In order to determine which therapies will be most effective, physicians at UCLA’s Pain Management Center first conduct a thorough, non-invasive physical examination of each patient to try and pinpoint the origin of his or her pain.

This exam involves a complete neurological and musculoskeletal exam, surveying the spine, nervous system, extremities and various joints.  The results of these initial tests may indicate whether the pain originates from the spinal cord or is contained in a peripheral nerve that acts as a conduit to a specific part of the body.  If necessary, X-rays, blood work and additional tests help physicians zero in on the source of pain.

Mind/Body Connection
Besides the physical burden, chronic pain affects the psychological and spiritual well being of patients and their families. Therefore, in addition to a complete physical work-up, physicians may include a psychological evaluation to help better understand a patient’s perspective and provide suggestions and support as they cope with their pain.

Non-invasive Treatments
Whenever possible, physicians first prescribe a conservative course of treatment, such as pain-relieving medications in combination with psychological support. Some patients benefit from techniques that combine aspects of Eastern medicine with traditional Western approaches.    

State-of-the-Art Techniques
If non-invasive therapies do not address a patient’s needs, he or she – together with a physician -- may agree to embark upon more aggressive therapies, such as:

Nerve blocks – local anesthesia or steroids injected near specific nerves in the spinal column that affect different parts of the body.  Three common – face, arm and hand; spine, lower back, legs and feet; and abdomen. 

Implantable drug delivery – The patient controls the release of local anesthetics and other medication directly into the spinal cord. This technique delivers smaller doses of medicine at regular intervals and helps reduce systemic side effects.  This is often the best approach for cancer patients, allowing them a greater degree of mobility.

Cryoanalgesia – A specialized tool freezes a nerve’s ability to transmit pain. What is this tool and is it implanted? This therapy is appropriate to treat nerves near the skin’s surface.

Radiofrequency Ablation– A specialized needle is inserted near a nerve and heated, which renders the nerve incapable of transmitting pain. This procedure is often effective for alleviating neck, back and disc pain. 

Spinal cord stimulators – A small device is inserted that stimulates the spinal cord with a small electrical current that interrupts the transmission of pain signals.