Interventional techniques of musculoskeletal chronic pain management include use of nerve blocks, root blocks, rhizotomies, cordotomy, etc.
Musculoskeletal chronic pain management is required during the following :
1. Low back pain
– Lumbosacral, spinal/vertebral syndromes
– Prolapsed intervertebral disc
– Lumbar canal stenosis
2. Neuropathies: Trigeminal neuralgias (Tic doloroux)
3. Phantom limb pain, pain of acute pancreatitis, post hepatic neuralgia
4. Myofascial syndromes
5. Headaches—Migrainous, non-migrainous
Drugs that are used in musculoskeletal chronic pain management are Opioids, Non-opioids,and Adjuvants.
Adjuvants : Various groups which individually on their own do not have significant analgesic properties but when administered in conjunction with various analgesics—both opioids or non-opioids or local analgesics (especially neuraxially)—may not only increase the efficacy of these drugs but may actually potentiate their analgesic properties.
Thus it is obvious that during musculoskeletal chronic pain management , use of opioids is not recommended in these patients due to their obvious side effects and complications.
As life expectancy is not compromised, addiction/physical dependence are major issues to be considered.