What is Algology (Pain Science)?

Pain therapy is a science that deals with relieving existing pain for a long time and increasing the quality of life of people living with these pains.

Chronic pain treatments can be classified as drug treatments, hypnosis, physical therapy, surgery/interventional treatments, injections, radiofrequency, and ozone. Interventional procedures are mostly special injections and are usually performed by anesthesiologists and algologists. Some sample treatments;

• Non-Surgical Lumbar Hernia Treatment
• Non-surgical knee calcification
• Widespread body pain, Fibromyalgia
• Headache
• Cancer pain
• Chronic wound treatment

Some of the application methods in pain treatments;

• Medication
• Injections with a local anesthetic
• Nerve warming (RF) procedures
• Catheter placement processes
• Ozone treatments
• PRP processes

Algology and Treated Pain Types

• Cancer pains
• Headaches
• Face and jaw pain
• Back and neck pain
• Chronic abdominal pains
• Pelvic pains
• Neuralgias
• Chest pains
• Fibromyalgia
• Joint pains
• Arm and leg pain
• Pain due to vascular spasm and occlusion
• Treatment-resistant acute pain
• Severe post-operative pain
• Hiccups
• Excessive sweating on hands and feet

• Treatment of patients with diseases such as urinary incontinence and who do not benefit from medical treatment with minimally invasive methods.

 

Interventional Algology Applications We Apply in Our Algology Clinic;

 

• Epidural/Peripheral PCA
• Epidural steroid injections
• Pain treatment of the posterior root ganglion with Pulsed Radiofrequency (DRG Pulsed RF)
• Facet joint injection and facet medial branch nerve block and denervation (Medial branch RF Thermocoagulation)
• Disc denervation and intradiscal interventions
• Erector Spina block and paravertebral blocks
• Epidural lysis (Racz procedure)
• Insertion of an epidural catheter and epidural port
• Caudal steroid injection
• Epiduroscopy
• Intra-articular injections (shoulder, knee, hip, jaw joint, etc.)
• Celiac plexus block
• Splanchnic block
• Gasser ganglion block
• Block of trigeminal nerve branches
• Sphenopalatine ganglion block
• Glossopharyngeal nerve block
• Phrenic nerve block
• Interscalene block
• Superior trunk block
• Supraclavicular
• Axillary block
• Trap neuropathies (Carpal tunnel syndrome, Tarsal tunnel syndrome, etc.)
• Intercostal nerve block
• Genicular nerve block and genicular nerve denervation
• Pudendal nerve block
• Greater occipital nerve (GON) and lesser occipital nerve (LON) block and radiofrequency therapy
• Other nerve (suprascapular, ilioinguinal, iliohypogastric, lateral femoral cutaneous nerve, etc.) blocks
• Radiofrequency therapy
• Botox injection in the treatment of chronic migraine
• Insertion of nerve catheters for a continuous block
• Stellate ganglion block.
• Thoracic sympathetic block
• Lumbar sympathetic block
• Superior hypogastric plexus block
• Impar ganglion block and neurolysis
• Soft tissue (muscle, bursa, tendon, and d.) injections
• Heel blocks
• Trigger point injection
• Dry needle therapy
• PRP and Stem Cell therapy
• Patient-controlled analgesia
• Insertion of an Intrathecal Morphine Pump
• Insertion of DCS (Dorsal Colon Stimulator)
• Insertion of the Sacral Nerve Stimulator (SNS)

 

Pain Groups Treated by Algology

 

It is possible to list the main pains that algology diagnoses and treats as follows:

• Cancer pains
• Neuralgias (pains like a short-term electric shock, such as trigeminal neuralgia, occipital neuralgia, etc.)
• Head and face pain
• Pain caused by tearing and injury of the shoulder joint and the muscles attached to the joint
• Neck, shoulder, and arm pain due to hernia, musculoskeletal system, or calcification
• Back pains
• Pain due to herniated disc
• Leg pains
• Pain due to spinal stenosis or spinal calcification
• Joint pains
• Pain due to fibromyalgia
• Pain due to shingles
• Chest pains

• Pain of unknown cause.

 

Neuropathic pains;

 

They are seen in the form of burning, cold, and tingling in the hands and feet and occur due to diabetes, nerve trauma, etc.

Hand and leg pains due to atherosclerosis or Burger, Reyno disease.

 

Interventional Treatment Methods;

 

Headaches and facial pains

 

• Occipital or sphenopalatine block / radiofrequency treatment for persistent headaches that do not go away with medication.
• Radiofrequency thermocoagulation (RFT) in trigeminal or occipital neuralgia.
• Block to the related nerve dermatome or stellate ganglion block in the zona

 

Neck pains

 

• Cervical steroid or intra-disc ozone/laser application in disc herniations.
• Trigger point injection for myofascial pain (trigger point injection).
• RFT for facet syndrome.

 

Shoulder and arm pain

 

• Trigger point injection for myofascial pain.
• Steroid injection, PRP, ozone, and RFT for joint pain, tendon, and ligament pain.
• Nerve block and RFT application for frozen shoulder.
• Ultrasound-guided median nerve release and steroid administration in carpal tunnel syndrome.

 

Back and trunk pain

 

• Trigger point injection with ultrasound guidance, trunk blocks in myofascial pains.
• Body blocks (nerve/plane), sympathetic blocks in addition to drug therapy in zona / neuropathic pain.

 

Low back pain

 

• Trigger point injection in myofascial pains, and body blocks.
• Transforaminal and epidural steroid injection in disc herniations, DRG pulse RFT application, laser application from the coccyx with epiduroscopy, intra-disc ozone / RF/laser application, IDET application.
• Transforaminal and epidural steroid injection, Racz catheter and epiduroscopy, and neuroplasty-adhesiolysis or laser application from the coccyx in failed back surgery.
• Administration of steroid or pulse RF or conventional RF in facet syndrome (lumbar osteoarthritis).
• Transforaminal and epidural steroid injection+Pulse RF / Conventional RF application in canal stenosis (spinal stenosis).

 

Cancer pains

 

• When it does not respond to medication or is very severe.
• Splacnic block in the stomach and pancreatic cancer pains.
• Superior hypogastric block in colon and pelvis cancers.
• Impar ganglion block in rectal cancers.
• Application of tunneled epidural catheter and/or spinal/ epidural port for diffuse chest, low back, and lower extremity pain.

 

Other pain treatments;

 

• Steroid, PRP, ozone, and RFT application for shoulder, hip, sacroiliac, and knee joint pain.
• Major and minor ozone therapy as a complementary treatment for pain in fibromyalgia, rheumatoid arthritis, ankylosing spondylitis, and many diseases.
• Lumbar sympathetic block with phenol / RFT in lower extremity ischemic pain (burger, atherosclerosis) and zona.
• Impar ganglion block in coccyx pain (coccydynia).
• Trigger point injection and various ultrasound-guided blocks for lower extremity myofascial pain.
• Ultrasound-guided local anesthetic + steroid injection and pulse RFT application in the piriformis syndrome.
• Spinal cord stimulator (SCS) (spinal cord pacemaker) when other treatment methods fail in failed back surgery.
• Painless delivery with epidural analgesia.
• Epidural blood and serum patch for headache after waist anesthesia.

PAIN IN THE TREATMENT OF CHRONIC PAIN

Body aches that make life a nightmare are a thing of the past. Moreover, thanks to a small battery. Incessant pain is relieved with battery treatment applied in the Algology Department of Gülhane Training and Research Hospital. Before the operation, the body is accustomed to the battery with electrodes. At the end of the observation period of about 2 weeks, the operation is started to attach the battery to the area where the pain is located. According to the results, the battery method is 90 percent effective in relieving pain.