Relief is on the Way
Of the many reasons Dr. Niti Cooper decided in medical school to pursue a career in pain management and anesthesiology, one may have stood out above the rest. Back pain is said to be among the most common reasons in the United States for someone to seek medical care, and helping those patients get past their seemingly hopeless situations and return to their favorite activities was an opportunity she could not pass up.
“Pretty much every single person is going to have back pain at some point in their life,” says Dr. Cooper, of Premier Orthopaedic Associates. “That just has to do with the anatomy of our spine and how much weight our back holds. If you think about it, it holds all the weight above your pelvis, so low back pain is definitely very common, especially in patients who are overweight or who have had a lot of wear and tear on their bodies. We see a lot of patients who are construction workers, plumbers, military workers—anyone who has used their body like that has a ton of low back pain.
“It’s a great feeling to help someone improve their function and get back to doing the things they were having difficulty doing or avoiding because of the pain.”
In the not-so-distant past, the first line of treatment recommended for nagging back pain was prescription medication, and ultimately, when all other options were exhausted, many patients ended up on the operating table. Since surgery remains a last resort for most people, and because of the recent shift away from pain meds because of the opioid epidemic, various alternatives have emerged—some that reflect the advancements of modern medicine, and others that harken back centuries.
For example, acupuncture, while long used in Eastern countries, is gaining more credibility by the day in the U.S.
“I think with people seeking alternative treatments, acupuncture is certainly trending and is interesting for people just because it’s something different,” says Dr. Alexander King of Rowan Medicine’s NeuroMusculoskeletal Institute. “I know culturally, a lot of people have never experienced it, but in Asia and the Middle East, people grow up with it and it’s actually not alternative—it’s the first thing to do when you get an injury or have pain. Rather than take a pill, you just get some manual treatment, whether it’s with hands-on manipulation, acupuncture or even herbal medicine.”
Dr. King sees a wide range of patients not just for back pain but also neck pain and pain resulting from operations, physical or emotional trauma, or fibromyalgia, among others. The modalities he offers vary by the patient, but the approach is always rooted in harnessing the body’s potential for natural recovery, and acupuncture is a big part of that.
“My grandfather was an acupuncturist, so it’s kind of been in my family for generations,” he says. “I did a fellowship in acupuncture during my residency, and it is really good at relieving chronic pain, as well as even acute pain. Essentially, you’re allowing the body to heal on its own by releasing its natural endorphins and creating some changes in the fascia in terms of fascia remodeling via collagen. It also helps your body go back to a balanced, parasympathetic nervous system, because with trauma, injuries or car accidents, you go into that fight or flight mode. Acupuncture can help bring it down and rebalance you from that state. It’s really good for allowing the body to heal.”
Dr. King also offers osteopathic manipulative medicine (OMM)—which is similar but more gentle than chiropractic treatment—along with lidocaine injections and cupping, which was popularized by swimmer Michael Phelps at the Olympics and is embraced by athletes as a natural healing mechanism. He is an instructor at Rowan Medical School as well, a frequent speaker and podcaster who is doing his part to train the next generation of doctors.
“There’s not another practitioner at Rowan as far as I know who does acupuncture, cupping and OMM in combination,” he says. “Granted, they all learn OMM as a foundational skill as a DO, but I think it’s important because a lot of patients will ask about these modalities, and if you haven’t had that experience in medical school, you might not have a good grasp of how it’s done, what it’s for and how it works. I think it really does inform future doctors about these practices, because they’re only going to get more popular as far as I’m concerned.”
Dr. Cooper sees adult patients of all ages for various problems, most commonly back pain, and primarily uses interventional pain management focusing on minimally invasive procedures and injections to return them to optimal health.
“Generally, I classify low back pain into three categories,” she says. “It can be muscular in origin, where they pull a muscle or strain a muscle and have tightness or cramping in their back. The second category is usually related to some type of disc pathology where a disc is pinching on a nerve and generally these patients will have back pain shooting down one or both of their legs, which is commonly referred to as sciatica. The third category that I see a lot of is patients who have back pain due to arthritis. This has to do with the wear and tear they’ve experienced throughout their lifetime as well as genetics and other factors.”
Whether patients are coming to her to recover from a previous surgery or to avoid one, most have usually lived with the pain for years and seen it affect their daily lives drastically.
“There’s different types of injections I can do to get patients feeling better,” she says. “It can be injections into the muscle known as trigger point injections; epidurals that are used to treat low back pain shooting into the legs, also known as lumbar radiculopathy; and then there’s injections we can do for arthritis where we can actually ablate or burn the nerve that makes you feel the arthritis in your back. There are definitely a lot of options and patients don’t necessarily need to live with the pain.”
In some cases, one injection can ease the pain for six months, a year or even indefinitely; other patients have to undergo treatment on a regular basis. Whatever it takes to improve their quality of life, Dr. Cooper is on board.
“It’s very rewarding,” she says, “to see someone who comes in hurting, upset and crying and help them get their life back.”
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Author: Matt Cosentino
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