methods are different.

“Based on clinical experience, each patient’s response to drugs is different. However, the medical field has now developed quick-acting but highly safe pain treatment methods, allowing doctors to choose appropriate treatments according to the situation. Therefore, patients can reduce the number of trials. The frequency of different drugs can also avoid high-risk treatment and the burden of excessive medical expenses. The cost of interventional treatment in the pain department is similar to that of colonoscopy.”

The purpose of treatment is to relieve the patient’s pain

Although the treatment technology is constantly improving, if the pain occurs for too long, it will not only increase the difficulty of treatment, but also make it difficult to cure it.

“For example, some elderly people have been haunted by raw snake pain for many years. Clinical findings show that if they receive treatment as early as the first one or two months, more than 90% of the patients can be cured, and there is no need for continued medication.”

He added that the main purpose of pain treatment,

It improves the quality of life by relieving pain for patients.

“Even if the pain is not completely eliminated, or requires long-term medication control,

But if treatment can help patients improve sleep, mood problems,

Regaining social and normal life is considered a success.

So as long as the patient does not give up, there must be a way to improve. “

Wen Li Ji

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