Chronic Pain
Ασκήσεις Φυσικοθεραπείας

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Chronic Pain
Major types of pain are:
  • The nociceptive pain (somatic pain) which results from injury or inflammation.
  •  Deafferentation pain (neuropathic) which results from injury of the nervous system.
There are several algorithms for the medical treatment of chronic pain. In case of pain refractory to medical treatment there are several surgical options.

Surgical Options:
  •  Morphine pump. The pump contains a refillable reservoir of morphine
    and is connected to a small tube which delivers the drug to the space around the spinal cord. The pump is of small size and sits under the skin of the lower abdomen. The drug is delivered directly to where it is needed (around the spinal cord) and therefore has less systemic sedative side-effects. There are various types of pumps available.
  • Spinal Cord Stimulator. The SCS delivers electrical current to the spinal cord. The stimulator is implanted under the skin of the abdomen and is connected subcutaneously with the spinal electrodes. The procedure could be performed under local anesthesia.

In our department we use different types of pain procedures including spinal stimulation for failed back syndrome or chronic pain of the extremities, and morphine pump implantation for chronic somatic pain.

Fig 1. A spinal cord stimulation system. The IPG is implanted under the skin of the abdomen

Fig 2
. The implanted electrodes in the spinal cord produce a local electrical circuit.