Treatment of osteoarthritis of the spine and herpetic neuralgia at the Pain Center, Mount Sinai Medical Center.
This presentation will briefly describe the operation of this Pain Center and discuss the two chronic pain problems most commonly seen in our geriatric population: osteoarthritis of the spine and herpetic neuralgia. Osteoarthritis of the spine is the most common radiologic finding in middle-aged and older people with low back pain. 32% of our patients have this diagnosis as the basis of their chronic pain. The typical patient is 72 years old and has a past pain history which includes several years of back pain treated by various physicians with anti-inflammatory agents and analgesics to no avail. Past history of surgery and drug abuse is rare; however, depression is common. Therapy at the Pain Center is primarily the use of an exercise program and epidural and/or subarachnoid steroids. At the last visit, approximately 70% of the patients have had significant improvement. Herpetic neuralgia is found in 13% of all patients seen at the Mount Sinai Medical Center Pain Center. Our typical patient is 73 years old and has had PHN for 10 months unrelieved by various topical and oral medications. Although rarely is there a history of drug abuse or surgery, extreme depression is common. If the duration of the neuralgia is less than one year, 85% of patients get significant or complete relief from the use of sympathetic nerve blocks and/or the subcutaneous infiltration of steroids and local anesthetic. Once the PHN has been present for more than one year, only 55% of the patients are improved.
D005431:Florida; D006566:Herpesviridae Infections / Q000628:therapy*; D006801:Humans; D009437:Neuralgia / Q000628:therapy; D010003:Osteoarthritis / Q000628:therapy*; D010044:Outpatient Clinics, Hospital; D010146:Pain / Q000209:etiology; D059408:Pain Management; D013122:Spinal Diseases / Q000628:therapy*; D013166:Spondylitis / Q000628:therapy