Chronic pain is one of the most common reasons for visiting the doctor and affects approximately 11-40% of the population worldwide.

By “chronic” we define any pain that persists beyond the time limit expected to stop or heal an injury or disease and usually exceeds the time limit of three months. It can affect all parts of the body, be benign or malignant, and may or may not be triggered by a specific event.

According to the definition of the International Organization for the Study of Pain (IASP), chronic pain is an unpleasant aesthetic and emotional experience that may or may not be related to actual or potential tissue damage. This means that we may no longer be able to locate or remember the original damage. Chronic pain is a disease and not just a symptom of a disease. This is because it is accompanied by permanent changes in the peripheral and central nervous system, which require specialized treatment to be reversed. Most patients think that it is expected and normal to be in pain, but it is not. When pain becomes chronic it always needs treatment.

Each patient experiences pain differently, depending on their genetic profile, past experiences, mental state, cultural diversity and more. Unfortunately, however, chronic pain is accompanied by a gradual burden on the person’s daily life, sleep, ability to work, mental health and quality of life in general, which makes the need for immediate diagnosis and treatment even more imperative. Our basic principle is that when pain is left untreated, it intensifies, prolongs and becomes more resistant to treatment. That is why our intervention must be timely.

The Pain Clinic is the place where chronic pain is diagnosed and treated and the symptoms that accompany it are alleviated. The investigation includes specialized questions about the nature and characters of the pain, as well as the factors that influence it with special questionnaires and clinical examination, in combination with various imaging tests required on a case-by-case basis.

Typical examples of diseases for which someone should contact the Pain Clinic are:

– pain of malignant etiology (cancer pain)
– chronic back pain
– pain after shingles
– chronic muscle and fascia pain
– chronic neuralgia (e.g. trigeminal neuralgia)
– painful peripheral neuropathy (in patients suffering from diabetes, or who have undergone chemotherapy, radiation therapy, etc.)
– “phantom” limb pain (after limb amputation)
– osteoarthritis pain
– pain of rheumatic diseases
– chronic pain after surgery
– chronic head and neck pain
– chronic regional pain syndromes (CRPS, algodystrophy)

Coping with pain

The treatment is multifactorial. It includes a combination of medication, with drugs included in a large spectrum of pharmacology (simple analgesics, weak and strong opioids, antiepileptics, antidepressants, local analgesics, etc.) with complementary treatments (physical therapy, acupuncture, etc.) but and invasive techniques, depending on the particular condition. Interventional techniques greatly accelerate pain relief, as they directly intervene in the problem without having the side effects of pharmaceutical treatments. They are performed under fluoroscopic or ultrasound guidance and help effectively in a multitude of ailments. Examples of interventional techniques are the application of epidural injection for chronic low back pain with radicular involvement, the application of intra-articular injections, the implementation of nerve blocks in painful neuropathies, the application of radio frequencies to painful joints or nerves, peripheral and central neurostimulation and many others.

Pain management should always be holistic. This means that we aim to manage the biological cause of the pain, the mental component with the appropriate psychological support, but also the social rehabilitation of the sufferer with the aim of improving the quality of life. This is done in collaboration with the appropriate specialties that will support the patient. The detailed discussion and investigation of the particularity of each patient will lead to the personalized treatment that suits him, always with respect to the patient’s personality and the particularities of each condition.