By UTMB Communications

Imagine it’s 2 a.m., and you’re awakened by excruciating pain. This is what Emilia Papavasiliou experienced many nights for more than 10 years.

And she’s not alone. According to the National Center for Health Statistics, one in four Americans reported having pain that lasted more than 24 hours.

“It was so bad I had to sleep on my couch, with pillows propped behind my back, just to get a comfortable night’s sleep,” Papavasiliou said.

Her pain started in her lower back and radiated down her left leg. After undergoing surgeries and visiting numerous physicians, she decided to try pain management.

“Most of our patients come in complaining of back pain, joint pain or pain related to cancer,” said Dr. Courtney Williams, clinical director of the University of Texas Medical Branch pain clinic in League City.

Papavasiliou’s pain was due to spinal stenosis (a narrowing of the spinal column that puts pressure on the spinal cord) and sciatica (damage to the sciatic nerve, which runs from the lower back down the buttock, hip and leg).

Treatment options vary per patient, but often start with a physical therapy recommendation.

“Getting the patient up and going, and functional is so important,” said Williams.
If needed, the pain clinic also offers prescription pain medication, nerve block procedures, spinal injections and psychological counseling.

Many suffering from chronic pain also experience depression. The clinic’s psychologist, Jeff Baker, helps patients deal with the emotional and mental stressors of pain.

Papavasiliou’s treatment plan started with physical therapy and pain medication but she ultimately found relief from steroid injections.

“I had a spinal injection 15 months ago, and my back has been pain free ever since,” she said.

The injections contain a steroid that calms the inflamed tissue, said Papavasiliou’s pain physician, Dr. Rene Przkora.

Papavasiliou also has arthritis in her hands. She had surgery on her right hand a few years ago that actually left her in more pain.

“That’s why I decided to go for the steroid injections for my left hand, and now my hand is pain-free,” she said.

According to Przkora, each patient responds differently to steroid injections. Some patients find immediate, long-lasting relief, while others require maintenance injections for ongoing relief. There are some patients who do not find any relief from the injections, he said.

The causes for chronic pain can vary from trauma to the natural deterioration of the joints. However, Williams believes our increased sedentary lifestyle contributes to chronic pain.

“Today, we aren’t as active and we weigh more, and those factors can contribute to chronic pain,” he said.

The National Center for Health Statistics reports that back pain is the leading cause for disability in Americans younger than 45, but it doesn’t have to be, Williams said.

He recommends that patients with pain first visit with their primary care physician.
“In addition, I encourage my patients to stay active through the guidance of a physical therapist,” he said.

If the pain doesn’t go away after three to six months, then it’s considered chronic, and you should ask your doctor for a referral to see a pain management doctor, he added.

“I tried surgery and other physicians, but Dr. Przkora provided me with options that led to my relief,” Papavasiliou said.