Chronic pain is no fun. Here in Bermuda, factors such as diet, injuries, lack of exercise for many, high stress jobs, and our humid climate (which can wreak havoc on painful joints) mean that we are no strangers to pain.
We recently spoke with two of Bermuda’s top Pain Specialists about the most common ailments they see daily, and the best treatments available for these aches on island.
Dr Charles Swartz of the Bermuda Pain Clinic named chronic and acute lower back pain, chronic and acute neck pain, sciatica, cervical radiculopathy (pain down arm), spinal stenosis, and neuropathic pain (Post Herpetic Neuralgia and Diabetic Neuropathy) as the most common ailments he sees.
Regarding treatments, Dr Swartz said, “Treatments available consist of the full spectrum ranging from conservative treatments to interventional management (IPM). IPM involves diagnostic and therapeutic blocks, plus radiofrequency ablation of the nerves. For example: SIJ injections, Facet joint injections, transforaminal epidurals (Cervical, Thoracic, and Lumbar), et cetera.
“I regularly refer to all complimentary specialties available on island as part of my pain therapy approach, i.e. physiotherapy, acupuncture, chiropractic etc. I am also very fortunate to have 24/7 access to our local Orthopaedic teams and our visiting spinal surgeon from Boston to discuss complicated issues and scans, et cetera.”
Dr Annie Pinto of Bermuda Pain Relief Center (BPRC) is philosophical in her approach to her job: “I describe my profession as a combination of an anaesthetist, neurologist, orthopaedist, rheumatologist and psychologist. Pain is caused not only by structural injury, but also by the anticipation of harm. It is modulated by emotions, and memories, which makes it very different from patient to patient.”
Shifting to common problems, Dr Pinto offers: “Lower back pain. Acute sciatica is a common condition. Over 90 percent of the population will suffer an episode of acute sciatica during adulthood. Most of these episodes resolve spontaneously, and with rest and time. If pain is severe, we have to treat it usually with rest, physiotherapy, and anti-inflammatories.
“Other conditions I treat include back pain from the back joints, also known as facet joints. This can be treated by different interventions, including facet denervations, which are very effective and have long lasting effects.”
She continues: “I have a number of patients with migraines, headaches, knee and hip pain, generalized and multifocal pain. I see anyone with any persistent and severe pain.
“Regardless of the source of the pain, once pain has become chronic, or persistent, the management must be different and it must include different modalities not just for treatment of the discomfort, but also to improve coping skills and function. At Bermuda Pain Relief Center, we offer an initial assessment to provide diagnosis and design individual and integrated treatment. This would include medications, injections, maybe surgical interventions, as well as physio and movement therapy, ergonomic assessment, and psychological support. We have designed an integrative pain program that helps to treat and manage pain, its causes, and its consequences. We help the brain to forget or ‘Unlearn the pain’ when required.”
The Bermuda Pain Clinic can be found in the King Edward Memorial Hospital, and Dr Pinto can be reached at [email protected] or on the BPRC website: www.pain.bm.