Leading with Understanding
Chronic pain is one of the main reasons why people see a doctor. Pain is a unique problem and it’s a problem that requires, first and foremost, that an appropriate diagnosis be made.
“You can’t see pain on a MRI scan, an X-ray, CT scan, or lab test.”
“Most of us have lived under a false assumption that if something hurts it will be fixed with surgery. We see a lot of our patients after they have been treated by their family doctor, chiropractor, physical therapist, and sometimes a surgeon,” says Phillip Essay, M.D., a pain management physician at Innovative Pain & Spine Specialists in Lincoln, Nebraska. “What we find in the end when they come to us is that the problem was misdiagnosed in the beginning. There was a focus placed on an MRI or X-ray, but in reality their pain was from something completely different. The diagnosis has to be the first step in treating the pain.” The experiences of the following two patients will help to explain this further.
Amy’s Story
When Amy decided to take on a landscaping project at her home, she had no idea her life would be forever changed. She was only 35 at the time, and she approached each day with energy and positivity. With her wheelbarrow full of wet dirt and rocks, Amy set out to freshen things up. What she didn’t expect was that the wheelbarrow would fall on her foot, crushing her bones and damaging her nerves. For years, Amy struggled with chronic pain that wouldn’t go away. Her husband, who works in the medical field, helped Amy navigate through various doctors, physical therapists, and chiropractors – but the pain persisted.
Amy was finally referred to Kelly Zach, M.D., at Innovative Pain & Spine in Lincoln, Nebraska. He recommended Spinal Cord Stimulation (SCS), a treatment that uses an implantable device to interrupt pain messages being sent to the brain that is used widely in people with leg and back pain. Within six weeks, Amy’s pain had been reduced by 90% and she was no longer taking pain medication. Amy is now enjoying time with her family again. She’s always eager to tell people that SCS is the best thing that’s happened to her.
Diane’s Story
A car accident over a year ago had changed Diane’s life. The impact from the T-bone crash caused whiplash to her neck. When x-rays showed no fractures to her neck, Diane was told that her pain would simply get better with time, that neck pain was normal after a car crash such as hers. However, when the pain in the left side of her neck continued after a couple of weeks, she sought further treatment. She was referred to a chiropractor and prescribed medications. She was given exercises to perform at home. But still her pain continued. It was then that Diane was referred to Innovative Pain & Spine Specialists in Lincoln.
“I could see the pain in her face when I first walked into her exam room,” Dr. Zach recalls. “There wasn’t just the obvious physical pain, but there was emotional pain related to the stress that she would be living with this neck pain forever.”
Dr. Zach recommended a treatment called radiofrequency ablation. This is a treatment to target the small joints of the spine that can become inflamed with trauma to the neck or with degenerative changes over time. This procedure involves using small needles to perform a targeted cauterization (burn) of the small nerves that surround the spinal joints. After the procedure, Diane had complete relief of her neck pain.
Amy
So, What is Pain?
If you asked 100 people this question, you would get 100 different answers, Dr. Zach notes. If you asked a 3-year-old what hurts, she might simply start crying at the thought of an “owie.” And if you asked a retired farmer what pain is, he might say, “Pain is in your head.”
The point is that pain is subjective and takes on a different meaning and experience for each of us. The American Pain Society defines pain as “an unpleasant emotional and sensory response to a noxious stimulus.” Think about that. An emotional and sensory response. Pain certainly affects our physical abilities. It decreases our mobility. It might limit our physical function. But pain also affects our relationships, our ability to think, it makes us tired. Pain leads to loss of work, decreased productivity, and causes tremendous economic burden. Our hope is that you find the right diagnosis which will lead to less pain in your life.
What is a Pain Management Doctor?
Again, many people would not be able to answer this question. The specialty of pain medicine has evolved over the last several decades. According to Dr. Essay at Innovative Pain & Spine Specialists, “A pain management doctor is someone that understands the complexity of pain. Pain is not always obvious on an X-ray or MRI. As pain doctors, we utilize various treatments to help us identify the source of the pain with an ultimate goal of improving the quality of life and function of each individual patient.”
So when patients come to see a pain specialist at Innovative Pain & Spine in Lincoln or Omaha, Nebraska, the doctors do not necessarily see that patient as a 50-year-old female with back pain. Rather, that patient is a 50-year-old housekeeper who cries not because of the physical pain but because that pain prevents her from being able to dance with her 6’ 5” husband. It is important to identify both the physical and emotional component of pain. How does pain affect her function? How does pain interfere with her quality of life?
“We can’t treat or make a prognosis or do any of the right things unless we have the diagnosis first,” Dr. Essay adds. “All of the testimonials and success stories happen because step one was done right. That’s what sets us apart from anyone else who tries to treat pain. That’s a big part of what we do as pain specialists.”