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MSWA Bulletin Magazine Winter 2022

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Farewell Sue Shapland | Pain and pain management series: Part 5 | MSWA's Employment Support Service | Tips for staying motivated over winter

NURSING With pump

NURSING With pump administration, a test dose is first injected into the spinal fluid to assess the effect, and if successful in relieving spasticity, a long-term intrathecal catheter is inserted from the spine through the abdomen and attached to the pump which is implanted under the abdomen's skin, usually by the ribcage. The pump is computercontrolled for automatic dosage and its reservoir can be replenished by percutaneous injection. This is done on a regular basis. Usually, every 12 weeks the pump is emptied and refilled as the efficacy of the drug is reduced over time. The pump also must be replaced every five years or so when the battery is changed. Consideration of intrathecal pump placement depends on severity of spasticity, suitability of patient, and is determined by a pain specialist. SUPPLEMENTS: Some people find that taking supplements can help manage chronic pain, although there is limited evidence to support this for some specific conditions. For chronic pain caused by osteoarthritis, some people find that taking glucosamine or chondroitin can help them. There is also some evidence to suggest that supplemental omega-3 fatty acids can help chronic pain that affects large areas of your body, as well as neck and shoulder pain and period (menstrual) pain. MEDICINAL CANNABIS: Medicinal cannabis may be effective for neuropathic pain if other medicines have not been helpful. This must be prescribed by a doctor with specific experience with its use in pain management. INJECTION THERAPIES/PAIN MANAGEMENT PROCEDURES: If various non-surgical measures have proved ineffective in providing adequate relief or are poorly tolerated, injection options can be considered. / Pain management procedures (PMPs) are usually not a cure for chronic pain, however, they can provide an effective way to improve your overall pain management. / PMPs provide pain relief so other long-term pain treatments have a better chance of working. / PMPs allow you to reduce pain medications and engage more effectively in physiotherapy and behavioural therapies. Sometimes pain procedures can actually ‘switch off’ sensitive nerves and produce long-term pain relief. An example of a pain procedure is an epidural injection: / If a protruding spinal disc is irritating a nearby nerve causing leg pain (sciatica). / Using an x-ray machine, a fine needle is placed into the epidural space next to the irritated nerve. / A small amount of local anaesthetic and steroid (cortisone) is injected around the nerve, via the needle. / Epidural steroid injections may reduce leg pain (sciatica) for weeks-to-months in 1-in-4 patients. / Epidural steroid injections DON’T treat low back pain, only leg pain. There are many other procedural options which target headaches down to ankle pain. These options are best discussed with a Pain Specialist. 34

Q: How can you release your body’s own medicine chest to relieve pain? A: SMILE. Smiling releases many of our ‘up’ chemicals including serotonin. We are wired from childhood that smiling means happiness, so that if you smile (even if you are unhappy) the body releases our ‘happy’ chemicals. Serotonin is the chemical released from chocolate and milk drinks – smiling does it without the calories. Walking at our own pace also increases serotonin and noradrenaline. Noradrenaline makes you feel more robust and able to cope with stressors or issues. This is what antidepressants can also do – but you can help by doing it naturally. Reminder: discuss with your GP or neurologist the best and safest options for you. We hope that this information has been informative. BRONWYN INNES MSWA NEUROLOGICAL LIAISON NURSE REFERENCES: / painhealth.csse.uwa.edu.au / healthdirect.gov.au / painaustralia.org.au / nps.org.au / mayoclinic.org / wpain.com.au / Coping with Persistent Pain: A guide for patients, partners, family and carers; (booklet) produced and published by Janssen-Cilag WOULD YOU PREFER TO RECEIVE BULLETIN ONLINE? If you would like to opt-out of receiving a paper copy of this publication, please contact communications@mswa.org.au to sign up to the e-magazine. 35

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