Chronic Pain Management – Article by Dr. Frauke Kawooya- All Images by: MFK Orthopedics & Paediatrics
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Chronic Pain Management – Article by Dr. Frauke Kawooya- All Images by: MFK Orthopedics & Paediatrics
THE MZEE has unbearable back pain radiating into his legs. After trying several methods to reduce it, including oral pain killers, therapeutic massages,
physiotherapy, and lifestyle changes as recommended by his GP, the pain never lessened to a level where he could move normally or find a comfortable sleeping position at night. Then a friend told him about a new Orthopedic Hospital in Muyenga and a doctor with “magic hands”…
This is how he came to see Dr. med. Mike Kawooya, a Senior Consultant Orthopedic and Accidental Surgeon at MFK Orthopedics & Paediatrics, Kisugu-Muyenga. The German-trained doctor and his wife, Dr. med. Frauke Kawooya, a Senior Consultant for Child and Adolescent Health, have returned to Uganda after 20 years of studying and working in Germany to offer a unique service not yet found elsewhere in Uganda or much of East Africa: Effective management of chronic back pain using a nonsurgical, minimally invasive procedure called infiltration therapy.
The old man sees Dr. Mike Kawooya for a consultation to understand the cause of his pain. Diagnostic measures, including lab tests and X-rays (all available within the facility), reveal the problem: He suffers from arthritis of the spine, a condition common in the elderly but which can also affect people in their late 40s.
Dr. Mike Kawooya explains every image taken and, after a thorough examination, advises undergoing infiltration therapy. Infiltration therapy is a medical technique where a substance, such as medication or an anesthetic, is injected directly into a specific tissue or area. The primary goal is to provide localized pain relief or treat a specific condition. For Mzee, the location is the lower back spine joints and their surrounding tissue. The treatment is outpatient and takes place in three consecutive sessions over one week, usually on Monday, Wednesday, and Friday.
In the morning, the patient arrives with a relative at the hospital, and vitals are taken. After a brief check of blood pressure, body temperature, and pulse, the patient is brought to the treatment room. A mobile X-ray machine, known as a C-arm (named for its shape resembling the letter C), is used to guide the injection of medication into or around the spine.
Under sterile conditions, a mix of steroids and anesthetics is administered directly to the inflamed and painful area. This therapy is not only used for facet joint arthritis but also provides relief for pain caused by herniated discs and spinal stenosis.
The C-arm provides real-time imaging, ensuring precise placement of the needle and delivering the medication exactly where it’s needed. This method improves accuracy and reduces the risk of complications compared to spinal surgery. Another advantage is the significant reduction in the use of oral painkillers, minimizing their side effects.
After the first session, the patient goes home one hour after the injection and, finally, can enjoy a good night’s sleep. By Wednesday, he returns, walking on his own without needing his walking stick. After the third session on Friday, he is able to move his body in ways he hasn’t in many months!
The effects of this pain management can last for several months, or even years in some cases. While it won’t turn back time, the quality of life for this old man has significantly improved after treatment at MFK Orthopedics & Paediatrics.
