| [INTERVIEW] Director Im Eui-seong, Specialist in Anesthesiology and Pain Medicine
| Chronic pain and chronic diseases require long-term and consistent management.
| Psychological treatment is essential to prevent depression.
Chronic pain caused by musculoskeletal disorders necessitates ongoing management, similar to how chronic diseases such as diabetes and hypertension are treated. Patients must understand that curing chronic pain takes time, and both medical staff and family members should support them to prevent the exacerbation of depression due to ongoing pain. Director Im Eui-seong of the Im Eui-seong Anesthesiology and Pain Medicine Clinic stated, “We need to inform patients that chronic pain requires long-term treatment for their comprehension, and we should explain in detail that, like other chronic diseases, it can be consistently managed to gradually alleviate pain.”
Q. What do you consider to be the most effective approach to managing chronic pain?
The foremost step is improving one’s lifestyle. While medication and injections are vital, it is crucial to alter lifestyle choices to minimize movements that lead to pain. Patients should acknowledge that, similar to hypertension and diabetes, chronic pain is persistent and requires management. Of course, in some cases, certain types of chronic pain, such as post-herpetic neuralgia, may be completely curable.
Q. Persistent pain can be psychologically taxing and diminish overall quality of life. How can one manage the psychological effects?
This is an area where medical professionals should provide significant support. Most patients I see in the pain medicine outpatient clinic are dealing with chronic pain. Many patients with conditions such as degenerative arthritis, spinal stenosis, frozen shoulder, or chronic headaches often suffer from psychological depression due to the longevity of their pain. Consequently, prescribing antidepressants plays an important role in managing chronic pain patients. These patients require ongoing management similar to how chronic diseases like diabetes or hypertension are treated. Instead of expecting quick relief from a single hospital visit, we guide patients to recognize that this condition necessitates continuous management and treatment. We also provide detailed explanations of treatment methodologies to help alleviate their depression regarding the persistent nature of their condition and reassure them that long-term management can lead to gradual relief.
Since medical staff only interact with patients during treatment, family members who frequently see the patient must assist in preventing the deepening of the patient’s depression.
Q. What lifestyle changes would you recommend for pain patients?
The most crucial aspect is weight management, along with the prevention and strict control of adult diseases like hypertension and diabetes. This is important because pain control through medication and injections can influence blood pressure and blood sugar levels; conversely, patients who struggle to manage these factors often find it difficult to control their pain. Additionally, ensuring a restful night’s sleep is vital. Though it may seem obvious, maintaining a regular routine, exercising, and avoiding overeating are essential for effective pain management.
Q. Please explain the role and limitations of drug therapy in pain management.
Drug therapy affects the entire body and may lead to systemic side effects. Focusing treatment on the specific area causing pain is generally more effective and can help reduce side effects. However, in cases where pain is widespread, injection treatments are limited, or psychological support is necessary, medication can serve as an adjunct. Additionally, for acute pain like sprains, anti-inflammatory analgesics can typically manage pain effectively.
Q. Can manual therapy be beneficial for pain relief?
Manual therapy involves the diagnosis and evaluation by medical staff, who use their hands or small tools to treat problematic soft tissues and realign deformed spinal joints. It can be considered a treatment that corrects spinal and joint alignment, aids recovery of hypersensitive nerves, and enhances blood circulation in peripheral tissues. This approach further addresses the underlying causes of problems to assist in restoring daily living activities. Treatment may include the use of hands or devices, and a physical approach can be utilized to encourage patients to rehabilitate themselves following treatment.
Q. What are the recommended postures for treating disc issues in the neck, lower back, etc.?
I recommend the following postures and practices:
⓵ Avoid prolonged sitting, especially on the floor or in chairs without back support.
⓶ Stretch adequately before and after exercises like golf or tennis to prevent muscle strain.
⓷ Refrain from looking down at your smartphone for too long while using public transport or in other situations.
⓸ When using a computer, ensure that the monitor is at or below eye level while sitting straight.
⓹ When sitting upright, maintain a straight spine, open your chest, and gaze upward.
⓺ Incorporate core exercises like planks into your daily routine.
Q. Could you explain spinal stenosis?
Spinal stenosis is a condition characterized by the narrowing of the spinal canal, which houses the nerves, for various reasons. It is primarily related to spinal aging and is commonly seen in the elderly. A hallmark symptom is intermittent claudication, wherein patients experience discomfort when standing or walking, while sitting provides relief. This often leads to a pattern of walking short distances before needing to rest. In contrast, a herniated lumbar disc results from nerve irritation caused by the displacement of an intervertebral disc, often leading to increased pain when sitting and relief while standing.
Q. Are there treatments for turtle neck syndrome other than for cervical disc herniation, and what lifestyle changes should be made?
With the increasing use of smartphones, many individuals are affected by turtle neck syndrome, which causes the cervical spine to curve unnaturally. This condition often contributes to cervical disc herniation, making posture correction essential. If pain or numbness occurs and disrupts daily life, consultation with a medical professional for treatment, including manual therapy, may be necessary.
As noted earlier, avoiding prolonged periods of looking down and developing the habit of maintaining a straight spine with the chest facing upward while seated is critical.
Jeongsinyeong Hidoc Health Medical Reporter hidoceditor@mcircle.biz
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Interview with Director Im Eui-seong: Insights on Chronic Pain Management
| Director Im Eui-seong, Anesthesiology and Pain Medicine Specialist
| Chronic Pain and Chronic Diseases Require Long-Term, Consistent Management
| Psychological Treatment is Also Necessary to Avoid Depression.
Chronic pain resulting from musculoskeletal diseases demands ongoing management similar to that required for chronic illnesses like diabetes and hypertension. Patients need to be educated about the nature of their condition as something that cannot be swiftly cured, while medical professionals and family members play a critical role in providing support to mitigate the risk of depression. Director Im Eui-seong from Im Eui-seong Anesthesiology and Pain Medicine Clinic emphasizes, “It’s vital to explain to patients that chronic pain needs long-term treatment, akin to other chronic diseases. Patients should understand that with consistent management, pain can gradually be relieved.”
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The Importance of Lifestyle Changes in Chronic Pain Management
Q. What do you think is the most effective approach to managing chronic pain?
Director Im asserts that lifestyle improvement is paramount. While drug therapies and injections are significant, patients must modify their habits to minimize movements that exacerbate pain. Acknowledging chronic pain as a persistent condition, much like hypertension or diabetes, helps patients understand that ongoing management is necessary.
Addressing Psychological Impact on Patients
Q. How can patients manage the psychological impact of repetitive pain?
Director Im points out that healthcare professionals must focus on the psychological aspects of chronic pain management. Many patients suffer from psychological distress due to long-term pain conditions such as degenerative arthritis and chronic headaches. He highlights the importance of prescribing antidepressants for those experiencing depression. Chronic pain requires ongoing management, similar to other chronic conditions, and it’s crucial for patients to realize that they may not experience instant relief. Continuous treatment, including addressing the psychological toll, can lead to gradual improvement.
Recommended Lifestyle Changes for Pain Patients
Q. What lifestyle changes would you recommend for pain patients?
Managing weight and controlling conditions such as hypertension and diabetes is vital. Drug treatments for pain can influence these parameters, and uncontrolled high blood pressure or blood sugar can, in turn, aggravate pain. Additionally, a good night’s sleep is crucial, and maintaining regular routines, engaging in light exercise, and avoiding overeating are essential for effective pain management.
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Understanding the Role of Drug Therapy in Pain Management
Q. What is the role and limitations of drug therapy in pain management?
Drug treatments can have widespread effects throughout the body, often causing side effects. Therefore, minimizing treatment to the site of pain may be more effective and can reduce potential side effects. However, when broad pain areas exist or when psychological support is needed, medication can still serve as a useful adjunct.
The Benefits of Manual Therapy
Q. Can manual therapy be beneficial in relieving pain?
Manual therapy involves diagnoses and evaluations by therapists, utilizing their hands or specialized tools to treat soft tissues and realign spinal joints. It aims to correct spinal alignment, facilitate nerve recovery, and enhance circulation in peripheral tissues to restore daily function. This type of therapy may include motor approaches to aid patient rehabilitation post-treatment.
Posture Recommendations for Disc Problems
Q. What are the recommended postures for treating disc-related issues?
Here are some essential posture recommendations:
- Avoid sitting for extended periods, particularly on the floor or in chairs lacking back support.
- Engage in adequate stretching before and after activities like golf or tennis to prevent muscle strain.
- Avoid prolonged downward gazing at smartphones in public transport or other settings.
- Ensure that computer monitors are positioned at or below eye level while sitting upright.
- Maintain correct posture by opening the chest and looking towards the ceiling while seated.
- Incorporate core exercises like planks into daily routines to strengthen the body.
Understanding Spinal Stenosis
Q. Can you explain spinal stenosis?
Spinal stenosis occurs when the spinal canal narrows, typically affecting older adults due to spinal aging. Patients often experience intermittent claudication, meaning they may feel fine when seated but experience lower back pain and leg numbness when standing or walking. This may force them to frequently sit to relieve discomfort, contrasting with herniated lumbar disc symptoms, which are often aggravated by sitting and relieved by standing.
Lifestyle Changes for Turtle Neck Syndrome
Q. What treatments or changes should be considered for turtle neck syndrome?
As the use of smartphones continues to rise, turtle neck syndrome—a condition characterized by an inverted curvature of the cervical spine—has become more common. This posture may lead to conditions like cervical disc herniation. Correcting posture is crucial, avoiding prolonged periods of looking down at devices, and developing the habit of keeping the spine aligned while sitting.
Health reporter Jeongsinyeong from Hidoc states, “Maintaining a healthy lifestyle and adhering to proper postural habits can significantly alleviate pain and improve quality of life.”
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