Dr. Brandon Claflin On Improving Elders' Lifestyle with Interventional Pain Management

As one of the most common medical conditions in the elderly over the age of 65, chronic pain can cause severe distress. It limits social interactions and overall mobility, which can affect quality of life. For many, this can also lead to depression and anxiety.

Pain management becomes tricky because the source of the pain might be hard to pinpoint and could be accompanied by a neuromuscular or cognitive disorder. For some, it might also be hard to explain the severity of the pain, and they may minimize it.

According to Dr. Brandon Claflin, there are pain management solutions that can help the elderly reclaim their quality of life. He is a board-certified physician in Physical Medicine and Rehabilitation, with a subspecialty board certification in Pain Medicine. He believes that, while surgery can be life-changing, it should only be approached as a last resort.

Below, Dr. Brandon Claflin discusses interventional pain management, including a few different types of treatments.

Interventional Pain Management vs. Pain Management

Interventional pain management is a series of techniques applied by a highly skilled medical professional to alleviate pain. The procedures are minimally invasive and often done on an outpatient basis. The techniques can include injections, radiofrequency ablation, stimulation, and nerve conduction studies.

“Pain management” is a broader term that describes the use of several methods, like medication, exercises, and physical therapy, to minimize pain. This type of treatment mostly centers on addressing flare-ups.

Interventional pain management, as part of a holistic plan, often includes those aspects, but is also concerned with finding and treating the root cause of the pain. A comprehensive pain management plan can include techniques that address short-term (acute or subacute) pain and long-term (chronic) pain.

Interventional Pain Management Techniques Explained by Dr. Claflin

Dr. Claflin has a long history in pain management and provides insight into some of the interventional pain management techniques:

Spinal Cord Stimulation (SCS)

When more conservative treatments aren’t effective, some patients opt for spinal cord stimulation. This procedure disrupts or modifies pain signals (in a process called neuromodulation) before the signals reach the brain. It does not alter or improve the condition that caused the pain in the first place.

The procedure involves implanting a small, battery-powered device (similar to a pacemaker) under the skin, usually near the lower back. The electrical impulses we spoke of that modify pain signals are placed near the spinal cord. (The stimulation is adjustable.)

Some conditions that may be managed by spinal cord stimulation include:

Back pain, including post-laminectomy surgery or persistent spinal pain syndrome (PSPS)
Complex regional pain syndrome (CRPS)
Diabetes-related neuropathy
Neuropathic pain

While this procedure is more invasive than taking an over-the-counter pain medication, it’s generally an outpatient procedure. It’s typically reversible, and patients usually go through a trial period first.

Radiofrequency Ablation (RFA)

RFA uses heat (generated through radiofrequency energy) that disrupts the pain-sensing nerves. RFA can be used to treat some types of arthritis, including facet joint arthritis and sacroiliac joint pain, both of which are commonly seen amongst the senior population.

Medial Branch Block Injection

Facet joints in the spine can become a source of chronic back or neck discomfort. These joints connect to sensory nerves called medial branch nerves, which carry pain signals to the brain. A medial branch block is a minimally invasive procedure in which a local anesthetic is injected near these nerves to temporarily block pain signals.

Transcutaneous Electrical Nerve Stimulation (TENS)

Transcutaneous electrical nerve stimulation requires a TENs unit, a small battery-powered device with pads that are placed on top of the skin. It sends low-frequency, low-intensity electrical currents through these pads to interfere with pain signal transmission at the spinal cord level.

TENS is not safe for those with pacemakers, heart conditions, epilepsy, or certain other medical conditions.

Epidural Steroid Injection (ESI)

A small dose of anti-inflammatory medication is injected into the epidural space (which contains fat and blood vessels) outside the spinal cord. Epidural steroid injections reduce inflammation, which can help alleviate the pain. As a secondary use, ESIs can also be a diagnostic tool.

Note that ESIs are generally not recommended for people with osteoporosis or diabetes, both of which are common in the senior population.

Quality of Life Outcomes for Seniors

Research shows that 36% of seniors are affected by chronic pain, with 13.5% experiencing high-impact chronic pain (HICP).

For seniors, the targeted interventional pain management can lead to a more active lifestyle, delay painful and invasive surgery, and reduce pain medication dependence. These treatments also allow for a more personalized approach, as doctors can create a treatment plan that tailors to the needs of the patient.

Interventional Pain Management Considerations

While these treatments seek to improve seniors’ lives, certain factors need to be considered:

Age and Health: Each therapy suggestion needs to take the age and general health of the patient into consideration.

Medication: Some medications may cause complications with the procedures, even if they’re minimally invasive.

Infection Risk: Most medical procedures carry the risk of infection, and interventional pain management is no different.

Reclaim Your Golden Years With Interventional Pain Management

Sometimes medical interventions such as surgery and medication don’t work or aren’t a viable option anymore. For older adults, this could affect their autonomy and relationships with loved ones. Thanks to experts like Dr. Brandon Claflin, elders have a chance of living their best lives through proper interventional pain management.