This post was written based on an appearance by Shantanu Kulkarni, MD, Pain Management Specialist, Orthopedics NorthEast, on the program PBS Healthline.
Many patients who are experiencing chronic pain in their necks, backs or knees are desperately looking for ways to improve their quality of life and get back to some of their previous activity level. If you feel like you’re ready to try a new treatment, you might want to see a pain management specialist to explore your options.
What to expect when you see a pain management specialist
When you visit with a pain management specialist, they will typically give you a physical exam and ask you questions about your pain and your lifestyle. Things like:
- Do you see a physical therapist?
- Do you regularly exercise?
- What medicines are you taking?
Then your doctor will likely give you an x-ray in the office. In some cases, they might want to do an MRI as well, depending on what they suspect is causing you pain. Your provider will be trying to assess if you’re suffering from joint pain or nerve pain so they can recommend the best treatment.
When I see a new patient, I’ll run imaging, but most importantly I listen to the patient explain their pain. To me, the most important thing when you talk to a patient is what they're telling you about how their pain is. That really tells you what's happening with them on a day-to-day basis.
One treatment: radiofrequency ablation
One procedure that is proving to be very successful for patients with chronic joint pain in their knees, necks and lower backs is called radiofrequency ablation. To see if you’re a good candidate for this procedure your doctor will first do a nerve block test where, under an x-ray, a needle is inserted into the nerves around your joint to numb them. If this anesthetic provides pain relief, this tells your doctor that those nerves are the ones causing the pain in your joint.
Then, for the radiofrequency ablation procedure itself, the doctor, under an x-ray, inserts very small needles into the identified nerves and burns away those sensory nerves. This will help eliminate pain for those specific joints.
Benefits from this procedure can usually be felt right away and can last up to three years. Best of all, it’s a quick, outpatient procedure and patients can resume their regular activity the next day.
The nerves in your joint will regrow, so your pain will likely return within three years, but the procedure can be repeated as needed if you’re still a good candidate.
Chronic pain considerations
It’s important to continue to do physical therapy before and after treatments like radiofrequency ablation. While these treatments help with the pain, only physical therapy can improve muscle strength and flexibility. I also recommend maintaining an active lifestyle if possible.
Remember, treatments won’t bring your pain to zero. The goal is to decrease your pain enough that you can resume your daily activities and have improvements to your everyday life.
