Pain Management Centre

Martigny Hospital Pain Management Centre (Centre de traitement de la douleur, CTD)

Martigny Hospital Pain Management Centre (Centre de traitement de la douleur, CTD)

For the past ten years, the Centre Hospitalier du Valais romand (CHVR) has housed a pain management centre at its Marigny site which is part of the Anaesthesiology and Resuscitation Department (‘Département d’Anesthésiologie et de Réanimation’, DAR).
In March 2012, the CTD was reinforced by the arrival of two new specialists, and it is becoming ever more sought-after. It provides consultations focussed mainly on chronic pain, in close cooperation with the Institutions Psychiatriques du Valais Romand (Psychiatric Institutions of the Valais Romand), the Palliative Care Department, the Neurology and Neurosurgery Departments and the Clinique Romande de Réadaptation (Rehabilitation Clinic for the Romand Region).

Most patients are referred to the CTD by doctors in the region, in order to evaluate the possibilities for treatment adapted to their specific condition. The chronic pains that are catered for are varied: most involve back pain, but numerous other conditions are treated, such as neuropathies (e.g. shingles, trigeminal neuralgia…), joint pain, pain connected with cancer, etc.

Care is provided as an outpatient service by a multidisciplinary team which considers the phenomenon of pain in all its complexity. As a rule, after having been seen by an anaesthetist who is specialised in pain management, the patient is handled by a team made up of nurses who are trained in analgesia, and other specialists. This multidisciplinary consultation leads to a treatment plan being suggested to the patient.
The treatment of chronic pain is based on a multimodal concept which includes medicines, physical therapy, psycho-social care and interventional procedures.
Technical procedures are part of the therapeutic strategy for pain, and several exist. Their primary purpose is to establish a clear diagnosis, and then to relieve or reduce pain. The main interventional procedures that are used include epidural infiltrations into the vertebra, radicular blocks, lumbar or cervical facet blocks, sympathetic blocks. Other targets are peripheral nerves for peripheral neuropathies, articular infiltrations and trigger points for myofascial pain (injection of local anaesthetics at a specific location).
The CTD also uses advanced interventional techniques, such as implanting medullary stimulators for neuropathic pain with various causes, as well as implanting intrathecal pumps.
The CTD also cooperates with the hospital’s palliative care department as soon as pain treatment is necessary. The aim is to find a treatment in order to relieve these patients’ pain in an early phase of their illness.

To sum up, analgesia is a vast and complex speciality, which is catered for in the Centre Hospitalier du Valais romand (CHVR) by a multidisciplinary team which does it utmost to relieve patients who are suffering from chronic pain.

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