Triage System Key to Multidisciplinary Approach that Brings Relief to South Coast Patients with Neck and Back Pain

Pain Management Steward Health Care

Given the statistics, it’s no surprise that Saint Anne’s Hospital has recognized the need for a multidisciplinary neck and back center in Dartmouth. Between 60 and 70 percent of the population suffers from acute or chronic back pain at some point in their life, with only a third of those actually seeking treatment.

The Spine Center of Saint Anne’s Hospital hopes to change that fact with a comprehensive approach to neck and back pain that not only treats the patient’s physical pain, but also addresses the anxiety and depression that often accompanies chronic pain.

The team includes neurosurgeon Charles Kanaly, MD, who is Medical Director of the Spine Center, pain management specialist Christopher Stowe, MD, and physical medicine and rehabilitation specialist Marc Adams, DO.

The physicians work collaboratively to diagnose and treat a wide range of neck and back ailments, including arthritis of the back, failed back syndrome, neuropathy, nerve entrapment, nerve injury, vertebral compression fracture, disc herniation, fractured spine, spinal tumors and spinal stenosis. A team approach from the outset ensures that every patient is directed to the right specialist, Dr. Kanaly says.

“The nurse navigator is critical to the process, acting as the patient advocate by screening the chart and then working closely with the team to determine the most appropriate provider,” he explains. “That way, care is coordinated across all disciplines so patients can get exactly the treatment they need most at all times.”

Because many people are reluctant to seek immediate treatment for neck and back pain, and experience social isolation due to mobility restrictions and prolonged absences from work, it is not uncommon for these patients to exhibit signs of depression and anxiety. Dr. Stowe says that treating the emotional pain is just as important.

“We understand that chronic pain is often associated with emotional stress and the development of both depression and anxiety,” he says. “For patients who have been coping with chronic neck or back pain, we make sure we treat both the physical and emotional sides of chronic pain.”

Getting patients into treatment sooner is one goal the team shares.

“There are many relatively simple things patients can do to improve if they currently have a problem,” says Dr. Adams. “The longer patients wait, the more difficult it becomes to treat them. Even if a problem is short-lived and self-limited, there are things that can be assessed and treated to help prevent recurrences.”

Dr. Stowe concurs.

“One problem we see is that patients often go years without seeking proper treatment and unnecessarily live in significant pain before coming to us,” he says. “The chances for success are much higher when a patient is seen early. It’s like putting out a fire while it’s still in the ash tray, instead of trying to put out a whole house fire.”

But many factors play a role in a patient’s reluctance to seek treatment, including the fear that any intervention will inevitably lead to surgery. That is not always the case.

“Surgery is typically the last resort,” Dr. Kanaly says. “Our triage system is able to engage those patients in need of urgent surgery and quickly get them the care they need.”

Meanwhile, several leading-edge interventional therapies can offer significant improvement without surgery.

“The most common injury we treat is neck and lower back pain,” Dr. Stowe explains. “We are able to offer patients a tremendous number of interventional procedures that can significantly reduce their pain. These include epidural steroid injections, radiofrequency ablation, trigger point injections and spinal cord stimulators, all the way to vertebroplasty, which is used to treat people with vertebral compression fractures.

“We also offer radiofrequency ablation, in which we interrupt the transmission of pain from the back and neck to the brain so that, even though the area is still painful, the patient doesn’t feel it. This can last for up to a year, allowing the patient to continue with an active life.

“We are always looking for the most recent developments in interventional pain management so that we can bring a sense of normalcy to our patients’ lives.”

If it is determined that surgery is required, there are some innovative procedures that ease recovery.

“Back surgery is constantly improving, and we are now able to offer minimally invasive options that speed recovery with less pain,” Dr. Kanaly says. “We also have a perioperative medication protocol that helps relieve the surgical pain with fewer narcotics.”

Physiatrist Marc Adams, DO (left), and Christopher Stowe, MD, pain management specialist, review the results of a patient’s diagnostic imaging. By working together, the physician team of Drs. Kanaly, Adams and Stowe develops the best treatments for conditions of the spine and neck.
Dr. Adams’ expertise leans toward less-invasive therapies based on his osteopathic medicine, physical therapy and neuroscience background.

“Patients want less invasive and safer treatments,” he says. “My use of osteopathic medicine allows me to approach the patient as a whole so that improving overall health is more the objective, rather than eliminating a specific symptom, which is often the effect rather than the root of a problem. With that approach, many other conditions can improve, as well, not just musculoskeletal problems.”

The key message the physicians would like to get out is that treatment options are available and that people who are suffering should seek them out early.

“My advice to anyone who is living in pain is to come and see us sooner rather than later so that we can begin to put them on the road to recovery and allow them to get their life back,” Dr. Stowe says.

Pulled from MDNews

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