Chronic joint pain is the end result of a number of conditions ranging from arthritis, trauma, or infections. The symptoms include pain, swelling, stiffness and limited movement of the joint. In Chronic Joint pain, the discomfort does not improve over time, and it becomes increasingly difficult to ameliorate the pain with pain medications.
More than 100 million Americans suffer from chronic pain at a cost of around $600 billion a year in medical treatments and lost productivity, according to a report from the Institute of Medicine (IOM).* The overwhelming pain, and resulting drug use and loss in wages results in financial difficulties, emotional problems and relationship challenges. Thus, there is a strong interest in finding treatments for this common problem.
Current medical dogma puts a primary emphasis on structural causes for joint pain. Such complaints lead first to physical therapy, medications, and splinting. If that fails, surgery is contemplated, and ranges from endoscopic ‘clean-outs” and repairs, all the way to joint replacements and fusions. In most cases this progression of care leads to the resolution of the pain. But in a small fraction of joint pain patients, the symptoms never abate, despite every one of the listed modalities being employed. This leads to the labeling of the patient as “crazy” or as someone with secondary gain. A range of circumstances can ensue; escalating doses of narcotics are often prescribed and addiction and the resultant psycho-social issues of narcotic addiction are introduced into the scenario. However, we have found that including the possibility of a neural origin of the pain in the evaluation, and offering nerve-based treatments, has made a profound difference in the outcome and quality of life for these patients. The innervation for most of the major joints of the extremities has been documented, and strategies for interrupting the pathways that transmit the painful impulses have been devised. These are some of the innovative techniques performed by the surgeons of The Institute for Advanced Reconstruction.