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A Multipronged Approach to Chronic Pain

Pain is the most common reason to see a physician and approximately 100 million Americans* experience chronic pain. Pain that persists for more than four weeks is referred to as chronic pain and it can affect every aspect of a person’s life: sleep, employment, socialization and daily living.

“Chronic pain means that things have changed in both the spinal cord and brain,” explains Ali Akmal, M.D., pain specialist with Meritus Pain Center. With chronic pain, pain signals can continue for weeks, months or years—even after the initial injury heals.

Dr. Akmal is fellowship trained in interventional pain management and treats patients with:

  • Persistent back pain
  • Arthritis-related pain in the back, shoulders or knees
  • Radiated pain from spinal stenosis due to herniated discs
  • Myofascial (muscle) pain
  • Cancer pain
  • Nerve pain from chemotherapy, amputation, diabetes, multiple sclerosis, shingles and spine surgery

Integrated pain management

Because pain is a complex and subjective experience, an integrated approach is required to address the pain. “With chronic pain, multimodality is key,” says Dr. Akmal. His approach to chronic pain includes:

According to Dr. Akmal, pain is connected to the area of the brain critical for emotional and memory processing. That’s why it’s important to understand the role pain plays in emotions, behavior and attitudes.

What’s best for the patient

Dr. Akmal’s goal is to identify the cause of pain and attack the pain generators. He looks at the safest and most effective therapies to provide the maximum benefit. His conservative and minimally invasive approach includes steroid injections, Botox injections and radiofrequency ablation which heats a small area of nerve tissue and decreases pain signals.

Physical therapy, which he emphasizes should begin right away, strengthens the muscles while steroid injections treat the symptoms. For patients who are overweight and struggling with arthritis, Dr. Akmal involves a nutritionist to help with weight management.

While opioids, like oxycodone, help address chronic pain, they must be used appropriately. “Over time, they stop working and cause risks to patients such as respiratory problems, constipation, dependence, accidental overdose and lower testosterone and estrogen levels,” says Dr. Akmal.

“Chronic pain is a disease process and must be treated and managed,” explains Dr. Akmal. As a Meritus Medical Group physician, Dr. Akmal works closely with primary care physicians, behavioral health therapists and physical therapists to foster health care collaboration and provide a continuum of care for patients.

If you’re experiencing ongoing pain, talk to your primary care physician or consult with a pain specialist. For more information on Dr. Akmal and Meritus Pain Center, call 301-665-4720.

*Source: Institute of Medicine of the National Academies.

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