Jake Measom, MD, Interventional Spine and Pain Management
When meeting new people, I am frequently asked, “What kind of doctor are you?” When I tell them I practice interventional pain management, the next question is invariably “What does that mean?”
Interventional pain management is the discipline of medicine devoted to the diagnosis and treatment of pain-related conditions to improve function and restore quality of life. In short, if it hurts, we can treat it and get you back to doing what you love. Generally, when people think of pain doctors, they think of two things, “cortisone shots and pain pills.” For a long time, they were right, going to a pain doctor meant steroid injections of some kind and a combination of medications, often including opioids and nerve medications like gabapentin. When injections work, they often need to be repeated every few months and can result in injection fatigue and even lose efficacy over time leaving patients with continued pain and fewer options besides increased doses of medication.
We still utilize steroid injections but gone are the days of treating just back pain and having therapies limited to “cortisone shots and pain pills.” Even in the past five years the number of painful conditions we can treat and the number of therapies we have available to treat those conditions has expanded exponentially. Of course, the most common things we treat are still back and neck pain. In addition to backs and necks we regularly treat pain involving the knees, shoulders, hands, feet, neuropathy, headaches, compression fractures, post-surgical pain, nerve pain, and the list goes on. Advances in the field have provided new, drug-free techniques to treat these conditions. Let me highlight some examples.
Do you get pain in your back and legs when you walk even short distances? You may have a condition called spinal stenosis, where narrowing of the spinal canal can compress nerves inside. Previously the only treatments were epidural injections and eventually surgery. Recent advances have provided new minimally invasive techniques to relieve spinal stenosis long-term without injections.
Does your low back hurt from riding in the car or bending to pick something up? You may have a condition called vertebrogenic low back pain, or back pain generated from inflammation of the nerves within the vertebral body. This is different than the back pain usually treated with traditional injections. MRI and physical exam can show if you’re a candidate for a procedure called basivertebral nerve ablation where we can deaden the nerve inside the vertebral body itself to treat pain.
Do you continue to have shoulder pain even after having shoulder surgery? It can be common that even after a perfect mechanical correction by your orthopedic surgeon you can still have significant pain generated from the nerves that supply sensation to the shoulder. In the past the only options were steroid injections and additional surgeries. Today we have the ability to place implantable micro-stimulators (both temporary and permanent) directly onto these nerves to treat pain.
So, if you have pain — anywhere — that’s keeping you from living life and doing what you love, call an interventional spine and pain specialist for an evaluation. Whether you’ve been to pain doctors before or your pain just started, there are new treatments available to get you back to living.