In 2020, the International Association for the Study of Pain redefined pain as "an unpleasant sensory and emotional experience associated with, or similar to, actual or potential tissue damage." Pain Consultation is a specialized consultation focused on the diagnosis and treatment of different types of chronic pain. These include nociceptive pain (caused by damage to body tissues), neuropathic pain (derived from lesions of the nervous system), and nociplastic pain (resulting from changes in perception).
This type of consultation is essential to improving the quality of life of patients suffering from painful conditions that can be debilitating and significantly affect their physical and emotional well-being. The most common pains treated in this consultation include: low back pain, fibromyalgia, pain caused by cancer or resulting from its treatments, musculoskeletal pain (degenerative osteoarthritis of various joints), diabetic polyneuropathy, post-surgical pain, post-traumatic pain, pain after spinal surgery, etc.
During the consultation, careful data collection will be conducted on the patient's pain and its impact on daily activities. With the help of questionnaires and a detailed physical examination, a diagnosis will be made. Afterward, treatment will encompass the various aspects of the pain.
A strategy based solely on pharmacology may underestimate the pain management approach, especially regarding persistent or recurrent chronic pain. Therefore, the Pain Consultation offers several minimally invasive pain intervention techniques, with excellent results in reducing pain and improving functionality and quality of life. These can be performed with ultrasound or x-ray support, with rapid recovery and on an outpatient basis. Pain intervention techniques include the following:
- Peripheral nerve blocks (responsible for the shoulder, elbow, hip, knee, ankle joints, etc.).
- Spinal nerve blocks (cervical facet block, lumbar facet block, sacroiliac joint block, etc.)
- Nerve radiofrequency (pulsed or thermal)
- Caudal, transforaminal, and translaminar epidurals
- 8% capsaicin patch placement
André Borges
Noélia Afonso
