Pain Management

Editorial StaffSeptember 8, 2022
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The Valley’s Top Pain Management Specialists share their tips for finding the right physician, selecting successful treatment options and taking preventative measures.

GATEWAY PAIN SOLUTIONS
If you suffer from back pain, migraines, arthritis or other acute or chronic conditions, it can often be overwhelming to find a treatment that works for you. If you’re struggling with where to start, Gateway Pain Solutions (gatewaypainsolutions.com) in Gilbert can help. First, it’s important to know what questions you should be asking when seeking out a pain management professional in the first place. Here are some ways to narrow down your search in order to get a tailored treatment plan suited for your specific needs.

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Is my doctor board-certified and fellowship-trained by a highly accredited program?
A pain management physician prescribes medication to the patient to lessen pain levels and may perform minor procedures to temporarily alleviate pain. Meanwhile, interventional pain medicine physicians use a combination of medications and procedures to eliminate a patient’s pain. These doctors undergo specialized training on advanced techniques to reduce or eliminate pain, and a select few – including Gateway’s Dr. Matthew T. Ranson – even have surgical certifications that ultimately aim to reduce the patient’s reliance on pain medicine, which in turn, restores the potential for an improved quality of life. Though some patients may have a more higher copay, interventional pain medicine offers a long-term solution for a persistent problem.

Is my doctor board-certified and fellowship-trained by a highly accredited program?
It’s important to pay attention to a physician’s level and quality of training. Board certification and fellowship programs are not a requirement for specialists, but they prove that the physician took the extra step to ensure further competency and quality of care for his or her patients. Dr. Ranson completed his fellowship at Duke University through the American Board of Anesthesiology and is double-board-certified.

Does the practice offer advanced pain management options?
Understand what treatment options are available and talk with your doctor about what remedies are right for you. Here are several cutting-edge approaches Dr. Ranson recommends for relieving pain without invasive surgery.

Neuromodulation: The severity and location of the pain in the body dictate what type of neuromodulation a patient might benefit from. Stimulation to the spinal cord, peripheral nerves, dorsal root or multifidi alter nerve activity and reduce the sensation of pain in that particular area.

Intradiscal injections: This non-surgical procedure uses allogenic tissue and micronized disc material to restore degenerative disc function.

Nerve ablation: In this minimally invasive method, a portion of nerve tissue is removed in order to prevent the transmission of pain signals to a certain part of the body.

Kyphoplasty: Cement or metallic devices are inserted to rebuild regular vertebral height after a spine fracture.

Fusions: This option stabilizes the spine and SI joints with limited anesthesia and recovery time.

PINNACLE PAIN AND SPINE
Dr. Matthew Crooks says the key to pain management is sleuthing out the source of the pain and going after it. “There are many options to actually target the pain at the root cause and address it, not just cover it up,” says the double board-certified, fellowship-trained interventional pain specialist. “And allow people to move forward, back to the things that they enjoy doing. There are many options that stay in pain management, other than pain medications, that restore activity and function and get patients back to their lives. You do not have to live in pain anymore.”

At Pinnacle Peak Pain and Spine (pinnaclepainaz.com) in Scottsdale, Chandler and Fountain Hills, owner/medical director Crooks and his team “treat every patient individually, from professional athletes and Olympians to weekend warriors to parents and grandparents.” The most common issues they treat are neck and low-back pain. “People do not realize that the routine daily neck and low-back pain they live with – and maybe have tried introductory therapies like massage and physical therapy to treat – are very treatable with safe and effective pain management procedures.”

Popular treatments include radiofrequency nerve ablation, which involves deadening nerves that sense pain in the neck or low back. “It significantly reduces neck pain and headaches, as well as low back pain, for long periods of time,” Crooks says. Another option is vertebral augmentation to address fractured vertebrae in the spine. “These minimally invasive procedures [vertebroplasty or kyphoplasty] are done on an outpatient basis,” he continues. Physicians place medical cement in “a painful, fractured vertebrae, eliminating the pain, and allowing return of normal height and posture.” 

Crooks says these approaches are nothing short of life-changing for patients who have been living in continual agony. “These procedures can reduce the pain for long periods of time – several months or even several years, combined with rehabilitation,” he says. “In many cases, with rehabilitation after procedures, the pain is gone and does not return, ever.”

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THE CORE INSTITUTE
A large portion of patients assume that pain management consists solely of medications and injections. However, The CORE Institute (thecoreinstitute.com) pain management team works closely with its physical therapy and rehabilitation departments to maximize patient outcomes by creating treatment plans specific to each individual’s lifestyle and goals. 

The CORE Institute specializes in all areas of orthopedic and spine care and offers both surgical and non-surgical treatment options. Its specialists treat a wide spectrum of conditions including arthritis, back pain, joint pain, neck pain, neurogenic pain and more.

Pain management specialists at The CORE Institute suggest staying active as a form of pain prevention. However, if the pain is hindering you from exercising, it’s important to address the issue by seeking out management options. An array of trending treatments and technologies are now available. Spinal cord stimulation continues to be at the forefront and has recently expanded to include diabetic neuropathy and low back pain. Further advancements include targeting the dorsal root ganglia (DRG), which has proven to be more effective in treating certain conditions when compared to traditional spinal cord stimulators. 

The CORE Institute prides itself on its multidisciplinary approach, which includes a team of specialists who work together and communicate with each patient’s primary care provider to promote safety, efficiency and peace of mind. 

Ultimately, The CORE Institute has changed the way orthopedic care is offered to the community, through consistency and commitment to excellence, innovation and learning.

INTEGRATED SPINE, PAIN AND WELLNESS
When Dr. Ashu Goyle opened Integrated Spine, Pain and Wellness (ispwscottsdale.com) in Scottsdale in 2008, he examined the healthcare system and acknowledged its flaws. His goal was to change the perception of the current pain management field and provide quality care to all his patients – in other words, to actually help patients heal instead of slapping a Band-Aid on the symptoms.

“Chronic pain is a symptom and needs to be addressed by getting to the root cause and treating the pain rather than masking it with a prescription,” Goyle says. “My goal has been to educate my patients and the community that I am here as a pain specialist and as a resource to help treat patients with acute and chronic pain and help them achieve the quality of life they desire.” As such, he has created a completely narcotics-free clinic that instead uses a holistic approach to get to the root of the issue and treat the whole patient. 

Treating each patient like family or a close friend is also at the crux of ISPW’s care philosophy. “A lot of the time, when a patient has chronic pain, it stems from something else, and they need a variety of modalities to help them heal,” Goyle adds. “Most patients these days complain and say they don’t feel heard. My goal has been to change that. Give patients the respect they deserve, and listen to them… I want to help patients get to the bottom of their health concerns so they can live their best lives.”

Goyle and his team specialize in various treatments to help patients suffering from chronic and acute pain – including back, neck and spine pain, tennis and golfer’s elbow and sacroiliac pain – via spinal cord stimulators, joint injections, radiofrequency ablation and epidurals. Dr. Goyle has also trained with some of the leading educators and physicians in regenerative medicine, which essentially uses a patient’s own body to heal itself. When a patient comes in for this treatment, a nurse draws their blood to extract platelet-rich plasma (PRP) and subsequently inject it into the injured site, which stimulates tissue and allows ligaments to repair naturally.

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Take care of your body: Treat it respectfully and listen when you have minor symptoms. Many patients will disregard minor pain signs and symptoms until they get worse and are forced to see a doctor. If you’re experiencing pain or discomfort, even if it’s minor, look into what is causing it so you can heal the issue. 

Physical therapy: Physical therapy can help teach you the body mechanics, and how to properly move so you don’t injure yourself or create pain problems in the future. 

Diet and lifestyle: At ISPW, we offer anti-inflammatory food coaching to teach patients how to eat and live an anti-inflammatory lifestyle. Inflammation is the root of many problems in the body. If you can improve your habits, you may reduce your risk for diseases, cancer and certain chronic pain conditions. 

Stretching and movement: As we age, our joints and ligaments aren’t as lubricated and can make it harder for us to move. Stretching and moving our body helps to induce natural lubrication to keep our joints and ligaments healthy and happy.

Another thing that sets ISPW apart in the pain management field is its comprehensive wellness component. Here is Dr. Goyle’s guide to keep pain at bay the natural way.

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COMPREHENSIVE PAIN MANAGEMENT
Not all physicians are keen on the term “pain management.” For Dr. James KellerShabrokh, it’s a bit of a misnomer. “I believe that the name ‘pain management’ has led to a misunderstanding of my specialty. Most people associate medications with pain management and oftentimes steer clear of even an initial consultation at a pain management office for fear of the prescription of narcotics and/or additional medications,” he says. 

KellerShabrokh’s specialty is physical medicine and rehabilitation, also known as physiatry. His approach is influenced by the passion for musculoskeletal medicine he developed during his residency, where “our primary focus was on understanding musculoskeletal function, helping patients regain lost function and overcoming pain using whatever modalities were available to us” – not just medication.

At Comprehensive Pain Management (azcpm.com) in North Phoenix, Tempe, Avondale, Peoria and Prescott, KellerShabrokh and his team treat patients with a holistic mindset, encouraging exercise, physical therapy and/or chiropractic treatment. “Injections are also an integral part of my practice and are very specific for the varying types of musculoskeletal injuries,” he says. “For low-back pain, this can be related to the joints of the low back, called facet joints or zygapophyseal joints, and treatment includes steroid injections, radiofrequency ablation or regenerative medicine injections oftentimes using platelet-rich plasma or sometimes even stem cells.” If the pain is related to disc issues and radiates down the legs, he might employ epidural steroid injections, regenerative medicine or intradiscal injections. 

KellerShabrokh encourages people to research their options and find a physician who fits their needs. “Not all pain management is created equal,” he says. “Developing a relationship of trust with your medical provider is essential… Medicine is also an art, and art requires practice and continual learning on the part of the physician to improve upon their skills and to match the remedy to the patient.”

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