From lifestyle changes to innovative procedures, pain management options abound. Empower yourself with the help of the Valley’s top pain physicians.
It may start with pain as you walk and wounds that are slow to heal. These are indicators you might have peripheral arterial disease, a systemic and progressive condition that involves the narrowing or blockage of blood flow in the blood vessels. More than 202 million people worldwide are diagnosed with this disease 1 (Fowkes, 2013) that, if left untreated, can lead to leg pain, loss of mobility, and even amputation. As overwhelming as it may sound, PAD can be managed. With the right information and treatment – including a full suite of innovative medical solutions from Becton Dickinson, a leader in healthcare safety and technologies – (BD, bd.com) – patients can be better informed on available care.
After screening for risk factors like diabetes, smoking, high cholesterol and family history, Phoenix-based vascular surgeon Dr. Jeromy Brink asks about the nature of the symptoms. “The one question I always ask is, ‘Can you go out and walk two blocks without stopping?’” Brink says. “If they say, ‘No, I can get to the mailbox and then I have to stop, and then I go to the end of the block and I have to stop,’ that’s claudication (pain due to a blood flow blockage). That’s PAD until proven otherwise.” Long before surgery, Brink advises lifestyle changes – stabilizing diabetes, ceasing smoking, managing cholesterol, increasing exercising – and specific medications. If surgery is necessary, he turns to minimally invasive interventions aided by BD’s cutting-edge products managed in Tempe and being used to help patients around the globe. These products include angioplasty balloons and drug coated balloons used to open a narrowed vessel, and other dedicated arterial vessel treatment devices. “There’s just so much data behind what they deliver,” Brink says. “It helps us take better care of patients.”
Doctors and engineers are working together to help keep patients moving on their feet Innovative technology from Tempe’s Becton Dickinson (BD) helps doctors to save limbs – and lives – affected by peripheral arterial disease (PAD).
If you suspect you or a loved one might have PAD, visit loveyourlimbs.com, a helpful hub of resources that includes a physician finder, patient and physician videos and information on how to manage PAD and avoid amputation. The Love Your Limbs™ PAD awareness campaign is BD’s patient initiative that Brink and his colleagues appreciate. “It’s great to have a company that is dedicated to providing an outreach and awareness program to help patients understand their disease process so that they can then be part of the evolution of their care,” he says. “It just speaks to the integrity of a company like BD.”
BECTON DICKINSON (BD) 1 Fowkes, Gerald, R., Rudan, D, et al. (2013).
There are many misconceptions about pain management, says Dr. Anuj Daftari, M.D., of The CORE Institute. “People often equate pain management to prescribing narcotic pain medications,” he says. “While there certainly is a role for the use of opioid analgesics to manage pain in the proper setting, these medications are often ineffective at treating many types of pain. In other cases, patients may assume injections are their only other alternative to medications.”
Educating patients about the causes of and full treatment options for their pain is a crucial part of The CORE Institute’s care philosophy. “A large population of our patients are healthy and active, but have pain or injury that is limiting them,” says Dr. Eric Feldman, M.D. “They are also concerned that this injury or condition may require surgery, so they often hesitate to come see a specialist. The CORE Institute’s team of integrated pain physicians work toward providing each patient with an individualized plan best suited to their activity level and goals by focusing on the most conservative modalities first.” The CORE Institute physicians also coordinate with a physical therapy team to create a holistic plan to treat acute and chronic pain, including neck, back, joint and extremity pain. Additionally, patients suffering from pain related to peripheral neuropathy, rheumatoid arthritis and fibromyalgia can find top tier care and relief.
“There are quite a few recent innovations in pain management that are helping patients,” Daftari says. “Regenerative medicine is an exciting new advancement… but it is not a cure-all. We are seeing in the community that many pain providers are using stem cells in treatment applications that have little or no evidence to support their use.” He and his colleagues “are up to date on all the latest studies looking at regenerative medicine treatment options and only recommend these treatments when the evidence supports that they may be effective.” Because The CORE Institute has multiple clinics, patients benefit from a group approach to their care. “It allows us to collaborate with a large and integrated team of the top specialists in orthopedics, neurology and physical therapy to create treatment plans best suited for each of our patients,” Feldman says. Additionally, its physicians are fellowship-trained, “which means that each physician has undergone additional and rigorous training specifically in this area.” Ultimately, the goal is for patients to “have a better quality of life and level of function,” Feldman says. “Seeing them smile as they walk in and how happy they and their families are to be able to return to the activities they enjoy so much has to be the most gratifying experience.”
The CORE Institute 866-974-2673 | thecoreinstitute.com
At Elite Pain & Spine Institute, the three practicing physicians share a threefold goal: “relieve pain, restore function and renew hope,” says Dr. Zeeshan Malik, D.O. “We see each individual personally, including our follow-ups, and do our own interventional procedures.” Malik and his colleagues, Dr. Ankit Patel, D.O., and Dr. Maaz Iqbal, M.D., have three locations, each with a built-out procedure suite “so our patients do not need to travel anywhere else when they come to see us,” Malik says. After examining patients and identifying the source of their pain, the physicians devise a treatment plan. “We understand that every patient’s experience with pain is very different,” Iqbal says. “Our goal is to create a unique, multimodal treatment plan to address all components of pain individually in order to treat the patient as a whole.” This may include oral therapies (medications like non-steroidal anti-inflammatory drugs, acetaminophen and, only if necessary, opioids) or topical treatments like ointments, creams or patches.
“Finally, there are interventional procedures that we specialize in, which can involve injections in superficial areas like a painful or spasmodic muscle, or injections in the deeper structures including the spinal region,” Patel says. These range from epidural injections “for pain involving the neck and arm, or the back and leg, and joint injections, which can improve movement of the neck and back.” Patel has been particularly encouraged by the development of interspinous spacers for people with back and leg pain related to spinal stenosis. “These patients usually walk around with a stooped posture using a cane or walker because standing up straight is very painful,” he says. “Placing an interspinous spacer allows these patients to have improved quality of life with the ability to ambulate pain-free. The procedure is very safe and is appropriate for those patients who would like to avoid spine surgery.”
With an aging population and the prevalence of technology use – desk jobs with many hours of computer time, “tech neck” from craning down to look at smart phones – with improper posture, Elite Pain & Spine Institute is seeing “a rising incidence of chronic pain secondary to degenerative disease,” Iqbal says. Additionally, “we are starting to see patients develop signs of degenerative disease at a younger age. I can see the field of pain management advancing much further in the next decade with more need arising in the general population.” Relieving pain is what inspired these physicians to pursue their careers, Malik says. “We have spent our whole lives dedicated to perfecting our art – continuing to stay up to date on the best treatments and modalities for our patients in addition to new research and therapies we are involved in,” he says. “So when our patients come in and say, ‘This is the first time I have been able to walk in the grocery store without having pain,’ it is like winning the lottery. It reinforces in our minds that we need to continue to help as much of our community as possible. Imagining and understanding what our patients have gone through and being blessed enough to give them their lives back is a feeling we can’t express in words.”
Elite Pain & Spine Institute 1641 E. Osborn Rd., Unit 6| Phoenix
For Dr. James KellerShabrokh, D.O., pain management is “about helping a person regain function” so they can enjoy life again. With his colleagues Steven Giacoppo, F.N.P., and Shelby Schweitz, F.N.P., KellerShabrokh treats musculoskeletal conditions including nerve, joint, muscle and spine injuries as well as chronic pain.
Comprehensive Pain Management’s approach emphasizes rehabilitative care that “utilizes things like chiropractic treatment, physical therapy recommendations and medications” as well as minimally invasive procedures such as ultrasound and electrodiagnostic medicine, various injections and radiofrequency ablation. “I try to make sure that the services that we provide are accessible to all,” KellerShabrokh says, and “to really help people decide what their best investment is for their own health.” For many, he advocates supplements or naturally derived substances to “obtain the same effect” as pharmaceuticals. “One example is turmeric, the yellow spice that people use in Mexican cooking and Middle Eastern cooking. It works very similar to an anti-inflammatory [drug].”
Regenerative medicine – through platelet-rich plasma and stem cell injections – has also been a boon for his field, when used intelligently and appropriately. “Up until the advent of this, we’ve never really had anything that harnesses the body’s healing processes. It kind of concentrates it down and applies it.” Tailoring a course of treatment to the individual is paramount, KellerShabrokh says. “In our practice, we really pride ourselves on our ability to listen to patients to help them navigate their treatment process. I think that’s what makes us unique, special and successful.”
Comprehensive Pain Management 3811 E. Bell Rd., Ste. 207 | North Phoenix
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The Lancet, 382 (9901), 1329-1340. For full product safety information please visit www.crbard.com/Peripheral-Vascular.
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