Dr. James McGowan with Patient

Finding a Fix for Chronic Pain

New Sentara Martha Jefferson Service Offers Specialized Treatments for Back and Neck Problems

Chronic back and neck pain can lead to major lifestyle disruptions, making everyday activities like walking and housework seem impossible, and causing enjoyable pastimes like sports and artistic hobbies to become unbearable. To address these types of issues, which are estimated to affect hundreds of millions of Americans, Sentara Martha Jefferson Hospital recently launched its new Advanced Back and Neck Care service. Staffed by the experienced specialists from Sentara Martha Jefferson Orthopedics, caregivers taking part in the service offer a wide range of therapies to provide pain relief and help patients get back to the activities they enjoy.

“We’re pleased to offer alternative therapies that may allow many patients to avoid surgery,” says Sentara Martha Jefferson physiatrist Geoffrey Keenan, MD.

Dr. Keenan, who started at Sentara Martha Jefferson in November 2015, and pain management specialist James McGowan, MD, who joined the hospital in August 2016, provide care for patients with conditions such as osteoarthritis, herniated discs, degenerative disc conditions and spinal deformities, among many others.

Formulating an effective plan to treat this kind of pain begins with making an accurate diagnosis using sophisticated diagnostic and imaging tools that enable physicians to pinpoint the source of a patient’s discomfort. While Dr. Keenan and Dr. McGowan typically start by conducting a complete medical exam and medical history review, it’s not always easy to determine what is causing the pain. When imaging tests come back with clean results, for example, meticulous detective work is often required to identify the root cause.

“We need to understand the biology of the patient’s pain,” Dr. Keenan explains. “Many times, problems related to the spine can cause pain in other areas of the body, or pain in the back can originate somewhere else. For example, hip arthritis might result in back pain and, conversely, hip pain could stem from a problem with the spine. And many times, pain is the result of a nerve problem. Diagnostic skill is key to getting to the root of each patient’s individual issue.”

Nonsurgical Therapy for Back and Neck Pain

Pain management techniques can offer tremendous relief for back and neck problems that cause chronic pain, but more aggressive treatments aren’t necessarily a good fit for every patient. Dr. Keenan and Dr. McGowan always try to start with the most conservative approaches to managing pain, recommending surgery only when other therapies have failed, or for acute issues. In many cases physical therapy, relaxation techniques or over-the-counter anti-inflammatory medications can help solve a patient’s problem.

“Oftentimes, conservative strategies are every bit as successful as more intensive or invasive treatments,” notes Dr. McGowan.

When more conservative approaches aren’t effective, however, the following therapies may be considered:

•     Soft-tissue injections can reduce inflammation of nerves, joints and muscles.

•     Prolotherapy, a type of injection that stimulates the body’s natural healing capabilities, is often effective for chronic tendinitis or chronic inflammation.

•     Percutaneous electrical nerve stimulation transmits electrical impulses through acupuncture-like needles into targeted areas on the body. Traditional Chinese acupuncture techniques also may be an option.

•     A wide variety of non-narcotic medications can be effective in relieving pain for some patients.

•     Radiofrequency ablation, a technique using radio waves to produce electrical currents that heat up targeted nerve areas, can help reduce the impact of painful stimuli.

•     Spinal cord stimulation is a technique in which a device, implanted into the spine, sends out mild electrical currents to reduce certain types of pain.

Regardless of which techniques are used for individual patients, physical therapy frequently plays a significant role in helping patients recover—including patients dealing with chronic pain that persists for a long period of time. Physical therapists working with Advanced Back and Neck Care collaborate closely with doctors to help patients improve flexibility and range of motion, as well as strengthen core muscles to better support the spine.

“Our focus isn’t necessarily on a cure for our patients,” says Dr. Keenan. “We’re usually working toward long-term solutions to relieve pain, improve function and provide enhanced quality of life.”

One-Stop Shopping for Pain Management

For Sentara Martha Jefferson patients, Advanced Back and Neck Care provides consistent management of pain and seamless care under one roof. The setting also allows doctors, physical therapists and other caregivers to collaborate and exchange ideas, providing personalized care for each patient.

“Everyone the patient needs to see is right here at Sentara Martha Jefferson—there’s no need to send patients to a different specialist across town,” Dr. McGowan says.

Dr. Keenan and Dr. McGowan hope the service eventually will expand to include a dedicated spine surgeon, as well as a specialist in pain psychology who can help patients deal with the anxiety and depression that often comes with chronic pain. Dr. McGowan believes the service will be a great benefit to the community.

“With Advanced Back and Neck Care, patients will be able to get multiple points of view from a coordinated team of specialists and other providers who have their own unique sets of knowledge. Cared for by a team with such diverse strengths, patients should benefit from better outcomes and get back to enjoying life more quickly.”

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