Many options for alleviating chronic pain

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Gina Roberts-Grey

Lenore Beetar of Woodbridge, Va., 89, wasn’t ready to slow down. The former Rockette high-kicked her way to an extremely active life raising her children, interacting with friends, and rarely resting in the same place for very long.

But in December 2014, a tumble down the stairs she described as “a beautiful somersault” resulted in a fracture in her neck. The subsequent pain threatened the otherwise vibrant and vital woman’s mobility and independent lifestyle.

A high threshold for pain, and the pride of not wanting others to worry about her, caused Beetar to try to hide her discomfort. But family members noticed a change in her activity levels and pressed her for information. When they learned of her accident, they took action, seeking medical attention from an orthopedic surgeon.

The recommended therapy was surgery; however, her age made that a difficult option for repairing the fracture. So instead of becoming one of the 100 million Americans living with chronic pain, she opted for kyphoplasty — an innovative treatment that essentially “glued” her fractured spine back together. 

Dr. Dan Kendall., a pain management specialist at National Spine & Pain Centers in McLean, Va., made a small incision in Beetar’s back to realign her vertebrae and inject a medical-grade cement-like material that fuses the bones back together.

Within 36 hours, Beetar resumed her normal hobbies and activities.

Multiple pain treatment options

Pain management specialists are trained to evaluate, diagnose and treat a wide spectrum of pain, including acute, chronic, degenerative, even arthritic, musculoskeletal and joint pain.

In addition to being on the leading edge of managing complex pain medication regimes, they partner with patients, their primary care providers and orthopedic surgeons to explore non-surgical or minimally invasive techniques for lasting pain relief.

That partnership was the difference between Barbara Johnson, 66, being isolated in her house due to pain and living an active life.

“I have four herniated discs; three bulging and lying on a nerve in a pocket below the spine,” she said. Pain that started in her back and radiated down her legs left Johnson unable to walk without a cane or by holding onto furniture around the house.

“I was trapped in my house. I was a prisoner to my pain, and that was horrible,” she said.

Unable to perform basic tasks — like shopping for groceries, let alone enjoying a lunch out with friends or travel as she once did — Johnson grew desperate for relief. “I slept in a recliner for six months because I couldn’t lie down in my bed,” she said.

Intense bouts of blinding pain had Johnson taking several trips to the emergency department in search of relief. Her orthopedic surgeon also prescribed several combinations of pain killers and tried to dull the pain with steroid injections. “I didn’t like the drugged feeling pain pills caused,” Johnson said.

She also wasn’t ready to have the back surgery her doctor recommended. “I have some health issues that could complicate surgery, and I was also concerned about spending a week in the hospital and several more in rehab.”

A friend suggested Johnson consult Dr. Beverly Whittenberg, a Washington, D.C. pain management specialist. After a detailed consultation and history, Johnson received radiofrequency neurotomy — an outpatient procedure that delivers special radiofrequency needles along inflamed nerves responsible for chronic pain, with thermal energy applied to the nerve until it is deadened.

“The good news is, treatment of pain can be precise and specialized,” said Whittenberg. “As a pain management specialist, I routinely use an array of innovative treatments to successfully treat pain and return people to their lives. And, these procedures are often covered by insurance and Medicare.” 

“I’m back to traveling and going to lunch. I’m a functioning human being again,” Johnson said.

Innovative treatments

Having access to and knowledge about a diverse number of treatment options sets pain management specialists apart from primary care physicians.

“Those physicians do a great job, but because pain is all we treat, we’re able to prevent acute pain from an injury from becoming lifelong chronic pain. We can pinpoint a diagnosis beyond ‘back pain’ to use options like radiofrequency neurotomy or spinal cord stimulation to treat the problem, instead of only masking or dulling it with steroid injections and pain killers,” Whittenberg said.

Spinal cord stimulation (SCS) utilizes a small implanted device that transmits mild electrical impulses to the spinal cord to disrupt nerves’ ability to send pain signals through your body. Based on their pain levels and tolerance, patients can easily control the intensity and frequency of the impulses with a remote control.

Among the most innovative advancements in pain management is the use of regenerative medicine therapies that stimulate your body’s own natural healing mechanisms using your own platelets and growth factors.

In spite of these procedures being considered experimental and not covered by insurance, many patients consider these procedures essential to their pain relief and healing. Perhaps that is the reason these therapies are on the rise among professional athletes, but also increasingly considered by the average pain patient, too.

And these pain treatments aren’t just for injuries. Whittenberg said pain caused by “getting older” or “tired joints” shouldn’t be brushed aside.

“Along with various treatments, pain management can help people with arthritis discover new and different forms of joint-friendly activity that promotes fitness and enjoyment without pain.”

Before beginning any new pain treatment, consult your regular physician and get a second opinion to get a fuller picture of what options might be best for you, and to consider any drawbacks to the procedure.