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This PDF is a medical lecture presentation by Dr. R. Corey Waller on the management of chronic pain, addiction risk, and advanced interventional pain therapies. It explains why traditional opioid treatment often fails in long-term pain management and describes different types of pain such as neuropathic, nociceptive, central, and combined pain. The document discusses the dangers of escalating opioid doses, addiction, overdose, and side effects, and emphasizes the importance of choosing treatment based on the type of pain. It introduces interventional approaches including nerve blocks, ablation techniques, intrathecal drug delivery systems, spinal cord stimulation, and deep brain stimulation. The presentation outlines how intrathecal pumps deliver medication directly to the spinal fluid for better pain control with lower doses and fewer side effects, and how neurostimulation devices modify pain signals before they reach the brain. It also explains patient selection, trial procedures, benefits, risks, complications, and future directions in neuromodulation, concluding that interventional and neuromodulation therapies can reduce opioid dependence and improve quality of life in chronic pain patients.
5 R. Corey Waller MD, MS, FACEP…
Main Headings
Failure of Pain Treatment
Types of Pain
Problems with Opioid Therapy
Pharmacological Treatments
Interventional Pain Techniques
Intrathecal Drug Delivery (IDD)
Neurostimulation Therapy
Deep Brain Stimulation (DBS)
Complications and Risks
Future of Pain Management
5 R. Corey Waller MD, MS, FACEP…
Topics Covered
Chronic pain and addiction risk
Neuropathic and nociceptive pain
Central pain syndromes
Opioid side effects and overdose
Nerve blocks and injections
Intrathecal pumps and catheters
Spinal cord stimulators
Electrical neuromodulation
Brain stimulation for pain and addiction
Patient trials and selection
5 R. Corey Waller MD, MS, FACEP…
Key Points
Not all pain should be treated the same way.
Long-term opioids often fail in chronic pain.
High doses increase addiction and overdose risk.
Neuropathic pain needs special medications and techniques.
Intrathecal pumps deliver medicine directly to the spinal fluid.
Smaller doses give strong relief with fewer side effects.
Spinal cord stimulation blocks pain signals before the brain receives them.
Trials are done before permanent implantation.
Complications can include infection, catheter problems, and loss of effect.
Neuromodulation may reduce opioid dependence.
5 R. Corey Waller MD, MS, FACEP…
Easy Explanation
This lecture explains why giving high doses of pain medicines (especially opioids) often does not work for long-term pain and can cause addiction and serious side effects. Different types of pain need different treatments. Instead of only using tablets, doctors can use special techniques like nerve blocks, pain pumps, and electrical stimulators. Pain pumps put medicine directly near the spinal cord, so smaller doses work better. Spinal cord stimulators send small electrical signals that stop pain messages from reaching the brain. These methods can reduce pain, improve daily activities, and lower the need for strong pain drugs.
5 R. Corey Waller MD, MS, FACEP…
Important Headings for Notes
1. Failure of Pain Treatment
Rapid dose increase
Poor pain control
Addiction risk
Overdose danger
2. Types of Pain
Neuropathic pain
Nociceptive pain
Central pain
Mixed pain
3. Drug Treatments
NSAIDs
Antidepressants
Gabapentin / Pregabalin
Muscle relaxants
4. Interventional Techniques
Nerve blocks
Steroid injections
Ablation techniques
5. Intrathecal Drug Delivery
Pump and catheter system
Direct spinal delivery
Lower doses needed
6. Neurostimulation
Spinal cord stimulation
Electrical signal therapy
Reversible treatment
7. Deep Brain Stimulation
Brain targets for pain and addiction
Future therapy
5 R. Corey Waller MD, MS, FACEP…
Sample Questions
What is chronic pain and why is it difficult to treat?
What are the main types of pain?
Why do long-term opioids often fail?
What are the risks of opioid therapy?
What is intrathecal drug delivery?
How does spinal cord stimulation reduce pain?
Why are trial procedures important before implantation?
What are the complications of pain pumps and stimulators?
How can neuromodulation reduce addiction risk?
What is the future role of deep brain stimulation?
5 R. Corey Waller MD, MS, FACEP…
Presentation Outline (Simple Slides)
Slide 1 – Title
Advanced Pain Management and Neuromodulation
Slide 2 – What Is Chronic Pain?
Definition and problems
Slide 3 – Types of Pain
Neuropathic, nociceptive, central
Slide 4 – Problems with Opioids
Addiction, overdose, side effects
Slide 5 – Drug Treatments
NSAIDs, antidepressants, anticonvulsants
Slide 6 – Interventional Techniques
Blocks, injections, ablation
Slide 7 – Intrathecal Pain Pumps
How they work and benefits
Slide 8 – Spinal Cord Stimulation
Electrical control of pain
Slide 9 – Risks and Complications
Infection, catheter problems
Slide 10 – Future Therapies
Deep brain stimulation
Slide 11 – Conclusion
Better pain control with fewer opioids
5 R. Corey Waller MD, MS, FACEP…
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