Chronic Pain Treatment Options for an Aging Population in Neurology: Justin Davanzo, MD

WATCH TIME: 5 minutes

"We have options for treatment for a lot of these [conditions] now, and while they may not be perfect, they oftentimes will provide patients with some level of benefit with regards to their pain. For people outside of neurosurgery and outside of pain management seeing these patients, I want them to know that we have options to help them and that there are things we can do to hopefully make that chronic pain better for them and improve their quality of life."

In neurology, there are many surgery treatment options for patients who may be experiencing chronic pain. For example, patients with trigeminal neuralgia may have surgery performed for nerve decompression, known as microvascular decompression.¹ Additional treatments for these patients may include rhizotomies and gamma knife radiosurgery, which are geared at deadening the nerve so that the pain is less. This type of surgery, considered a minimally invasive treatment approach, could be reserved for older patients or even patients who are not candidates to undergo a more extensive.²

For occipital neuralgia, treatments may include occipital nerve stimulation, where clinicians put stimulation wires near the peripheral nerves in the head and the back of the head near the greater occipital nerve.³ There’s different procedures for chronic low back pain and peripheral neuropathy as well such as spinal cord stimulation for treatment, which has been shown to improve patients with low back pain in recent years.⁴

Recently, Justin Davanzo, MD, a neurosurgeon in the department of neurology at Allegheny Health Network, recently sat down with NeurologyLive^® to provide a closer look at the different types of treatments for pain. He briefly discussed the rising prevalence of chronic pain in the aging patient population, as well as how some of the newer surgery procedures have been effective for treating patients with chronic low back pain. Moreover, Davanzo spoke about how collaborative care improves treatment outcomes for patients with chronic pain in neurology such as for trigeminal neuralgia of traumatic brain injury.

REFERENCES
1. Lv W, Qin Y, Liu X, Zhang L. Treatment of recurrent trigeminal neuralgia after microvascular decompression: How to select. J Clin Neurosci. Published online July 13, 2024. doi:10.1016/j.jocn.2024.07.005
2. SohrabiAsl M, Shirani M, Jahanbakhshi A, Iranmehr A. Efficacy and Challenges: Minimally Invasive Procedures for Trigeminal Neuralgia Treatment in Multiple Sclerosis - A Systematic Review and Meta-Analysis. Stereotact Funct Neurosurg. 2024;102(3):156-168. doi:10.1159/000538516
3. Mossner J, Saleh NB, Shahin MN, Rosenow JM, Raskin JS. Occipital nerve stimulation in pediatric patients with refractory occipital neuralgia. Childs Nerv Syst. Published online April 2, 2024. doi:10.1007/s00381-024-06376-x
4. El-Naggar AO, Reis CL, Hatheway JA, et al. Using Lower Amplitudes to Maintain Effective High Dose Spinal Cord Stimulation Therapy (SCS Dosing Pilot Study). Neuromodulation. 2021;24(3):532-539. doi:10.1111/ner.13258