Relieving Pain with Listening, Empathy and Intervention

Pain can be one of the most difficult symptoms for a medical professional to treat.

“Different people perceive pain differently. There are no lab tests for it. You can’t technically see it with medical imaging, yet the experience of pain can dramatically alter someone’s entire quality of life,” says Tobias Musser, M.D., of Shepherd Spine and Pain Institute, which offers comprehensive treatment for individuals experiencing chronic pain.

One patient who understands that all too well is 23-year-old Tegan McCampbell of Conyers, Georgia. She was playing soccer six years ago when she was cleated in her knee. When two surgeries didn’t ease her immense pain, her doctors told her parents it was all in her head.

“It's a burning, throbbing, like somebody is stabbing you,” Tegan says. “It feels like my knee is in a vise grip and somebody is making it tighter and tighter.”

Her parents knew it wasn’t a figment of her imagination, so they took her to the Mayo Clinic in Jacksonville, Florida, where they diagnosed it as Reflex Sympathetic Dystrophy or Complex Regional Pain Syndrome. After many treatments at other doctors closer to home, she began to see Erik Shaw, D.O., at Shepherd Spine and Pain Institute. Trying nerve blocks at first, he later implanted a pain pump that reduced her pain dramatically.

“You have to have empathy,” Dr. Shaw says. “You have to find out the duration of the pain, their family support and all the things that make up a human being’s life. Understanding these things helps you to be a better doctor.”

Shepherd Spine and Pain Institute takes a multi-disciplinary approach to the practice of medicine and specializes in the evaluation, diagnosis and application of interventional treatment for the management of pain. Providers see patients who have chronic pain, whether if be from a spinal cord injury, spine degeneration, neurologic disease, arthritic joints or simply lower back pain, which is what brought veterinarian Ann Welch to the Shepherd Spine and Pain Institute.

Five years ago, Ann began experiencing pain shooting from her back down her left leg. She underwent surgery for a herniated disk at an Atlanta hospital.

“Prior to the surgery, I’d say my pain was a four or a five on 10-point scale,” Ann says. “Afterward, it was an eight.”

Ann found she sometimes had to ask a colleague to take over the surgeries she performs because the pain was too intense. Many times, a half-day was the most work she could manage, but after seeing, Dr. Musser she’s now back to a full schedule.

“We give patients space and time for them to be listened to when we do a comprehensive evaluation,” Dr. Musser says. “By the end of that first visit, patients are very thankful that we’ve spent so much time with them and were able to develop an actual plan of care. In this way we focus on high quality of care rather than quantity of care. We are not like some pain clinics that shuttle patients through a like a mill.”

At Shepherd Spine and Pain Institute, treating each patient like the individual they are is key.

“I evaluate their medical records to see if I agree with the patient’s current diagnosis,” Dr. Shaw says. “I do that because if you assume someone else was correct, then why wasn't their treatment correct and why didn't their treatment help?”

The fact that Dr. Shaw believed Tegan and wouldn’t give up meant a lot to her, she says.

“He kept everything really upbeat,” Tegan says. “He said we're going to try this, and if it doesn't work, we have another step we can go to. Dr. Shaw and the whole Pain Institute treats you like one of their family.”

Dr. Musser follows a simple routine when a patient comes to see him for the first time.

“My first step is to read the medical records in great detail,” he says. “Then, before I meet them, I take a deep breath and erase any picture I created of them when I reviewed their records. I start with a fresh slate”

Because so many pain patients have had difficulty being taken seriously by their physicians, Dr. Musser says it’s important to go into the examination room without any preconceived notions.

“When I meet them, I have to get them to feel comfortable,” Dr. Musser says. “A lot of them have been mistreated for so long, they don’t feel like they want to open up to you. This is important because I am trying to figure out a puzzle, their pain, and it is up to the patient to give me many of the clues it takes to piece the puzzle together.”

A medical detective herself, Ann was very quiet when Dr. Musser came to meet her for the first time. She wanted to see how he behaved, whether he thought he knew the answer right away. She was impressed by how he had studied her case before her appointment.

“This is a mystery to everyone,” she told him. “They don’t know why I have this pain, and they’ve all given up. ‘Will you take this journey?’ I asked.”

“Absolutely,” Dr. Musser told her.

After a round of investigations and a trial, Dr. Musser implanted a spinal cord stimulator in Ann to block pain signals from reaching her brain. And now her pain is down to just a two on the 10-point pain scale.

“They really care about you,” Ann says. “You're not a number. They take their time with you to solve the problem, and that’s a comforting thing.”

A referral from a medical provider is required for patients to be seen at Shepherd Spine and Pain Institute. Medical providers can find out how to make a referral here.

Written by David Terraso
Photos by Louie Favorite and Phil Skinner