NEW OPTIONS IN PAIN MANAGEMENT

SEPTEMBER 16, 2013
Pain is the most common reason to seek medical care, and is the least understood aspect of health care, according to Kathryn Borgenicht, MD, of Bozeman Deaconess Internal Medicine Associates. That’s why Dr. Borgenicht, chair of the Hospital Pain Committee, and fellow committee members have introduced several new pain therapies at BDHS in the past two years based on “re-teaching” the brain.

Neuroplasticity, or brain plasticity, is used to “rewire” the brain to create new responses. It encompasses a variety of therapies including aromatherapy, massage, music, art, cognitive and behavioral therapy, acupuncture, dry needling and others.

“The brain has learned to be on pain,” said Dr. Borgenicht. “It can unlearn. We used to believe the brain was static after a certain age, but it turns out the brain is very flexible.” In fact, research shows that experience can change both the brain's physical structure and functional organization by modifying connections between neurons, thus altering how the brain responds to signals.

In the past, the first treatment used to manage a patient’s pain at BDH has been medications. Now, aromatherapy is offered in the Family Birth Center or following surgery, including peppermint to reduce nausea and pain and lavender to promote relaxation. Rehabilitation Services offers dry-needling for muscle and connective tissue pain and headaches. Similar to acupuncture, dry needling involves inserting solid needles (as opposed to hollow hypodermic needles) into muscular trigger points, rather than the traditional “meridians” targeted in acupuncture. Combining therapies, such as music and massage, involves multiple senses that can cause the brain to reprogram itself and adapt, particularly for chronic pain.

Also, Pain Resource Nurses (PRNs) have been specifically trained in pain management, and are assigned to the ICU, ER, Family Birth Center and the Medical and Surgical floors, offering their peers information about these additional strategies.

Hospital patients are asked to comment on how well their pain is managed during their hospital stay. Chief Nursing Officer Vickie Groeneweg said survey results since these strategies have been implemented indicate that patients have received better pain management.

Since pain is an important symptom of illness or injury, patients both in the hospital or at a clinic need to ask their provider how best to treat it. “Pain is not good,” Dr. Borgenicht said. “It affects how we function, can cause depression and interrupt sleep. Our goal is to allow the patient to function well.”
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