What You Should Know About Pain and the Goals of Pain Management

acupuncture DEFINITION OF PAIN (according to The International Association for the Study of Pain):   An unpleasant and emotional experience associated with actual or potential tissue damage.

Pain is the most common reason humans seek medical attention.  Unfortunately most doctors are not specifically educated in the management of chronic pain.  This is also true of the veterinary profession.   To further complicate matters, we (pet owners and veterinarians) face a particularly challenging task in assessing our nonverbal pets and patients that evolutionarily have developed instincts to hide disease and pain.

FOOD FOR THOUGHT:  The inability to communicate in no way negates the possibility that an individual is experiencing pain and is in need of appropriate pain relieving treatment.

Here at the Veterinary Medical Center of CNY, our Pain Management team members have devoted hundreds of hours in advanced training to recognize and treat pain in our patients.  Our approach is to address pain by incorporating multiple “modalities” which may include medications, physical rehabilitation, acupuncture, myofascial trigger point therapy, and other treatments.  The primary professionals on our team, Dr. Michelle Burnett, Dr. Polly Fleckenstein, and Certified Physical Rehabilitation Provider Lis Conarton, LVT, are consistently receiving advanced formal training in veterinary pain management, making them uniquely qualified to assist your pet.

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Pain and function are connected.  Changes in activity, behavior, and physical ability may all be indicators of pain in pets.  Pain can negatively affect muscle function, and muscle (myofascial) disease, in turn, can be a major cause of pain.  This connection means that medications alone rarely allow a chronic pain patient to recover.  Our pain-specific nerve pathways and our muscles are no different than our joints, our hearts, or our eyes – they are all susceptible to major breakdown in their form and function.  Medications alone may alleviate some symptoms, but often will not address the source of the pain.

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To achieve the best possible results we apply a coordinated strategy, bringing together a broad range of therapeutic options available to us.  This strategy is based on the individual needs of the patient and integrates all available therapeutic options to obtain the best possible patient outcome.  Once we have the patient stabilized at their optimal level, we then gradually decrease the therapies (both physical and medicine based) until we find the minimum required to maintain patient comfort and quality of life.

Advanced pain medications help “reset” the pain pathways to a less sensitized state.  This can have an immediate effect on patient comfort and function.   Concentration on rehabilitation and strengthening, however, is crucial to the restoration of long standing comfort and return to function.

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The general approach that many veterinarians take in treating pain is by prescribing, almost exclusively, a nonsteroidal anti-inflammatory drug (NSAID) such as Deramaxx, Rimadyl or Metacam.  Interestingly, NSAIDs are the most commonly used pain medication in veterinary practice but also have the greatest potential for causing damage to the kidneys, liver and/or the gastrointestinal (GI) system.   Aging pets are the most likely to be chronically painful, and are also most likely to have some compromise of kidney, liver or GI function.  Regardless of  age, any pet on an NSAID drug should be closely monitored (bloodwork and possibly urinalysis) on a regular basis.

Fortunately, we have other options.  If you are concerned and want more answers now, contact us at 315-446-7933 and ask to speak with our Pain Management Service. More information is also available on our website www.vmccny.com

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Written by Dr. Michelle Burnett, Director of VMC's Pain Management Service