Spokane Pain Management Specialist

Dr. Don Williams

Osteopathic Manipulation (OMT)
Workers Compensation - OWCP
and Washington L&I (LNI)

Spokane Valley Clinic

(509) 991-3054

10 Minutes from Central Spokane

Pain Management and Osteopathic Manipulation (OMT) of Neuropathic Pain

Neuropathic pain is caused by damage or injury to the nerves that transfer information between the brain and spinal cord from the skin, muscles, and other parts of the body.

The pain is usually described as a burning sensation and affected areas are often sensitive to the touch. Symptoms of neuropathic pain may also include excruciating pain, pins and needles, difficulty correctly sensing temperatures and numbness. Some people may find it hard to wear thick clothes as even slight pressure can aggravate the pain.

When nerves are damaged or dysfunctional, the result can be neuropathic pain. Injury, disease, illness, and other factors can impact nerves, causing dysfunction and pain. Neuropathic pain and neuralgia both can be caused by irritated or damaged nerves. Pain management specialists may offer a treatment modality such as Osteopathic manipulative treatment (OMT) or medical pain management of the chronic pain.

Every part of the body is impacted by nerves for sensation and function. Neuropathic pain is caused by disruption in the normal nerve function. Infection, physical damage, radiation, inflammation, impingement and many other factors can impact the way a nerve signals the brain. Diabetes, shingles, amputation, trauma and nervous system disorders are common of the related issues that can cause neuropathic pain. Neuropathic pain occurs when nerves signal distress or pain to the brain when there is not a cause or source of pain present. Symptoms include: shooting, burning or intense pain without stimulus, tingling or needling sensation, pain caused by non-painful stimuli, such as heat or cold, abnormal sensation in affected area.

Pain Management Approach to Treating Neuropathic Pain

The primary goals of pain management for neuropathic pain are to manage the pain as much as possible and to minimize the negative side effects of the treatment. Individuals with chronic neuropathic pain may be referred to a pain clinic for assessment, management and advice on living with chronic pain. Osteopathic manipulative treatment (OMT) has been used with success in the treatment of neuropathic pain and has very little risk of adverse effects.

Every person is different and your doctor will take into consideration your needs so as to suggest the most suitable treatment for you. There are various treatments available for neuropathic pain and often it is a ‘trial and error’ process to find the best option for an individual.

Regular painkillers such as non-steroidal anti-inflammatory drugs or NSAIDs (for example ibuprofen) are usually not effective for neuropathic pain.

Here is a brief outline of the most common pain management treatments:

Examples: gabapentin, Lyrica

Primarily used for the treatment of epilepsy, these drugs can also reduce nerve pain and ease neuropathic symptoms. Being prescribed an antiepileptic medication does not mean you have or you are at risk of developing epilepsy. The drug carbamazipine is usually used for people with a diagnosis of trigeminal neuralgia.

Common side effects: drowsiness, dizziness and headaches

Examples: amitriptyline, venlafaxine, Cymbalta or duloxetine

Primarily used for depression, this group of drugs has also been found to have an effect on pain management of nerve pain. Being prescribed an antidepressant does not mean that you have or you are at risk of developing depression.

Common side effects: drowsiness and dry mouth.

Pain management with opioids
Examples: codeine, dihydrocodeine and morphine, oxycodone, fentanyl, buprenorphine

The evidence of benefits in using opioids to treat neuropathic pain is not clear however some individuals find them beneficial. It is suggested to discuss with your doctor about the potential benefits and risks before you start taking an opioid.

Common side effects: feeling ‘spaced out’, constipation, drowsiness, nausea.

Capsaicin Cream

Derived from red peppers. The cream is absorbed through the skin to reduce levels of Substance P, the neuro-transmitter which is associated with inflammation and pain. Beneficial effects may be experienced with regular use.

Common side effects: Localized heat and redness.

Lidocaine patch

It can ease pain which affects a small area of the skin.

Common side effects: irritation and redness.

Injections/nerve blocks
Examples: usually a combination of a local anaesthetic agent, opioids and steroids.

Nerve blocks do not have a long-term effect but they can reduce the pain for several days or weeks.

Common side effects: numbness or tingling in the area injected, increased discomfort for a few days.

Transcutaneous electrical nerve stimulation (TENS)

A TENS machine produces a mild electrical impulse. Electrodes from the machine are placed on the skin over the area of pain. It is believed that selective stimulation of certain nerve fibers could block signals carrying pain impulses to the brain and spinal cord which may help to relax the muscles and ease the pain. TENS can be self-administered however it is advisable to give individuals a supervised trial prior to use.

Common side effects: allergic reaction/skin irritation from electrodes.

Osteopathic manipulative treatment (OMT)

Osteopathic manipulative treatment or OMT is a hands-on way that doctors of osteopathy or a DO may use to align the body which is an effective form of pain management.


Acupuncture is a treatment which originates from ancient Chinese medicine and it involves the insertion of fine needles into specific points/energy channels on the body. It is believed that this stimulates the nervous system and the body’s own healing response which in turn helps with pain management. Acupuncture needles are very fine and when inserted through the skin the sensation is often described as a tingling or dull ache.

Other therapies

People may also find pain management benefits in other therapies that can be used in conjunction or as an alternative to conventional treatment. These include therapies such as meditation, reflexology, aromatherapy and homeopathy. A change in lifestyle may also be beneficial for pain management. Changes include following a balanced diet, doing gentle exercise (in agreement with your doctor), drinking plenty of water and avoiding smoking and drinking alcohol.

Living with neuropathic pain

Chronic pain is a very complex and each person is affected differently. It has many physical and psychological components and individuals can experience fatigue, anxiety, mood changes and depression.  As pain cannot be seen, it is hard to explain to someone exactly what it feels like and therefore it is hard for others to understand just how much it can affect everyday life.

About Dr. Don Williams

Dr. Williams is board certified in Osteopathic manipulative treatment with the American Osteopathic Association and is a pain management specialist in the state of Washington.  His clinic is located in Spokane Valley and he provides treatment to patients from the Spokane, Spokane Valley, Post Falls and Coeur d'Alene areas.