Chronic pain doesn’t always start with an obvious injury. Sometimes it develops gradually from years of wear and tear on your spine or joints. At other times, it follows an acute injury that should have healed but didn't.
At Advanced Pain Management Center in Portland, Oregon, interventional pain management specialist Vladimir Fiks, MD, diagnoses the underlying cause of your chronic pain and uses targeted treatments to address the specific structures generating your symptoms.
Acute pain starts suddenly and fades as your body heals. You cut your finger, the tissue repairs itself, and the pain stops. This process typically takes days to weeks.
Chronic pain persists for at least three months. Your nervous system becomes sensitized and amplifies pain signals even when the original injury has healed. Sometimes the pain develops without any identifiable injury at all.
Your brain adapts to constant pain input by changing how it processes signals from affected areas. What started as a localized problem can spread to other regions as these neurological changes take hold.
Understanding what’s generating your chronic pain determines which treatments will work best. Common causes of chronic pain include:
The discs between your vertebrae lose flexibility and cushion over time. As they degenerate, they can bulge or herniate, putting pressure on nearby nerves. You might feel pain in your neck or lower back that worsens with sitting, bending, or twisting. When a disc presses on a nerve root, the pain can radiate down your arm or leg.
Stenosis narrows the spinal canal, which houses your spinal cord and nerve roots. This narrowing usually develops from arthritis, thickened ligaments, or bone spurs that grow into the canal. The compressed nerves create pain, numbness, or tingling that often affects your legs.
Facet joints connect the vertebrae in your spine and allow controlled movement. When cartilage in these joints breaks down, bones rub together and create inflammation. The pain concentrates in your neck or back and feels worse when you arch backward or twist.
Fibromyalgia causes widespread pain throughout your body without visible tissue damage. Your nervous system processes pain signals abnormally, creating tenderness across multiple areas. The pain moves around and fluctuates in intensity, often accompanied by severe fatigue, sleep problems, and difficulty concentrating.
Some people continue experiencing pain after spinal surgery or develop new pain in different locations. Scar tissue can form around nerves, hardware can irritate surrounding structures, or the surgery might not have addressed the actual pain source.
Headaches become chronic when they occur at least 15 days per month for three months or longer. Migraines cause severe, throbbing pain usually on one side of your head, often with nausea and light sensitivity. Tension headaches create pressure around your head from muscle tension in your neck and shoulders.
Dr. Fiks uses several diagnostic approaches to identify exactly what's causing your chronic pain:
If your pain immediately improves after a diagnostic injection, Dr. Fiks knows he’s found the right target for treatment.
Dr. Fiks uses minimally invasive procedures that target specific pain generators rather than just masking symptoms. These include:
Fluoroscopic guidance allows Dr. Fiks to deliver medication directly to pain-generating structures. The local anesthetic provides immediate pain relief that confirms the correct pain source, while steroid medication offers longer-lasting anti-inflammatory effects.
Common injection sites include:
These injections can reduce pain for weeks or months depending on the condition being treated.
Radiofrequency ablation creates controlled heat lesions that disable pain-transmitting nerves. Dr. Fiks uses specialized needles to heat nerve tissue to precise temperatures that destroy pain fibers while preserving motor function.
Regenexx™ treatments harvest your own bone marrow cells, concentrate them, and inject them into damaged spinal structures. These cellular treatments may help repair degenerated discs and strengthen weakened ligaments that contribute to abnormal spinal movement.
Multiwave locked system (MLS) laser therapy delivers specific wavelengths of light that penetrate deep into tissues to reduce inflammation and accelerate cellular repair. Each treatment lasts about 10 minutes with no discomfort or recovery time needed.
Different types of pain respond better to certain medications. Nerve pain often requires medications that calm overactive nerve signals, while inflammatory pain might respond better to anti-inflammatory drugs.
Finding what’s causing your pain is the first step toward effective treatment. Dr. Fiks can evaluate your symptoms, identify the specific structures causing your discomfort, and create a treatment plan that addresses your condition.
Call Advanced Pain Management Center in Portland today or schedule a consultation online.
