Bend Spine &
Pain Specialists

929 SW Simpson Ave.
Suite 250
Bend, OR 97702

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Chronic
Neuropathic Pain

Narcotic
Pain Medications

Radiofrequency
Ablation

Chronic Neuropathic Pain
Impact of chronic pain
Welcome to Bend Spine and Pain Specialists.  We understand the impact that chronic pain has on your life.  A typical chronic pain patient has seen several physicians before coming to us.  Often a patient will have had several expensive imaging studies already, but still no answers.  Many unfortunate patients have already undergone spine surgery and still there is pain.  Why can’t someone just figure out this pain and fix it?  Many patients ask this question.  

Feeling daily pain is an isolating   experience.  Most of us can put up with intermittent pain, but when pain becomes a daily experience, our mood becomes anxious, angry or depressed.  The pain becomes a nagging distraction that prevents us from focusing at work, reduces our important life activities, and impacts our sleep.  Because pain changes our mood and our activities, spouses and friends are also affected.

The meaning of pain
Why do we experience pain?  Pain is a protective mechanism to reduce our chance of dying from traumatic injuries.  Pain gives us a chance to withdraw from an injurious situation.  If we become injured, then pain motivates us to escape from a potentially life threatening situation.  Afterwards, pain subdues our activity so that we can heal from the injury.  There is a genetic mutation in humans where no pain is felt.  These people rarely survive childhood due to infection from wounds that are not attended to. 

Physicians are taught to view pain as a sign of disease.  The pain points to some kind of tissue damage, and doctors expect the location of the pain to correspond to where the damage is.  We assume that the intensity of the pain is related to the severity of the damage.  Most of the time, this reasoning is correct.  However there are conditions where pain is unrelated to tissue damage or treatable disease. 

Pain can be misleading
The only way that we are aware of pain is through the activity of nerves that travel through the spinal cord and up to our brains where we map out a location and character of the pain.  Humans who become aware of pain attempt to assign a meaning to the pain.  We try to create a story that explains the cause of the pain.  We then seek to modify our behavior or get help.  However, what happens when the pain signal is a lie?

Sometimes pain can result from a malfunctioning nerve, rather than an area of tissue injury.  Bothersome pain can result from an over-sensitive nerve.  In this case the severity of the pain is NOT related to the severity of the tissue injury.   When a nerve is malfunctioning and sending a false pain signal we suffer, yet there seems to be nothing wrong with the painful part of the body.  Unusual pain attributed to nerves also feels like pins and needles or excessive sensitivity.  Does that make you crazy?  No.  These symptoms occur from neuropathic pain and abnormal pain sensitization.  The problem lies in a malfunctioning nervous system that sends too many pain signals to the brain.  This is called neuropathic pain.  Overly sensitive nerves are called sensitized nerves.

What are the causes of neuropathic pain?
There are three classic medical conditions that cause nerve injury and pain; diabetic peripheral neuropathy, post-herpetic neuralgia, and chemotherapy induced neuropathy.  There are diseases that doctors don’t understand very well that cause abnormal sensitization to pain such as fibromyalgia and reflex sympathetic dystrophy. There are other diseases that result from nerves exposed to inflammation such as carpal tunnel, sciatica, and facet joint (spine) arthritis. Injured nerves can also send abnormal pain signals after healing from amputation, surgeries such as hernia, mastectomy and spine surgery.  Chronic pain is also the result of the continuous unrelenting advance of diseases such as arthritis or cancer.

What are causes of sensitization?
Nerves become sensitized from inflammation.  Inflammation occurs when injured tissue releases chemicals that cause immune responsive cells to accumulate in damaged tissue.  This is accompanied by swelling, increased blood flow, and pain.  We are all familiar with the pain associated with an acute injury as well as the long term pain of chronic arthritis.  Sensitization due to inflammation is part of the cause of pain from these afflictions.  Immune cells in the spinal cord called glial cells can also cause sensitization to pain.  Intense pain signals from the body coming into the spinal cord can cause changes in the network of relay nerves that result in excessive pain messages being sent to the brain.  This is called central sensitization.  Treatments such as epidural steroid and local anesthetic injections attempt to target these sensitized nerves.

Our approach to Pain Management
We treat patients with chronic back and neck pain, pain after spine surgery, sciatica, and other chronic pain conditions.  We are not alternative medicine.  We are an advanced medical subspecialty practice.  Dr Ford is a Board Certified specialist in anesthesiology and pain management.  His 15 year background in anesthesiology and Fellowship training in pain management makes him ideally suited to provide interventional treatments for pain.   

Intervention means using tiny needles under live x-ray guidance to inject medications in specific areas of the nervous system to diagnose and treat painful conditions.  We try to achieve a balance between the use of non-addictive pain medications, injection therapy, nerve destruction techniques, spinal cord stimulation and exercise to achieve as much pain relief and function as possible.  We strive to be compassionate and aggressive with our conservative approaches to managing pain.  Most patients can be helped, even when other doctors have given up.

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