Breaking Free of the Pain

Of the nearly 56,000 runners and walkers who participated in Atlanta’s Peachtree Road Race on July 4, Marsha Scott was among the most unlikely participants.

Not that she wasn’t an athlete – she’d run the race many times before – but her 2013 race signified a remarkable comeback.

Just four months earlier, Marsha was “in bad shape,” as she describes. “I was in pain, taking a lot of medication and trying to manage it all by myself. I was pretty desperate.”

Her condition stemmed from knee replacement surgery and subsequent follow up procedures in November 2012, which limited her mobility and left her in physical agony. Doctors said they could do no more than prescribe narcotics, which were causing terrible side effects.

All that began to change with Marsha’s first visit to Shepherd Pain Institute in February 2013.

There, she met with Erik Shaw, D.O., an interventional pain management specialist and supervising physiatrist at the Institute. “The minute I met with him, I knew I was in good hands,” Marsha recalls. “He clearly understood what I going through and said he could help. It was very reassuring.”

Dr. Shaw immediately switched her medications and also performed a nerve block procedure. Four months later, she was happy to be walking with her husband in the Peachtree, free of medication and treatment.

“I went into my appointment just to thank him,” Marsha says.

Shepherd Pain Institute treats all kinds of pain, from the simple to the complex. Some are current or past Shepherd Center inpatients; others, like Marsha, are referred for pain caused by illness, injury or surgery.

What sets the Shepherd Pain Institute apart from other centers is the staff’s experience in caring for people with catastrophic injuries.

“We see complex pain issues and use a lot of different modalities for diagnosis and treatment,” says J. Tobias Musser, M.D., an interventional pain management specialist and Dr. Shaw’s colleague. “And we have experience in the whole continuum of care for catastrophic injury. As a result, we have a lot of different tools and can offer a large number of options to those that are less complicated.”

The first step in fixing the pain is determining the source. Then the doctors can chart out a course of treatment. “Everyone is at different stages of pain when they come in,” Dr. Shaw says. “We need to determine what part of that pain is medical, what part is psychological and what part is anatomic, or part of the body. We have to figure out how to address the problem in the right order.”

The medical staff at Shepherd Pain Institute ventures beyond narcotics to treat pain. Some examples:

• Nerve blocks – injections of medication into a specific area of the body. These are used to both diagnose and treat pain.
• Neuromodulation – implanted electrodes, or pacemaker-like devices, that stimulate the spinal cord. Dr. Musser calls this “the best option for non-pharmacological pain management.”
• Biofeedback – using thoughts to control the body and relax certain muscles. This is both a treatment option and a coping mechanism.
• Manual (osteopathic) therapy – manual manipulations to bones that can sometimes relieve pain.

Choosing the right approach depends on the patient’s symptoms and circumstances. “We take a personalized approach to each patient,” Dr. Musser emphasizes, “because no two people have the exact same pain experience.”

Both doctors caution that the first course of treatment may not work; sometimes a few options may have to be tried. “Sometimes we’re successful right away, whereas other times, it takes a little longer,” Dr. Shaw adds. “Quite often, the situation is that the longer the patient has suffered from the pain, the longer it takes to figure out what the pieces are.”

If medication is necessary, Drs. Shaw and Musser try to prescribe safer pain medications with fewer side effects. And they point out that while pain doesn’t always disappear, it can at least be made more manageable.

The Institute’s multi-disciplinary approach also distinguishes it from other pain management centers. In addition to the two physicians, the team includes a case worker, two psychologists, a physical therapist and highly trained nurses and technicians. The psychologists are specifically trained in pain management and the issues associated with it, such as depression, anxiety and relationship issues.

“Because we have an integrated team, we can give something to our patients that they can’t get anywhere else,” says Marsha Hanson, the Institute’s nursing manager. “The collaboration with the entire team is one of our greatest strengths. Our doctors are good at what they do, they think outside the box and they are up to date on the latest technology and techniques.”

For more information, see www.shepherdpaininstitute.org.

Written by Sara Baxter
Photos by Gary Meek