Chronic pain, which is pain lasting six to 12 weeks or longer, can be debilitating for the people who have it.

The source and location of that chronic pain can be as varied as the individuals who suffer from the pain, be it leg pain, neck or shoulder pain, pain from an old injury, pain from a hip or knee replacement surgery, arthritis pain in its many forms, facial pain or joint pain, to name a few of the possibilities.

Dr. Miguel Figueroa has seen it all.

Many doctors will just prescribe a pain medication and be done with it, but not Figueroa, who is a neurologist, specializing in pain management at Merit Health Natchez Outpatient Therapy Services.

Figueroa said he believes prescribing pain pills, opioids or otherwise, is not an effective way to treat chronic pain.

“Pain is processed through the brain and spinal column,” Figueroa said, and as such he tailors treatments in that area.

Opioids and other pain pills, he said, do have legitimate uses, such as for patients who have just broken bones or have some other emergency pain that needs immediate relief or for patients in the final stages of a terminal disease who are in constant severe pain.

In such cases, addiction is not a concern.

“Long-term opioids don’t work very well for chronic pain,” Figueroa said, adding that opioids offer practically no functional improvement over the use of Tylenol or ibuprofen for pain relief. “Opioids are a gateway drug.”

He noted that the latest numbers available show that 64,000 people died of opioid use in 2016 and noted that not all of those opioid deaths were related to legal prescriptions.

Once someone gets hooked on opioids, it is a tough habit to break and many of the addicted people go from doctor to doctor trying to get a prescription. If that fails, some of them turn to the black market or discover heroin as an alternative.

“If you are just looking for medicine, you can come see me but you will be disappointed,” Figueroa said. “It is a relationship (between doctor and patient). I’m going to study the situation and do the right thing.”

Rather than just prescribe medicine, Figueroa has a variety of procedures he can utilize, including blocking nerves and cauterizing them, which can provide six months to a year of pain relief. Spinal injections, using cortisone can help, as can spinal cord stimulators, which interfere with pain signals to the brain.

While proven effective, cortisone injections have side effects, including weight gain and raising the patient’s blood pressure so the benefits must be weighed against those concerns, he said.“Regenerative medicine might be an option,” Figueroa said, adding a process exists in which the patient’s blood is drawn, put through a centrifuge and plasma is extracted and a percentage is injected back into the patient. “It is pure packets of growth factor.”

Other regenerative procedures include injecting patients with stem cells.

Insurance, however, does not cover regenerative procedures for chronic pain because in most cases a lack of research exists to show their effectiveness.

The procedures are not too expensive — as far as medical procedures go — ranging from $1,000-$3,000 and can be done in office in as little as 30 minutes.

Finding the right treatment for the right condition is key to helping patients overcome their chronic pain, Figueroa said.

The treatments can only do so much to help patients, Figueroa said, but all chronic pain patients must make lifestyle changes to overcome the underlying issues causing their chronic pain.

Losing weight, eating a healthy diet, exercise, meditation and stopping smoking are among the top lifestyle changes Figueroa said he recommends to patients.

Figueroa cited one recent study in which British researchers found “That even smoking just one cigarette a day still has a significant impact on a person’s risk for developing heart disease or having a stroke.”

He said beyond just the nicotine the carcinogens and tar contained in cigarettes deliver ill effects as well and smoking can make it difficult to overcome underlying factors creating chronic pain.

Figueroa is involved in the American Academy of Neurology and advocates to make regenerative medicine more acceptable.

The organization also is lobbying Congress to develop safe, effective alternatives to opioids for pain management, lobbying Congress to fund new research into pain management and to expedite pre-authorization for medical procedures such as utilizing the internet to facilitate approvals rather than waiting for regular mail.