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2100 Dorchester Avenue
Dorchester, Massachusetts 02124
617.296.4000   chmail@cchcs.org

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Living Healthy -- Common Medical Q&As;
  Pain Management

Today we no longer have to allow pain associated with an injury, disease or surgery to consume us. There are a variety of new and advanced ways to control pain.  Jeffrey Jackel, MD, DMD, is a pain management specialist at Caritas Carney Hospital. Below, he answers common questions people have regarding intense pain and explains the most efficient treatment methods.

Q. Can serious pain be controlled?

A. Yes. Today there are much more efficient ways of controlling pain than narcotics and nonsteroidal anti-inflammatories which we relied on in the past. 

Q. What are the new treatments that you use to control pain?

A. There are two main forms of treatment that we commonly use. The first is to administer a series of nerve blocks. Nerve blocks are injections that numb the affected area and halt muscle spasms.  The second treatment is a procedure we perform called radiofrequency rhizotomy. This procedure, which uses radio waves to generate precisely controlled heat, can effectively destroy a nerve’s ability to cause pain.

Q. How do you determine exactly where a nerve block should be administered?

A. First we use MRI or CT scans to determine exactly where the problem is. Then we typically use the C-arm—a sophisticated x-ray machine—to locate the landmark, the place where the injection should be administered.

Q. When you say that you inject nerve blocks, what exactly are you injecting?

A. The injection is usually a mixture of cortisone and local anesthetic. 

Q. What are the most common causes of pain that you treat?

A. At Caritas Carney Hospital, many people who come for the pain management service have back pain caused by either a herniated disc or spinal stenosis, the degenerative spine condition that is common in older individuals. Rib fractures, neuropathy, cancer pain and post-herpetic neuralgia (shingles) are other conditions that cause individuals to seek serious pain relief.

Q. If a person must have surgery, how do you treat the post-operative pain while the patient is still in the hospital?

A. Many people are familiar with patient-controlled analgesia (PCA), which allows individuals to safely administer their own pain medication. At Caritas Carney, some patients are also benefiting from PCEA—patient-controlled epidural anesthesia.

Q. What is the difference between patient-controlled analgesia (PCA) and patient-controlled epidural anesthesia (PCEA)?

A. Rather than using an intravenous line like in PCA, PCEA involves placement of a catheter in the spine’s epidural space to deliver effective pain relief. 

Q. What should a person do if he/she is suffering from serious pain?

A. Individuals with recurring or persistent pain should consult with their primary care physician to see if a referral to a pain management specialist is appropriate. Appointments can then be scheduled by calling (617) 296-PAIN.  If your health insurance plan requires a referral from your primary care physician, please obtain the referral before calling to schedule an appointment.