The Right Relief

by Peter Proko | Sep 28, 2020
The Right Relief

New treatments and procedures have given chronic pain sufferers an optimistic outlook.

September may be considered Pain Awareness Month, but for anyone dealing with chronic pain, it’s a day-to-day struggle. In fact, the Centers for Disease Control and Prevention (CDC) estimates that as many as 50 million people in the United States suffer from chronic issues, which account for the most common reasons why adults seek medical care.
While many of those people may attempt to simply live with the discomfort, there comes a time when conditions worsen and the pain not only becomes physically debilitating, but it also starts to take a psychological toll. At that point, it may feel like things are too far gone. But, thanks to technological advancements and cutting-edge treatments, South Jersey pain specialists are finding ways to ease the suffering and give their patients a new lease on life.
“Chronic pain interferes with work, leisure, sleep and the general enjoyment of life,” says Dr. Michael O’Keefe of O’Keefe Chiropractic Center P.A. in Medford. “In essence, there’s no magic bullet for pain management. It’s more of a process derived from a careful evaluation that ultimately leads to a successful outcome.”
Noticeable Changes
Ten to 15 years ago, if a patient came to O’Keefe’s office with severe musculoskeletal problems, there was only so much he could do for them outside of trying to reduce some inflammation and refer them to another specialist more equipped to directly address their needs. New therapies have changed that drastically.
Spinal decompression therapy has been a particular game-changer. This computer-modulated, traction-based system has been highly effective in relieving pain for patients with symptoms tied to disc degeneration and herniation in the cervical and lumbar spine.
“The therapies now being applied—spinal decompression, cold laser therapy and instrument manipulation—are relatively new advancements in chiropractic medicine and it has expanded the groups of people we can treat,” O’Keefe says.
Dr. Miteswar Purewal, a board-certified anesthesiologist and board-certified pain specialist from Relievus, which has offices throughout South Jersey and the Philadelphia area, says that non-surgical solutions have done wonders to treat cases of spinal stenosis.
“Two or three years ago, the only options for spinal stenosis patients were epidural injections—or being referred out for major spinal surgeries that included three- or four-day hospital stays and a long recovery,” he says.
The latest minimally invasive options such as the Mild and Vertiflex procedures have been extremely effective, according to Purewal. The former uses an epidural needle to remove excess ligament through a 5.1 mm portal while the latter involves implanting a device or “spacer” between the spinous processes. This holds the vertebrae open, relieving pressure on the nerves and the spinal canal.
“These are same-day procedures with no general anesthesia and afterward, patients are able to stand longer, walk longer and ultimately get back to their lives. This is a great step for patients who have failed traditional pain management before but held off on having major surgery. Now they have another option,” Purewal says.
Dr. Laura Spivack is the director of the new Rowan Medicine Center for Chronic Pelvic Pain, the first of its kind for this area and something that she says will fill a void in the local medical landscape. “Chronic pelvic pain affects millions of men and women and can be very difficult to treat,” she says.
Because pelvic pain can be associated to many parts of the body, Spivack says collaboration between doctors of various specialties is key to optimum patient care. And because the field is constantly evolving, molecular research is crucial.
“The understanding of pain in general and how it is experienced, there’s been so many developments in that field that we are just starting to scratch the surface,” says Spivack.
A Proper Diagnosis
Before any pain specialist can properly address matters, the most important thing for any patient is to receive an accurate diagnosis. By delving into the patient’s history, doctors get a better understanding of what is they are dealing with and the likeliness of success with intervention increases.
Purewal says this vital step is paramount because it allows doctors to understand the root causes of pain and work to formulate an individualized approach to treatment that will better serve the patient. Furthermore, it may reveal what has proven to be non-effective in the past.
“I also like to know what treatments the patient has had and the results of those treatments,” he says. “Proper diagnostic testing is also critically important to get a clearer picture of any anatomical causes of their pain.”
Before a patient even steps foot into the Rowan Medicine’s new pelvic pain center, they must fill out a detailed questionnaire that will help Spivack and her colleagues gain an immediate understanding of their past history so they can make the initial consultation one of value.
“By the time a patient comes to see a specialist, they’ve been to several other providers. The overarching theme is they start to think they are crazy because no one can see anything wrong with traditional imagery and labs,” says Spivack. “In some aspects, their quality of life has been negatively impacted.
“So, knowing where you are starting from with patients is important because people are very distressed and frustrated. When a patient feels heard and validated, it overwhelmingly provides a lot of comfort because they are starting to get some answers and a sense there’s going to be a partnership with the physician and treatment team.”
Once a diagnosis is made and a treatment plan has been executed, the process to a pain-free lifestyle is still an ongoing one. In order to continue to curtail issues, patients need to take an active role in their recovery, according to O’Keefe.
“I think now more than ever, people are beginning to realize that with many types of health conditions, they need to be a participant in their care,” he says. “Exercise, diet, getting the right amount of sleep; with proper measures you can minimize the pain associated with musculoskeletal problems.”
The Pandemic Effect
While the threat of the COVID-19 pandemic has put a renewed focus on individual health, it’s also true that medical professionals have been preaching the benefits of living an active lifestyle for some time. But, for those limited by chronic pain, that may not be a reality. Add in fears associated with the virus and you wind up with people avoiding treatment, which can potentially lead to larger problems down the road.
Spivack says there’s a definite relationship between chronic pain and depression and that the pandemic has only heightened concerns.
“People are at increased risk of anxiety and depression with the stress of the virus, so it’s all the more important to have chronic pain addressed and treated,” she says. “Knowing that some people are skipping routine screenings [for any type of medical care], I think will have a negative downstream effect. It’s important for individuals struggling to get treatment.”
“Patients should understand that delaying treatment will only worsen chronic conditions. Such delays can cause a patient’s pain condition to exacerbate and lead to other negative health events,” Purewal says.
O’Keefe agrees, stressing the importance of dealing not only with pain symptoms but other health issues. “Those issues have not stopped,” he says. “There are great [safety] measures being taken so people can get on with their medical care.”
Some of these measures include shields at the front desk, checking temperatures of those who enter the building, filing out a COVID-19 questionnaire prior to arrival for an appointment, the wearing of masks and other sanitizing and safety guidelines outlined by the CDC.
Spivack says the rapid rise in telemedicine has also been a major benefit to both doctors and patients, and she also believes some of the changes to the way care is being administered these days will have a lasting effect.
“There will ultimately be some beneficial aspects of how it relates to medicine,” Spivack says. “It’s forcing our medical system to reevaluate certain things and how we do them.”

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Published and copyrighted in South Jersey Magazine, Volume 17, Issue 6 (September 2020).

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Author: Peter Proko


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