Pain Management during Childbirth

Posted by Brigham and Women's Hospital June 10, 2014

Dr. Camann advises women to prepare a birth plan, but to stay open and flexible.

In the following video, Dr. William Camann, Director of Obstetric Anesthesia at Brigham and Women’s Hospital, describes the numerous medical and non-medical options women have for pain management during childbirth.

Non-medical pain relief options include the use of hydrotherapy or immersion in a water tub, birth balls, mental imagery or hypnotic techniques, and the use of a doula or birthing coach. Dr. Camann notes that many of these non-medical pain relief options are also compatible with medical pain relief options, which include patient-controlled administration of epidural anesthesia, drug combinations, and soon-to-be available inhaled nitrous oxide.

In the event a cesarean delivery is required, Dr. Camann also describes how BWH physicians are using an approach called the family-centered cesarean to make cesarean deliveries as natural and family-friendly as possible.

Read More »

Comprehensive Spine Care: Surgical and Non-Surgical Treatment

Posted by Brigham and Women's Hospital May 6, 2014

Treating back pain can be very challenging, requiring the expertise and coordination of more than one medical specialty.

Certain spinal conditions, such as back pain, are very common. However, treating these conditions can be very challenging, requiring the expertise and coordination of more than one medical specialty, including physical medicine, pain management, and surgery.

“Back pain is a very common complaint, but a very non-specific complaint. Back pain and leg pain can be caused by many different things, including spinal stenosis, disk herniations, and instability. The procedures that we offer are really tailored to the specific patient with a specific disorder, based on imaging and exam,” says orthopedic surgeon Dr. Chrisotopher Bono, Co-Director, Brigham and Women’s Comprehensive Spine Center.

To ensure the correct diagnosis and treatment for spinal disorders, patients who are referred to the Brigham and Women’s Comprehensive Spine Center are evaluated with state-of-the-art diagnostic procedures and imaging. Often, the first step is conservative, non-operative treatment by physiatrists, pain management physicians, and other specialists.

Read More »

Fibromyalgia: Aching for Pain Relief

Posted by Brigham and Women's Hospital November 19, 2013

Fibromyalgia patients usually experience widespread pain and discomfort.

Today’s post is written by Dr. Edgar Ross, Director of the Pain Management Center at Brigham and Women’s Hospital (BWH).  The post was adapted from an article that appeared in the September issue of the newsletter published by the Osher Center for Integrative Medicine at BWH.

Fibromyalgia is a poorly understood syndrome that is quite common but can be difficult to diagnose and treat. The symptoms of fibromyalgia include widespread soft tissue pain, disturbed sleep, fatigue, and characteristic tender points that are multiple and  diffuse. Conditions such as migraine headaches, chronic fatigue syndrome, depression, irritable bowel syndrome, restless legs syndrome, and temporal mandibular joint dysfunction are often associated with fibromyalgia. Fibromyalgia patients usually experience widespread pain and discomfort.

The processes within our bodies that can produce symptoms of fibromyalgia are not well understood. The leading theory suggests that the origins of fibromyalgia may relate to an over-reaction of the central nervous system to all types of sensation. These disturbances can have an impact on sleep. Sleep studies of patients with fibromyalgia frequently identify a lack of restful sleep.

Fibromyalgia can be difficult to diagnose because the signs and symptoms in patients can vary from visit to visit. In 1990, the American College of Rheumatology published a list of tender points that can be used to establish the diagnosis. Though laboratory testing is not useful for making a diagnosis of fibromyalgia, it can help rule out other conditions that mimic this condition.

Read More »