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Healthy Seniors: Relief With Pain Management Techniques


Part of our series on healthy senior living. Take a look at some of the advanced treatments available to help relieve pain related to operations and aging.


Editor’s Note: This article is part of a series this issue on healthy senior living. Also see our articles on Senior Living Accommodations, Healthy Eyes and Healthy Ears.

Too many people live day in and day out with chronic pain. From migraine headaches to arthritis, inoperable joint and spinal pain, residual pain from past trauma to the constant pain associated with diseases such as cancer, patients rely on pain management specialists to find solutions that alleviate or completely stop the misery that robs them of their quality of life.

While over-the-counter and prescription medications are often effective, the fact that no two people are alike makes it challenging to find just the right medication and the best level of usage to ease the pain without inducing worrisome side effects or addictions.

Fortunately, recent advances founded on sound health care principles are providing better methods of treating pain than ever before. When oral medications fail to relieve the pain sufficiently, patients can be referred to specialists for alternative treatments.

Dr. Alfred Rosche is an interventional pain management specialist and owner of Advanced Pain Intervention, 534 Roxbury Drive, Rockford. He is certified by the American Board of Pain Medicine to treat chronic pain through invasive techniques such as nerve blocks or injections.

“I utilize trigger point injections extensively and perform them under the highest standards of safety and efficacy,” Rosche says. “To aid in this procedure, I use fluoroscopy for all trigger points. Most importantly, I mix contrast agent with every trigger point to show exactly where the medicine flows.”

Rosche inserts a small needle into the painful area, or trigger point, using X-ray guidance (fluoroscopy) and a local anesthetic (numbing medication). The injected medication numbs the trigger point and alleviates pain. Sustained relief usually is achieved with a brief course of treatment. The injection may cause a twitch or pain that lasts a few seconds to a few minutes.

After the procedure, there is very little recovery time and many patients return to work the same day, says Rosche. Numbness from the anesthetic may last about an hour and a bruise may form at the injection site. Any pain resulting from the injection can be relieved by alternately applying moist heat and ice for a day or two.

With some patients, a full course of physical therapy helps with recovery and strengthens their backs and core muscles.

Rosche’s treatment options include blood patches, Botox injections, carpal tunnel injections, celiac plexus blocks, lumbar, cervical and thoracic epidurals, occipital nerve blocks, radiofrequency ablation, selective nerve blocks, small and large joint injections, trigger finger injections and more.

“These injections are effective and sometimes long-lasting,” Rosche says. “My practice is the only one of its kind in the Rockford area.”

Pain relief also may be achieved from a less-invasive, more hands-on method of treatment, particularly when pain stems from causes within the body’s unique structure. For example, myofascial pain syndrome is a chronic condition that results from pressure on sensitive points in muscles, called trigger points.

This can cause pain in seemingly unrelated parts of the body. Myofascial pain typically occurs after a muscle has been contracted repetitively because of repetitive motion related to work or hobbies, or by stress-related muscle tension.

While nearly everyone experiences muscle tension pain at one time, the discomfort associated with myofascial pain syndrome persists or worsens. Symptoms can include deep, aching muscle pain that persists or worsens, a tender knot in a muscle and difficulty sleeping because of pain.

Myofascial release is another way to treat myofascial pain syndrome. Marla Monge, LMT, a licensed massage therapist with Brynwood Myofascial Therapy LLC, 6072 Brynwood Drive, Rockford, explains that her modality is totally different from traditional massage and physical therapy.

In her clinic, Monge provides myofascial release, a safe and effective hands-on technique that involves applying gentle, sustained pressure into the myofascial connective tissue restrictions to eliminate pain and restore motion. This essential “time element” has to do with the viscous flow and the piezoelectric phenomenon: a low load (gentle pressure) applied slowly allows the fascia to elongate.

“When patients come in, some of them have been through all of the other traditional treatments including injections,” Monge says. “When nothing else helps, we look at the patient’s entire body’s fascial system, from the top of their heads to the bottom of their feet.”

Monge adds that, with 2,000 pounds of tensile strength per square inch, the fascial tissues that protect and bond the body’s internal musculoskeletal structure play a major role not only in how each person’s body reacts to pain, but also where.

“Trauma caused by surgeries, falls and accidents can cause the fascial structure to tighten down and twist,” Monge says. “This can continue slowly over a period of time, often as long as two to five years or longer. When this happens, the body sends pain signals to the brain that can affect the neck, shoulders, hips, back and legs.”

But Monge adds that she begins with the patient’s pelvis to determine the true source of the pain.
“If you look at the pelvis as a basin filled with water, and then envision it as not level, the water spills out,” Monge says. “Nothing from above the pelvis or below it functions normally because the balance is compromised. Just because a patient’s back hurts doesn’t mean we shouldn’t look elsewhere for the cause. Where it hurts may not be the real issue.”

Once she uses myofascial release to balance the pelvis, the rest of the body can start to correct as well. Monge says the constant pull on bones and muscles is reduced or relieved, taking pressure off nerves, muscles and the circulatory system.

Gosia Zasadny, PT, a licensed physical therapist at Brynwood with 20 years’ experience, adds that the connective fascial tissues impact every cell in the human body.

“While traditional physical therapy and massage focus on bones and muscles, we work on these tissues,” she says. “When the body is out of balance, connective tissues don’t allow the muscles to do their work. Knees don’t properly support the legs, backs hurt, and if these issues are not addressed, the patient comes back again and again in pain.”

By focusing on realigning the body to its true, natural balance, Zasadny adds, myofascial release and physical therapy address pain more effectively. Both Monge and Zasadny are expert myofascial release therapists.

“Our modality helps patients heal and find relief from their pain,” Monge says.

As new medications and methods for treating chronic pain are developed, more people who live with this debilitating condition are finding relief and living fuller, more active and satisfying lives. Pain management specialists agree there is every reason to be optimistic about helping patients of every age to live pain-free or with significant pain control and reduction in the future.

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