The use of medications, diet, supplements, and lifestyle interventions constitute medical management. The Denver Spine and Pain Institute takes a comprehensive approach towards medical management, and all medications are prescribed within this philosophy of care.
The providers at the Denver Spine and Pain Institute will thoughtfully include medication management, when indicated, in your overall pain management program. We draw from medication classes that include mechanisms for reducing inflammation, analgesics that target pain directly, and other medications drawn from other classes. Opioid medications may be prescribed when necessary. Other classes of medications assist in managing pain include:
Other medication classes that can be used to manage pain as well as manage associated symptoms.
Other associated symptoms may include insomnia, depression, or anxiety, among others. The presence or absence of these symptoms will influence which class or classes of medication to choose from. For example, if sleep is a problem, we will choose a medication that will assist with pain management as well as sleep. Some antidepressant medications are excellent for treating pain and may be chosen for treating pain alone or to serve both purposes, treating depression and pain. Some of the muscle relaxants can be used to help with sleep, and the anti-inflammatory medicines are good for treating pain and can be combined with Tylenol or other medications to boost their effect. These medication decisions are also made in the context of developing a multimodal approach which may include physical therapy, massage, psychology, and lifestyle changes.
When our tissues or nerves are injured, it not only sets up a local inflammatory response at the site of injury, but also within the brain and spinal cord. This reactive brain inflammation is known as neuroinflammation. Normally it only lasts a short period of time and resolves when the tissue injury heals. In some cases, however, this inflammation does not resolve normally and a chronic problem results. Changes occur at nerve endings and tissue at the site of injury, which can lead to a hypersensitivity of the local nerves and tissue.
When this does not resolve normally, a peripheral neuroinflammation can develop, and an abnormal signaling from the nerves (neuropathic pain) can develop. The same cycles of inflammation can occur in the brain and spinal cord. Normally, there are chemical signals within nerves and the brain, largely effecting nerve cells called glial cells. Glial cells signal a return of the normal status of the brain, or homeostasis. If the inflammation continues, this can also cause persistent hypersensitivity to nerve signals from the site of injury, which also contributes to neuropathic pain.
One of the goals of medical management is to help suppress this inflammation, both at the site of injury and the spinal cord/brain, to help resolve the neuroinflammation, restore homeostasis, and reduce or eliminate pain. This can sometimes be accomplished early on after an injury with the use of oral anti-inflammatory medications, oral corticosteroids, or topical applications. Other tools we utilize include:
These components, alone or in combination, can be very effective at bringing down the bodies’ inflammatory level, helping to restore the nerve cells in the brain/spinal cord and periphery towards their normal state. This in turn will reduce pain.
The providers at the Denver Spine and Pain Institute can assist with the reduction or eventual cessation of your opioid medication. These decisions are made mutually between you and your trusted care provider and are based on discussion, history, goals, and other factors. These factors may include the impact that opioids are having on your body, such as causing constipation, sedation, or cognitive slowing, as well as any safety considerations that may arise from unsafe medication combinations, mixing with alcohol or other drugs. Depending on the situation, you may choose to:
Reduce or taper your opioid medication very gradually, over weeks or months.
Transition at an intermediate rate
Rapidly or immediately switch to other, safer options.
These options may even include a transition to buprenorphine, which is considered an atypical opioid, and one that can be tapered or used for lengthy periods of time as a safer pain management option. It can also be used to help prevent withdrawal symptoms or opioid cravings when this is an issue.
Excellent Medical Management of Pain
At the Denver Spine and Pain Institute, we have seen firsthand how pain can diminish your quality of life and make it difficult to enjoy your day-to-day activities. Our team is dedicated to providing you with the necessary relief to get you back to life.
Our Connected Care Approach™ was designed specifically with your needs in mind, to help you get back to enjoying life without the challenges and frustration that can come with persistent pain. This approach includes:
A comprehensive discussion of care options, including medical management, physical therapy, diet and lifestyle coaching, behavioral health treatments, and other state-of-the-art options.
Care plans uniquely tailored to your needs and goals.
Caring relationships with our team to ensure you receive the best possible treatment.
Mutual decision making and guidance to help you make an informed decision.
Schedule an Appointment
lease contact us today to schedule an appointment. The Denver Spine and Pain Institute serves patients in Denver and the surrounding areas of Colorado.