Pain Management Takes a Step Forward
A Total Approach to Wellness
A little pain can makes you uncomfortable. A lot of pain can make you miserable. If you are suffering from acute of chronic pain, the physical and emotional roller coaster ride wreaking havoc with your life is no stranger.
Spine Diagnostics & Therapeutics is dedicated exclusively to guiding you through your puzzle of pain. Relief may be possible even sooner than you think.
Unique in its concept, Spine Diagnostics & Therapeutics, practicing at the Pain Management Center at Presbyterian Hospital of Plan, offers key differences in its approach to the diagnosis and treatment of pain related disorders.
"Exclusively dedicated to pain management, we are focused on the body's response to pain stimuli. We employ a variety of techniques from several modalities to help reduce the impact of pain, while caring for the overall functioning of the while person," says Steven L. Remer, M.D. "Our individualized program assists patient sin achieving a higher degree of comfort and function, returning them to a more productive lifestyle. It is very satisfying to help people regain their independence - and their smiles."
Spine Diagnostics & Therapeutics' physicians use high-tech advancements, as well as good old-fashioned listening and hands-on evaluation. This patient oriented approach allows them to develop a clear and reproducible diagnosis and construct an appropriate treatment plan. Instead of Sherlock Holmes' magnifying glass, these soon to be 21st century sleuths utilize diagnostic injections performed under fluoroscopic guidance (a form of real-time X-ray), in order to determine the specific pain generators. These various diagnostic procedures aid in the delineation of specific structures - such as joints, nerves, intervertebral discs and muscles - which may be responsible, individually or in combination, for the generation of painful signals throughout the body. In fact, it is very rare to find only one structure to be responsible for the patient's pain; there are usually several. All must be addressed. With this information, treatment benefits can be maximized.
J.L. White, Jr., M.D. continues, "It is very important to identify the underlying sources off pain since all treatments are based on that diagnosis. For instance, if an individual with back pain is found to have a bulging or protruding disc on an MRI, one should not automatically assume the disc abnormality is the source of pain. We must prove it. This where the use of diagnostic procedures becomes crucial."
The second part of their name, 'Therapeutics', refers to the actual treatment focus of the practice. The doctors develop specific treatment plans tailored to each patient according to a variety of factors including diagnostics, the structures involved, the longevity of the problem and the total degree of physical and behavioral dysfunction (impact upon a patient's personal, family and social life and lifestyle). This plan may be as simple as the institution of a variety of physical movement techniques whose purpose is to restore the normal musculoskeletal functioning, to interventional therapeutic injections. Injections, in general, are facilitators of rehabilitation, not 'total fixers'. They help restore normal tissue function.
For those whose suffering persists from an irreversible disease process, their expertise includes the implantation of 'high tech' devices. Once such devise in the spinal cord stimulator, which blocks the pain signal electrically at the spinal cord level. Another is the implantable drug administration system, which actually administers very small amounts of pain medications into the body, while avoiding the potential side effects and potential addictive problems associated with high dose oral narcotic medications.
Treatment of chronic pain requires a multidimensional approach. The consequences of pain must be addressed such as lifestyle changes, altered family dynamics, stress and depression. Spine Diagnostic and Therapeutics offers alternative modalities including biofeedback, stress management, personal and family counseling, and mind/body techniques. They are in a constant process of improvement with planned additions to include group formats, and nutritional evaluation and counseling.
J.L. White, Jr., M.D. adds, "Unfortunately, particularly in chronic situations, it may not be possible to eradicate pain completely. If that is the case, then our challenge and focus becomes managing the pain so as to minimize its negative effects upon a person's life. A key aspect of our mission is to promote well-being - wellness."
"Pain Management is a natural off-shoot of anesthesiology," explains Steven L. Remer, M.D. "Anesthesiologists are trained to block pain during surgery and childbirth. The perfect progression was to develop ways to relieve or prevent pain in everyday life. Since chronic pain permeates all aspects of life, it requires many avenues of care all working together in coordination to achieve positive results."
"Previously, the pain management specialist was seen as the 'last resort' for dealing with chronic pain. Physicians are now realizing that earlier identification of pain generators and the use of pain management techniques may prevent, slow, and in some cases reverse the effects of structural, neurological, and muscular dysfunction.
"We would love to be able to promise every patient complete elimination of pain," adds Dr. White. "Unfortunately, that is not a realistic goal. Pain 'minimization' is more accurate, especially in cases that have progressed over time. Picture the growth of a tree. It begins as a small seedling, simple and fragile. Then it grows and becomes a mature tree with solid branches, a thick trunk and complicated, twisted root system. Healing the seedling is faster and more complete than working throughout the layers of the tree. We are trained to improve the tree but know that with early intervention we may actually prevent development of future problems with the seedling."
All of Spine Diagnostic & Therapeutics' patients are important to the doctors and the staff. They chose this specialty to be of service to people who might not otherwise find help. Two outstanding examples illustrate what proper care may achieve. A woman in her early thirties had been treated for migraine headaches for sixteen years. She was in extreme discomfort on a daily basis and was bedridden on average three days a week. Strong oral medications, including narcotics, were to little or to no avail. Upon diagnostic evaluation it was discovered that she did not suffer from migraines, but rather from cervicogenic headaches. After a few weeks of treatment she had only slight awareness of any symptoms and was able to participate in daily activities unhampered.
An extremely gratifying and rare case was that of a healthy adult male who played recreational baseball. During a normal game situation he slid into a base as usual. Later than day, he developed unusual symptoms. Sudden-onset back and leg pain quickly increased in intensity and spread to his shoulder. If he stood on his leg, discoloration appeared and was accompanies by numbness, tingling, and burning. Traditional pain medications gave almost no relief. He was forced to use crutches. MRI and x-rays results were negative. Within a week he was in a wheelchair. He received medical opinions inferring that the rapid state of deterioration might lead to amputation. The workup at Spine Diagnostics & Therapeutics revealed an uncommon pain syndrome. Treatment was instituted and within three weeks, the young man was back at full strength and had returned to his normal routine.
Even though most cases are not as dramatic as these are, improvement may be possible. Bringing leading-edge medical advances to their patients is of primary importance for Spine Diagnostics & Therapeutics. They began using Botox® long before it reached its current popularity. Botox® is derived from the bacteria Clostridium botulinum and is injectible medication that acts locally on the muscle to control spasms. Botox® has been effective in reducing pain in cases of severe muscle dysfunction. The results have been extremely encouraging.
The approach of Spine Diagnostics & Therapeutics is to find the underlying cause of the problem, improve it as much as possible and continue with various avenues of care, bringing the patient to a higher level of wellness.
Dr. White noted that pain care has come a long way from the days when a 'pain doc' could only offer blockage of painful sensations through heavy use of pain killing medications, either in pill form or by injection. Fortunately, in the early 1990s, modern medicine recognized this dilemma and created the specialty of pain management. Board certified anesthesiologists could now train at the fellowship level to understand the complex puzzle of pain, its causes and its overall effect on all aspects of health. New diagnostic techniques and new treatment therapies were developed. The specialty continues to evolve based on the efforts of physicians such as Steven L. Remer, M.D. ad J.L. White, Jr., M.D., who are always seeking additional ways to help the majority of their patients achieve their goal… a state of wellness.
If you are suffering from a chronic or even acute pain problem that is affecting your life, call Spine Diagnostics & Therapeutics at (972) 981-8592 to schedule an appointment with the 'medical detectives'. Feeling good is only a phone call away.
