Treatement of sharp and chronic pain

Pain is the most common reason for seeking medical help. Pain that lingers is stressful, debilitating, and depressing for anyone who experiences it. It affects the quality of life – the person loses his desires, daily activity, sleep, and social contacts.<br><br> The medicine of pain has only a 50-year history, but a lot of progress. The treatment of pain these days is complex and includes medication, techniques, physical treatments, and psychological support. However, not all pain can be relieved completely, but the goal is to improve the patient's quality of life. Today, pain should not be thought of as a symptom of disease, but as a disease.

How can we help you?

Pain Management Unit

The Pain Management Unit is a medical unit focused on the treatment of acute and chronic pain. It can help with pain due to musculoskeletal disorders, arthritic pain, back and low back pain, migraines, shoulder, knee or hip pain, pain syndromes after abdominal surgeries and other surgical interventions, neuropathic pain due to vascular disease and diabetes, chronic pain in oncology patients, etc.

The therapies we offer are conducted by Dr. Viktor Stefanov – a leading specialist in this field for Bulgaria – a specialist with extremely extensive experience in the treatment of acute and chronic pain, regional anesthesia and ultrasound-guided techniques for local anesthesia. Dr. Stefanov works according to all modern guidelines regarding pain. The treatment is strictly individualized and patient-centered.

Non-medical methods (drug-free non-traditional methods)

If deemed necessary, you may be referred for consultation to the Department of Physical and Rehabilitation Medicine, where you may be prescribed acupuncture, laser therapy, collagen therapy, electro-procedures or kinesitherapy.

Types of pain

Acute (short-term) pain is associated with tissue trauma and resolves quickly as the tissues heal. It lasts between 3 and 6 months. Common causes of acute pain include trauma, surgery, childbirth, medical tests, or some type of illness. Acute pain must be treated in time to prevent it from becoming chronic. This type of pain can be controlled solely by prescription drugs.

Chronic (long-term) pain can be caused by diseases such as arthritis, musculoskeletal disorders, back pain, and migraines. This type of pain is the most common and affects more than 40% of the European population. It needs a specific diagnosis and complex treatment. During the diagnostic process, consultation with an internist, neurologist, laboratory, and imaging tests will be necessary. Chronic (long-lasting) pain can also be caused by cancer or other terminal illness. The control of oncological pain depends on the stage of the underlying disease and its stability. With disease in remission, pain can be controlled in most individuals. When this is not possible, our goal is to achieve levels of pain relief at which the patient has a near-normal daily routine. In terminal patients (in the last and incurable stage of disease) our aim is to reduce, as far as possible, their suffering.

What can you expect:

Pain treatment response varies between individuals, even when they report the same complaints. Your doctor will talk to you, assess your medical condition and your pain, then determine which medication, combination of medications, or technique is appropriate for you.

Conditions we can handle for you

1. Musculoskeletal and arthritic pain:
- Upper body pain: ultrasound-guided shoulder, elbow, and wrist blocks.
- Lower body pain: knee pain due to gonarthrosis, pain after knee and hip replacement, hip and ankle pain.
- Myofascial neuralgia – ultrasound guidance trigger point blockades.

2. Chronic headache in its different forms:
- Occipital neuralgia
- Idiopathic atypical facial pain (facial pain)
- Trigeminal neuralgia
- Hemifacial neuralgia

3. Neuropathic pain:
- In diabetics
- Chronic peripheral vascular disease
- Complex regional pain syndrome (CRPS)

4. Spinal pain:
- Epidural
- Facet
- Transforaminal
- Sacroiliac blockades

5. Pelvic pain syndromes:
- Pudendal neuralgia
- Pyriformis syndrome

6. Pain syndromes after abdominal surgery

7. Chronic pain due to oncological or terminal disease

Route of action

We believe that a complete assessment of the patient's health status and making an accurate diagnosis is the foundation of successful pain management. The lack of an accurate diagnosis often dooms treatment to failure and can pose a risk to the patient. Our team believes that only if you share the full story of your pain and suffering can we determine how it is disrupting your life. We have the ability to reach the correct diagnosis through our state-of-the-art equipment and apply modern methods and techniques.

What we’ll do together

1. Consultation and diagnosis – discussion with the patient and/or their close companion and examination – physical and ultrasound (if applicable). Provide diagnosis based on a multidisciplinary approach. If necessary, referral for consultation with other specialists (from the medical centre or hospital) and laboratory and imaging tests.

2. Treatment

2.1. Non-invasive approach

Prescribing medications (including such on yellow and green prescription lists). Medication treatments vary greatly depending on your pain. Analgesics may be administered by different routes: by mouth, as a muscle injection, as a vein injection, and through the skin (patch).

2.2. Invasive techniques

Ultrasound-navigated peripheral nerve blocks – a safe and effective technique that we at Hemus Medical Center prefer and value.

Anesthesia through an epidural catheter – anesthetics’ delivery into the epidural space (for hospital treatment).

Patient-controlled analgesia – a method that allows the patient to self-administer opiates using a programmed pump. The program does not allow overdosing. It is administered in severe pain or postoperatively. The program does not allow overdose. It is used for severe pain or post-surgery.