DEFINITION
FACTS
CAUSES
SIGNS AND SYMPTOMS
rTMS AND PAIN MANAGEMENT
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DEFINITION

“Pain Management (also called pain medicine) is the discipline concerned with the relief of pain. Acute pain, such as occurs with trauma, often has a reversible cause and may require only transient measures and correction of the underlying problem.” (Wikipedia, 2007)

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FACTS

• Most visits to physicians are prompted by pain problems (approximately 80%)
• In the workforce, decreased productivity due to pain costs approximately $61.2 billion dollars a year
• Treating pain is a complex matter, as pain is subjective and can often be transient in nature
• Pain intensity levels can be affected by one’s age, gender, muscularity, weather, sleep, and smoking behaviour
• Women are more prone pain than men due to differences in sex hormones

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CAUSES

• Pain may be acute or chronic
• It is caused by some form of trauma to a region of the body (e.g., motor vehicle accident or fall) and translated to the brain. Pain is then manifested physically and emotionally
• Chronic pain is experienced when, long after the sight of injury has healed, pain sensors continue to be stimulated and signal the brain. This results in permanent pain processing alterations in the brain and spinal cord.
• Central neuropathic pain is the result of nerve compression, multiple sclerosis, Parkinson’s disease, post-stroke pain, and post-traumatic spinal cord injuries
• Peripheral neuropathic pain is caused by post-herpetic neuralgia, phantom limb pain, trigeminal neuralgia, complex regional pain syndrome, carpal tunnel syndrome, and radiculopathy (cervical and lumbosacral)

SIGNS AND SYMPTOMS

The experience of pain is subjective, transient and complex. It may be mild, moderate or intense. Sensations may include the presence of aches, tightness, burning or numbness.

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rTMS AND PAIN MANAGEMENT

• Pain is sensed through a chemical release at the site of injury. These chemicals stimulate the C-type nerve fiber nociceptors. From here, pain signals the dorsal horn located in the spinal cord. It is here that the spinothalamic tract, a bundle of nerve fibers, translate pain to the brain (the somatosensory cortex, hippocampus and amygdala).
• rTMS therapy for pain management is able to target the somatosensory cortex (physical aspect of pain) and areas of the hippocampus and amygdala (emotional aspect of pain)
• rTMS has been shown to have a rapid therapeutic onset for treating various neural disorders with extremely mild or no side effects.
• Repetitive Transcranial Magnetic Stimulation therapy (rTMS) when properly modulated and focused on areas of inadequate activity increases the number and frequency of transmissions, thereby restoring areas with damaged neural communication.
• “At present, about 270 patients with chronic pain treated by motor cortex stimulation have been reported in the literature. Even if they were not all systematically improved, a relevant pain relief was observed in 52–73% of the patients with facial or post-stroke pain, and in 44–88% of the patients for the other indications.” (Lefaucher et. al, 2004)
• “This study confirmed that a single session of 10 Hz rTMS over the motor cortex could reduce pain level in patients suffering from chronic, intractable neurogenic pain… Firstly, antalgic effects obtained after a single session of real rTMS were significant compared with placebo in patients suffering from severe chronic pain resistant to all medication.” (Lefaucher et. al, 2007)
• 10-20 high frequency treatment sessions, over a period of 1-2 consecutive weeks
• Treatments are administered to three areas over the Motor-Area which is associated with pain.
• Please contact MCC staff members directly to obtain further details.

Search journal articles on Pain Management

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