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The Cleveland Clinic

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The Cleveland Clinic Foundation

 

Pain Management Department

9500 Euclid Ave., C 25

Cleveland, OH  44195    (216-444-7246, or 800-392-3353)

 

website:  www.ccf.org

 

Contacts:  Nagy Mekhail, MD, PhD  -  Chairman

The Cleveland Clinic Foundation formed a pain management unit in 1979, and since then has treated an estimated 2,000+ people for chronic pain conditions (average of 200/year). This is one of the largest programs in the nation, if measured by the volume of patient-visits (approximately 19,000 in 2000).  Growth of nearly 20% is expected for 2001.  Treatment is provided in a private and separate hospital unit devoted entirely to the rehabilitation of those with chronic pain. The clinic operates inpatient, day program, and outpatient programs.

This clinic serves people with acute and chronic pain: low back problems, reflex sympathetic dystrophy, cancer, arthritis, muscle and joint pain, nervous system disorders including shingles, gastrointestinal problems, and those suffering from migraine headaches.

The Pain Management Department is accredited by CARF, the Commission on Accreditation of Rehabilitation Facilities, which develops the standards for multidisciplinary clinics.  The clinic takes an interdisciplinary team approach to the evaluation and treatment of pain. The center is directed by physicians in the Division of Anesthesiology who are fully trained and board-certified in pain management. It is closely linked with the Departments of Psychiatry and Psychology, Physical Medicine and Rehabilitation, Neurosurgery, Orthopaedic Surgery, and the Cleveland Clinic Cancer Center and the Spine Center. In addition to its pain management physicians, the team includes specially trained nurses and nurse clinicians; psychologists; occupational and physical therapists; a financial counselor to help with questions about insurance coverage; and a social services department.

The Cleveland Clinic Foundation is designated as a regional referral center for reflex sympathetic dystrophy by the national Reflex Sympathetic Dystrophy Syndrome Association. Services usually provided on an outpatient basis include reconditioning exercises, work hardening, counseling, education, biofeedback training, and medication management. If outpatient care does not resolve the problem, more extensive day or inpatient treatment is then recommended.

Day and inpatient programs involve the same therapies, except that day care patients go home or to a local hotel each night, while inpatients spend the night in the hospital. 24-hour care is required for those who are most severely disabled, who need detoxification, or whose depression or medical condition demands closer observation. The usual length of stay is 3.5 weeks.

Follow-up treatment is strongly recommended. The clinic's monthly, free Aftercare Program includes discussion of progress and difficulties, physical therapy "brush ups", practice in assertiveness and stress management, and medication management, as needed.

Treatment by The Pain Management Department involves evaluating the patient’s medical records, and evaluations are performed by the Department’s pain management physician, psychiatrist or behavioral specialist, and physical or occupational therapist. In addition to blood tests and X-rays, other diagnostic tests which may be performed include:

·        Telethermography, an innovative imaging technique that measures body temperature changes that can signal sources of pain

·        MRI (magnetic resonance imaging) exams, which create pictures of the body’s internal structure without X-ray exposure

·        CAT or CT scans (also called computerized axial topography) that show muscles, disks, ligaments, bones, and the spinal cord

·        EMG (electromyography), a test used to stimulate nerves and identify any nerve damage or irritation

·        Regional nerve blocks, which help locate sources of pain.

Range of Treatment Options...

  • Interdisciplinary cancer pain treatment

  • Acupuncture

  • Therapeutic nerve blocks

  • Intercostal nerve blocks

  • Lumbar Sympathetic Blocks

  • Facet Nerve Block  

  • Celiac Plexus Block

  • Stellate Ganglion Block

  • Trigger point injections

  • Spinal drug delivery systems

  • Spinal cord stimulation

  • Spinal endoscopy

  • Intradiscal electrothermal therapy

  • TENS (transcutaneous electrical nerve stimulation)

  • Bioelectric treatment

  • Psychological counseling

  • Physical and occupational therapy

  • Dietary and nutritional counseling

  • Kyphoplasty

The patient may be seen by specialists in pain management, rehabilitation medicine, physical therapy, neurology, orthopaedics dentistry, gynecology, internal medicine or other specialties. A financial counselor is available to help with questions about insurance coverage; as well as a social services department.

The Cleveland Clinic Foundation also operates The Cleveland Clinic Cancer Pain clinic, a joint effort between the Cleveland Clinic Pain Management Department and the Cleveland Clinic Taussig Cancer Center. The Clinic is comprised of an interdisciplinary team of professionals which provides comprehensive evaluation and treatment of cancer pain. The clinic reports that an estimated 3.5 million people suffer from cancer pain daily, and 90% of patients with advanced cancer say pain is the most distressing symptom of their disease.

 

* page last updated 01/14/2008

 

Cleveland Clinic | Johns Hopkins | Mayo Clinic | Mensana | Norman Marcus | Pain Control of Georgia

Rosomoff Center | Scripps | University of Washington | Wake Forest

 

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