This article was written by Dr. Bradley Schulte, Pain Management Specialist with St. Elizabeth Physicians. He works out of the Spine Center in Highland Heights, KY and Greendale, IN.
Innovative treatments for back pain: Q&A with Dr. Bradley Schulte, St. Elizabeth Pain Management Specialist
Q: What does an interventional pain management specialist do? When should people seek help from an interventional pain management specialist?
A: Interventional pain management is a far-reaching specialty. Pain is one of the most common reasons that people seek medical treatment.
Typically, I see patients after they’ve been referred by their primary care provider and have tried multiple treatments to address pain. This can include physical therapy, chiropractic care or medications, including anti-inflammatories. When these treatments aren’t enough to get the patient back to functioning normally, it’s time to discuss other treatment options.
We also see patients who are working with other providers, such as spine surgeons. We collaborate with their providers to determine if it’s possible to manage the patient’s medical issues with conservative care or if surgical intervention is the best option.
Once a patient comes in for an evaluation, we perform a comprehensive history and physical examination. Based on those results and their medical conditions, we develop a treatment plan to address their pain. This treatment will typically involve continued physical therapy and any required imaging, including X-rays, CT scans and MRIs. These images help us decide which interventional treatments to consider for pain management, such as injections of numbing medicines or steroids, ablations where heat is selectively applied to specific areas to block pain signals or other more advanced procedures.
Q: From your perspective as an interventional pain management specialist, what’s one thing people should be aware of to prevent disease or catch it early?
A: Maintaining a relationship with your primary care provider is crucial because they can help you stay up to date with any recommended screening tests and treatments. These regular appointments will give you access to early evaluations and potential referrals to specialists if you need them.
In the world of interventional pain management, we focus on improving quality of life by helping people manage their pain. Exercising regularly and eating a healthy diet go a long way in helping you maintain a healthy lifestyle that can protect you against developing chronic pain.
Q: What’s something surprising about your specialty that people might not know?
A: When people usually think of an interventional pain physician, they think about someone who prescribes pain medication. The specialty is much wider than just using medicine to manage pain, though.
We specialize in the use of injections to alleviate pain in many areas of the body, most commonly the management of back and neck pain. However, we treat much more than back pain. We treat patients with joint pain, nerve pain, arthritis, migraines and less common pain syndromes, such as phantom limb pain — the pain that lingers after an amputation.
We address this type of pain by using X-rays and ultrasounds to perform image-guided procedures. These procedures let us precisely place needles to deliver medications to specific areas. They also ensure we exactly place medical devices, such as electrodes to deliver small amounts of energy to the spinal cord or catheters for medication delivery within the spine.
Q: What is St. Elizabeth doing in this field that is unique or leading edge that is helping patients?
A: At St. Elizabeth, we offer patients all treatment options and every service available to treat chronic pain. This includes physical therapy, advanced imaging, pain psychology and more. They don’t need to go anywhere else.
As board-certified, fellowship-trained specialists in interventional pain medicine, we offer leading-edge procedures. That includes being the first practice in the area to offer the Intracept procedure, a method designed to help patients with low back pain who have not responded to other treatments.
Intracept is an outpatient procedure that involves very small incisions. Recovery time is minimal, so patients quickly return to their daily lives.
To decide if a patient is a candidate for Intracept, we comprehensively evaluate their current pain and assess their previous treatments. Based on this evaluation, we may also perform an MRI. Previous patients who’ve undergone Intracept have enjoyed several years of pain relief. So, patients who are good candidates have a significant potential to benefit from this procedure.
Q: What is currently on the horizon for your specialty? What advances might we expect in the next few years?
A: The world of interventional pain medicine is always progressing and evolving. Over time as the field of interventional treatment has developed, many specific interventions for chronic pain that doesn’t respond to medication have been developed — particularly after the opioid epidemic.
Many devices and specialized procedures have been developed. For example, kyphoplasty manages spine fractures, and minimally invasive lumbar decompression or interspinous spacers alleviate pain from spinal stenosis, a narrowing of the spinal cord. These minimally invasive developments let patients avoid open, more involved surgeries. Many are outpatient procedures with much quicker recovery times.
As interventional pain physicians, we are interested in multiple advanced therapies, including spinal cord stimulation. It’s a subset of the field of neuromodulation, technology that directly impacts the nerves. This is a treatment used in specific instances when other treatments have failed to provide enough relief.
With spinal cord stimulation, we apply energy over specific areas of the spinal cord to change the way pain is transmitted and processed. This therapy has been around for many years but we’re constantly working to advance and refine the technology and techniques. As just one example, improvements to battery technology could increase device longevity and enable the delivery of different energy waveforms to treat pain. At St. Elizabeth, we offer all the treatments mentioned so far and are adopting the most recent evidence-based treatments to allow for the best, most up-to-date treatments for our patients.
To learn more please visit St. Elizabeth Physicians Pain Management or call (859) 212 -7000
