Finding Better Methods

 Finding Better Methods

Local providers offer patients with chronic and acute pain effective treatments that avoid heavy medication and opiatesKevin Michell Managing pain is a wide concentration in health care, encompassing everything from taking care of lingering pain after injury or surgery to mitigating chronic issues that stay with a person throughout their life. This is complicated by the personal nature of pain—it can be very subjective between people’s different sensitivity to it and willingness to be open with physicians about the pain they’re experiencing.

And, for some people, chronic pain can be a constant aspect of their lives that doesn’t feel like it can ever be improved. But one Mercy Health patient recently had a new treatment that changed her entire life.

Ava Strole had been dealing with scoliosis her whole life, as she was diagnosed at 6 years old. She had been treated many times in many different ways and, in her mid-50s, was referred to Dr. Aarti Singla, a Mercy Health physician specializing in physical medicine, rehabilitation and pain management.

“When she was young, she was wearing a back brace and suffered from chronic pain from a pretty young age,” says. “She went through three back surgeries but continued to have quite a bit of pain despite the surgeries.”

Strole’s surgeries were often quite invasive, including implanting rods in her spine to try to help her stability. But her treatments weren’t very effective at improving her quality of life and required a lot of medication to help her get through each day.

“She used to go to a different pain management doctor where they used what she called ‘a cocktail of drugs,’” recalls Singla. “She would go there every month and continue to not get better. The surgeon who last did her back surgery sent her to me and we worked to basically take her off pain medications and improve her overall functional status.”

Mercy Health went with a therapeutic route to reduce the need for Strole to take opiates while also improving her daily wellness.

“After some interventional options we proceeded with spinal cord stimulation, which is what eventually helped her quite a bit,” Singla says. That method involves using an implantable device that uses electrical stimulation on the spine to mitigate pain by blocking pain signals to the brain from nerves in the spine. The device is placed under the skin in a patient’s lower back and functions like a pacemaker by occasionally sending a low electrical current to spinal nerves.

Singla arranged for Strole to get the spinal cord stimulator temporarily inserted for a weeklong trial to see how well it helped to reduce her constant pain.

“She did really well with the trial,” explains Singla. “She was actually able to go and lift her grandkids and spend time with them, where before she was in a recliner all the time. She used to sleep every night in the recliner, and she was actually able to get rid of that because she had such significant pain relief with the trial.”

After the success of the trial, Strole had a permanent device implanted after the trial device was removed. After decades of chronic pain and taking medications that didn’t help to alleviate it, the spinal cord stimulation worked wonders for her. For the first time in a long time, she could walk around a farmer’s market, lay flat on a bed and be active with her family. After a two-month recovery period from the final surgery, Strole was pain-free, no longer having to take opiates and off almost all her medications.

She’s back to living her normal life instead of having to be in doctor’s offices all the time and constantly bogged down by pain, Singla says. Strole comes back in for check-ups and provides Singla with updates every three to six months.

Spinal cord stimulation is becoming less of a fallback option for chronic back pain in health care and is being recommended more frequently for patients whom therapy, surgery and medication isn’t working. As a more preferred option, it can really improve a chronic pain sufferer’s life, just like it did with Strole, Singla explains.

“It used to be used a lot later in the treatment algorithm,” she says, “but it’s being used earlier because it has great results and people continue to do well with it.”

Prioritizing pain management methods that don’t require a patient to take opioids is a prominent topic in the field and resulting in other options being used earlier in treatment. The opioid crisis, for which southwest Ohio has had an unfortunate front-row seat, has not only changed how health care providers go about treating pain, but also how patients request treatment. Many people coming to doctors for help with their pain are aware of the dangers of opioids and request options up front that don’t involve taking them.

Another form of pain treatment that has gained in popularity is the array of regenerative therapies that stimulate the body’s own healing ability in localized areas to renew muscles, ligaments, tendons and other areas. Platelet-rich plasma (PRP) injections are a common form of this, utilizing the clotting abilities of platelets to heal and renew damaged areas.

“Usually your body does it very well for places that have great blood supply, like if you have a cut or skin injury it’s easy for your body to heal that area,” explains Singla. “But areas like tendons, joints and discs in the back, they don’t have great blood supply so the body can’t heal it the way you do if you had a lesion or cut on your skin.”

PRP injections can be useful for both addressing pain resulting from injuries such as torn muscles and ligaments or with issues like bursitis and tendinitis that can either be acute or chronic. The process involves drawing less than two ounces of a patient’s blood, separating the plasma and platelets from the red and white blood cells using a centrifuge and then directly injecting the concentrated plasma into the affected area.

This constructive and regenerative method encourages better and quicker healing after acute injury than physical therapy and rest, and can actually make muscles, tendons and ligaments heal stronger than they were before injury. It tends to work effectively for people of most ages up to 70.

Methods like this can be enhanced with other therapies that manage a patient’s pain and help them recover strength after injury or a long time of inactivity resulting from chronic pain. Aquatic therapies continue to be a popular choice as it puts less stress on a person’s body while providing enough resistance to rebuild strength.

Importantly, health care providers like Mercy Health prioritize medication management to help patients dealing with pain to get treatment while avoiding opioid medications when possible. Chronic pain doesn’t have to require a lifetime of medication and the potential dangers of dependency that come with it as treatments like spinal cord stimulation and PRP injections continue to demonstrate their efficacy for all types of pain management patients.