“Miss Mary Poopins is a survivor. We've had her many years,” Rachael says. “This chicken has been through it. She runs everyone.”

You might say that Rachael has also “been through it.”

In 2021, she was diagnosed with a rare bone cancer, chondroblastic osteosarcoma. Her treatment included chemotherapy, followed by surgery to remove a tumor and half of her pelvis, replacing the bone with a 3D-printed titanium pelvis.

After surgery, she participated in inpatient rehab close to home.

“I was there for two weeks and just basically learning how to live in a wheelchair because I was non-weight bearing for about a year,” she says.

She continued with outpatient physical therapy and moved from using a wheelchair to using a walker. Now, she sometimes walks with a walker, sometimes with a cane. Even though her mobility has improved significantly, she continues to experience complex pain.

“A lot of neuropathy down my left leg, specifically. And I was doing pain management in Chattanooga. They were doing as best they could for me, but it was just they never could really get it completely under control.”

Researching New Options

A friend of Rachael’s husband had sustained back injuries during her military career and told them about Shepherd Center.

“We started doing some research,” Rachael says. “She had told us just what an incredible game changer it was for her.”

After learning more about the Dean Stroud Spine and Pain Institute at Shepherd Center, Rachael became a patient there in early 2025. She says Shepherd Center felt different.

“I really felt like I was listened to,” she explains. “It's never felt like I'm being looked at as someone seeking pain meds or like I'm being judged for why I'm there. I feel like there's such a warmth and a respect for what people are experiencing.”

The expertise of Shepherd’s staff, coupled with their attention to Rachael’s needs and goals, led to improvements in her pain management.

“Immediately, the doctor saw where we could make some changes to my pain medication … I've been able to come off of a lot of the opioid oral medications that I've been on … We've been able to make a lot of changes, and that's given me a better quality of life,” she says.

Rachael’s care team also suggested she try a spinal cord stimulator, a surgically implanted device that she says has been very helpful in managing her nerve pain and neuropathy.

And, they recommended she visit Shepherd’s pain therapist to address some of the emotional toll of the cancer diagnosis and the pain.

“I didn't even know [pain therapists] existed,” Rachael says. “So, I started seeing her right away. And it was just such an incredible opportunity to work through a lot of these things that I've not unpacked in my life. I never really had the time to grieve that I got sick … that pain, you know, sits within your body. And I didn't recognize all the connections from pain in my body interconnected with my brain. So she really helped me to release a lot of that and taught me many different techniques that I can [use to] help regulate my body.”

Now, Rachael comes to the Pain Institute once a month for treatment. She and Chris turn the trips to Atlanta for her appointments into “day dates,” tacking on lunch or dinner at different restaurants they want to try. She says they feel the hope in the halls at Shepherd Center, and she looks forward to her visits.

“I feel like I'm a friend there amongst people. I know the individuals, I see their faces there, everyone is welcoming and saying ‘Hello,’ and ‘How can I help?’”

Rachael encourages others who are experiencing chronic pain to advocate for themselves, do their research, and seek out care if they feel they have run out of options. She also says having Chris as a care partner, someone who can advocate for her when she can’t advocate for herself, has been a big part of her journey.

“And then lastly, but most importantly,” she says, “has been my faith, … my faith in the Lord has been something that has allowed me to continue to have hope and encouragement, and that pain can be pain, but life can be beautiful in the midst of it all. And that, you know, you have bad days and good days, but you have to look for the good every day as well.”

And although she’s still learning to live with some limitations, she finds the good in being able to manage her pain enough to work full-time, be a mom and a wife, travel, and do other things she enjoys, including enjoying life on their plot of land.

“That's the dream, live on the land, have a little farm, start doing things like making sourdough bread, and have a little farm stand. Who knows?”

Written by Ruth Underwood

Both Elizabeth and Paul learned some of these practices through their participation in a clinical trials pilot study at Shepherd Center. The study, funded by the Samsky Spine and Pain Research Fund, aimed to explore the feasibility and acceptability of a mindfulness meditation training program and to determine whether it could lead to improved ability to cope with pain and increased health-related quality of life outcomes. Having the tools to help manage frustrating calls and heavy traffic was a bonus.

Since breaking three vertebrae and sustaining other injuries in a fall about eight years ago, Elizabeth has experienced chronic pain. Her doctor’s warning to be careful, coupled with a fear of falling again, led her to stop many of her activities, which, in turn, led to isolation and depression at the loss of her socially and physically active life. She began coming to The Dean Stroud Spine and Pain Institute about a year ago, participating in physical therapy and adaptive yoga with great results. When she heard about the Mindfulness-Meditation Study, she knew she’d like to give it a try. 

“Because I want to get better. It's mindfulness and yoga, and I thought, ‘There's something here,’” she recalls. “I knew how much the yoga had helped, so I thought, ‘Well, more ways to look at something, more ways to move.’ It's just been incredible.”

Paul has been a patient at the Andrew C. Carlos Multiple Sclerosis Institute for about 20 years and has participated in research at Shepherd in the past. He was already curious about meditation, so when Erica Sutton, MA, CRC, clinical research coordinator at the Virginia Crawford Research Institute at Shepherd Center and principal investigator for the 12-week study, asked if he’d like to participate, he was in. 

“I have been on the fringes of trying to understand meditation and what it does,” says Paul. “Then Erica, out of the blue, called. ‘Hey, Paul, I was thinking about you. You said you always want to participate in things, and I think I have the right choice for you here — it's called mindful meditation.’”

Sutton, who practices meditation herself and holds two clinical meditation certifications, says she wanted to introduce people to its benefits. 

“I built a protocol based around meditation, and for people who are new to meditation and mindfulness, I wanted to show some of the different ways that people can engage in these mindful practices.”

Connecting and Reflecting

Participants in the program attended weekly classes at Shepherd Center and a weekly virtual support group session for eight weeks, followed by four weeks of practicing on their own, during which they could continue to attend virtual sessions. 

During each class, Sutton and her colleague, Alexandra Juarez, EP, RYT 200 HR, introduced participants to a variety of meditation and mindfulness practices, including visual meditation, sound baths, breathing techniques, guided body scans, and mindful eating.

Sutton and Juarez intentionally included time in each session for participants to catch up, share reflections on the tools they’d learned about, and connect with one another — a practice Elizabeth found especially meaningful. 

“Being able to talk to people … sharing how we handle it mentally, emotionally, and physically, even though all our stuff is different, has been a really important part of the mindfulness group,” she says.  

“Part of the benefit of having the study in person is that they get to have a social connection as well, and they really do enjoy that,” says Sutton. “Being able to see people with different diagnoses and to come together collectively with the same goal in mind has been a beautiful process.”

Between classes and during the four weeks of independent practice, participants kept journals documenting the mindful meditation they tried throughout the week and their reflections on the practice. 

“At the end of the study, we will use the diaries to collect those analyses to see if there were any improvements in areas of their overall well-being,” Sutton explains. “We're looking at any changes, primarily in the relationship to pain, so that's something that's important about this study. 

Although we targeted people with chronic neuropathic pain, it was not because we were looking to cure anything, but to build a better relationship with how they navigate and manage life with chronic pain. So, we're looking at their relationship with pain and overall quality of life. Was there any improvement with that? And then of course the safety and efficacy of the study.”

And Sutton hopes that this pilot study of 10 participants will lead to something bigger.

“It's a feasibility study. We're taking this hypothesis, and we're testing it in a small group with the hope that we can conduct more research on a larger scale, and thus translate that into clinical practice.” 

A Variety of Tools

Paul says he has noticed a change in his stress levels and energy.

“I'm like, ‘Am I really noticing that much of a difference that fast?’” he reflects. “My pain levels have gone down from like a six to a two. … I'm sleeping seven hours very easily. I'm in a deeper sleep. … I’m waking up with a lot of energy.”

And he’s even been able to use some of the relaxation techniques he’s learned instead of taking pain medication. 

“Through all the different techniques I've learned, I don't need it. When I feel that pain going across my shoulders or down my spine or my lower back or even on my leg, I'll just do a nervous system reset, and it's been working,” he says.

Elizabeth says learning so many different forms of meditation has been very helpful. 

“I might have known a bit of here and there, but to be very thoughtful, if I'm in pain, let me try this. And finding out which things work for me,” she explains. “Each class was a focus on a different way of meditating. I've known my whole life, ‘Oh, meditation is good,’ and I’d try it, and my mind gets too busy somewhere, and I just haven't been able to meditate. So, learning which ways to meditate has been so important — which ones work for me.”

“It's been very rewarding to hear the feedback and watch what tools they use,” Sutton says. “What we teach is that there's no right or wrong. It's a personal practice, and what's important is that they are making the space to carve out that time for themselves and to use whatever feels best for them in the moment.”

Paul also appreciates having a variety of tools to try. 

“I've used every single technique, and I found it very beneficial. It's a
healing of the soul, in my opinion,” Paul says. “I feel like when you're doing these things, you find yourself, you really get in touch with yourself, with your body, and it's been refreshing.”

Elizabeth says her daughter has noticed how she’s becoming more of her old self again, getting out, reconnecting with friends and family, and engaging in life.

“It's just progress every day,” Elizabeth says. “It has been life changing.” 

If you’d like to find out more about research at Shepherd Center, visit https://shepherd.org/research/redefining-rehab/find-studies/

Written by Ruth Underwood
 

“I have a very strong faith. So really, my life is around church, my children, my husband Tim, and our community and all that entails — and being as involved in each of the facets as much as possible. And that's kind of where I am right now. That's what gives me joy — and being at Shepherd. I'm often there three times a week.”

These days, Katie comes to Shepherd Center most often for outpatient physical therapy, but over the past year and a half, she’s also been a patient in the Wound Clinic, Dean Stroud Spine and Pain Institute, and Wheelchair Seating & Mobility Clinic.

In January 2024, Katie was scheduled to have a hysterectomy. But at the very start of the surgery, her vena cava, one of the largest veins in the body, got nicked, leading to significant blood loss. Katie was in a minimally conscious state for 11 days, sustained damage to multiple organs, and developed sepsis from blood clots, resulting in the need to amputate one of her legs.

“Waking up without a leg, you're very vulnerable. I had to deal with the fact that I couldn't go to the bathroom myself and deal with all of the things that are involved with this level of shock. But we started to think about what the next few months would look like, and I had heard of Shepherd — I knew what kind of place Shepherd was. And my husband and I, along with our family and friends, really wanted to go to Shepherd.… It is a gift from God that someone answered the phone and scheduled my appointment in the Wound Clinic.”

Beginning to Heal

At the Wound Clinic, Katie says the staff made her feel at home. Her case manager, Kathie Kurtz, whom Katie calls her guardian angel, noticed that the wheelchair Katie was using wasn’t a good fit, so she suggested Katie visit Shepherd’s Wheelchair Seating & Mobility Clinic, too.

As Katie healed, she got a prescription for physical therapy, but when pain made therapy difficult, Kurtz suggested Katie visit Shepherd’s Spine and Pain Institute. There, she saw Michael Smith, D.O., whom she credits with helping her discontinue the strong narcotics she was taking for pain. He unpacked each facet of what was causing her pain and tackled them individually, but with a holistic view. In addition to nerve, bladder, and wound pain from the original trauma, Dr. Smith addressed the shoulder pain that came from pushing her wheelchair and back pain from scoliosis she’d developed from sitting in her wheelchair for an extended period. He referred her to Alaina Hammond, Psy.D., ABPP-RP, a clinical psychologist at the Pain Institute, to talk through the trauma and pain she had experienced.

“He looked at it from ‘I'm seeing you, but let me find other areas within our Shepherd care team that we can add to your specific case and help you.’”

Katie felt like Dr. Smith did everything he could to put her at ease.

“He even offered to play Taylor Swift during a procedure one time because I'm obsessed with Taylor Swift. Knowing him, his personality is so stoic and very business-like, but … there's just an immediate trust and a caring, empathetic relationship on both sides.”

“My husband will tell everybody, ‘Dr. Smith is putting her together piece by piece. He's putting her back together. And this is my wife again. He's helped her get back behind the wheel and drive. He's helped her realize that she can get up in the morning, take the kids to school, and keep her leg on because she's not in severe pain from her femur rubbing into the prosthetic.’ … He's made life easier. And I wouldn't even just say easier. He's made my life better. And that's a big deal.”

Getting Back to Life

Dr. Smith and Kathie Kurtz referred Katie to Allan Peljovich, M.D., MPH, a Shepherd Center consulting orthopedic surgeon, to address phantom pain in her leg and later nerve pain in her fingers. Dr. Peljovich performed an innovative targeted muscle reinnervation (TMR) surgery on Katie’s leg. In the surgery, he connected some of the nerves leading to Katie’s amputated leg to other nerves and muscles, reducing the incidence of phantom pain.

“Instead of having it 24/7, I now only have phantom pains maybe once every three days. And that's huge for an amputee.”

The surgery meant delaying when Katie could get her first prosthetic, and the extended time sitting meant she had to work hard in physical therapy to realign her hip, but with her pain managed, she made significant progress and has since returned for a second round of physical therapy — with big goals in mind.

“This second time with PT, I kind of had to make a decision,” Katie explains. “Am I going to be someone that is walking regularly again? … Am I going to be able to go upstairs and put my children to sleep? Am I going to be able to walk to the soccer field where a wheelchair can't go on the grass? … And I had to make that choice where I don't want to go home and just put it [the prosthetic] away. I want to learn to have stamina to cook for my family, and to do the laundry and put it in their drawers, and just simple things like that. And Sandy [Alexander, my PT] is helping me get there. I'm walking really well with no help, and it's been almost exactly one year with this prosthetic. I went from having a walker to the crutches to a cane, and now I don't have anything. And I'm super proud, really proud of this. And it's all because of Shepherd.”

Encouraging Others

And physical therapy isn’t all Katie has been up to this year. While Katie couldn’t return to her job as a data engineer, she and her best friend, Maureen, started a nonprofit based on one of Katie’s other loves – creating art. The nonprofit, Everyday Art, includes art workshops and an online gallery where artists who don’t have a presence in galleries can sell their work. A portion of sales goes to the nonprofit, and with that money, Katie and Maureen assemble art kits for patients at local hospitals and outpatient facilities.

“I get to spend the rest of my life, hopefully, giving people the chance to do art when they feel alone, or maybe they just need some time for themselves, or maybe it’s allowing someone struggling with limb loss to find a different way with their prosthetic to paint something, and it's still going to be beautiful,” Katie says.

She encourages others experiencing chronic pain to “trust the process.”

“It works. You can live with chronic pain and not always be in severe pain, and that's something very important to realize for somebody who is coming to a pain center for the first time,” Katie explains. “You can get that number eight or nine down to a two or a three, and that makes a huge difference. It goes from you being depressed and immobile to being happy the majority of the time and able to function.”

And as for “Leslie,” Katie’s glittery pink prosthetic, Katie sees it as an opportunity to educate people and spread hope.

“That's why I wanted it [the prosthetic] to be loud and proud. And I wanted people to knock on it and ask questions because I can also have the opportunity to talk about hope and faith — believing in miracles. And it may not always look perfect in your life, but they happen.”

Written by Ruth Underwood

At Shepherd, Erik Shaw, D.O., medical director of the Dean Stroud Spine and Pain Institute at Shepherd, took him off morphine and started him on a medical pump, a spinal stimulator, and physical therapy. Shepherd “helped me tremendously,” John says. 

John, who owned a lock and key service, was carrying a clipboard and some parts for a safe in 1991, when he slipped on gravel, fracturing his back in seven places. Surgery left him in constant pain. Post-surgery pain is a common issue for clinic patients, says Marsha Hanson, MBA-HM, BSN, RN, CRRN, Shepherd’s director of outpatient services. The Spine and Pain Institute also treats clients whose discomfort results from injuries, arthritis, and various other causes. Treatment can include procedure-based and minimally invasive interventions, psychological care, physical therapy, and yoga. “We’re also developing more of a wellness program,” Hanson says. 

John adds his own personal twist to pain treatment. At Shepherd, he is known for his jokes. “Some of them are a little on the smutty side,” he admits. But, he adds, “Laughter is good medicine.”

Written by Gayle White

This story is an excerpt from “Mission Moments: 50 Years of Rebuilding Lives One Moment at a Time,” a book celebrating Shepherd’s 50th anniversary in 2025. You can explore the full eBook or purchase a hardcover copy here. 

“Things were never the same after that,” she says of her accident.

For more than a year, Caroline, who was 17 at the time, endured worsening burning pain, hypersensitivity, and fatigue in her right leg, hip, and back.

“I didn’t really have a diagnosis, and the doctors didn’t know how to help me,” she says. “Nobody understood what I was going through.”

In December 2019, Caroline’s doctor referred her to the Dean Stroud Spine and Pain Institute at Shepherd Center. In her first visit with the Pain Institute’s Medical Director, Erik Shaw, D.O., Dr. Shaw determined she had complex regional pain syndrome. He told her there were things he could do to help relieve her symptoms.

She started with pain blockers and immediately experienced some relief. Dr. Shaw also prescribed medication to make her flare-ups less frequent and intense. The hypersensitivity improved, and through physical therapy, she gained mobility using crutches.

In Fall 2022, doctors implanted a spinal cord stimulator that further mitigated the pain. The device has enabled her to reduce her medication and has lessened her dependence on mobility aids such as crutches and a cane.

“The changes were gradual but steady,” Caroline says of her improvements over the past four years. “Any relief I felt gave me great joy. I could wear leggings and shoes. I felt like putting on makeup. The person I had been was slowly coming back. My experience at Shepherd has been absolutely incredible,” she continues, “from the doctors to the therapists to the nurses – everyone has been incredibly supportive and kind. It’s obvious that they care and put everything they can into getting you better.”

Caroline is now in her fourth year at Kennesaw State University, studying chemistry. After she earns her degree, she hopes to become a scientist specializing in neuroscience research and chronic pain conditions. It’s a future she had trouble seeing after her injury.

“At first, everything was so daunting and depressing,” Caroline says, “but now I realize that even with this condition, I can do so much more. Shepherd Center gave me hope.”      

Written by Sara Baxter

I am a physical therapist in the Dean Stroud Spine and Pain Institute at Shepherd Center. I work with people who have chronic pain issues limiting their function or negatively affecting their quality of life. I have worked at Shepherd Center since 2004.

Q: What is chronic pain?

The simplest description of chronic pain is pain that continues for more than three months. It can generally be understood as pain that lasts longer than it took for an injury or illness to heal. Sometimes this happens for no obvious reason. Pain is like an alarm system to help protect us, but with chronic pain, the alarm can get too sensitive. During the past 30 years, we have learned that chronic pain can change our nervous systems and how our brains process pain. We strive to be mindful of our words because how we talk about pain can strongly influence a person’s understanding of their condition and pain experience.

Q: What do you want people to understand about chronic pain?

Pain is not equal to tissue damage. If the tissues are healed from an injury and the person is still experiencing pain, then there are ways to address it. If a person is experiencing pain, they are experiencing pain, even if you can’t see it. The better someone understands how pain works, the better they can manage it. One easy-to-access resource is www.Retrainpain.org.

Q: How does physical therapy for chronic pain differ from other forms of physical therapy?

It’s all physical therapy! The profession is changing, and more PT programs are including pain science, which leads to improvements in approaches to pain. As a specialty pain clinic, we sometimes focus more on things that can be difficult to measure. We often see people with neurological conditions that affect how they move. Over time, altered movement patterns can influence orthopedic issues that increase pain with daily activities. A lot of things can influence the pain of someone living with a long-term chronic condition. Some people begin to experience pain with activities that are not normally expected to hurt. That is a sign the pain system has become increasingly sensitive. For some people experiencing chronic pain, we use a series  of “brain exercises” called Graded Motor Imagery. It’s a strategy to get the pain alarm system to return to its normal settings.

Q: What is your favorite part of your job?

People living with pain can be frustrated with healthcare experiences because they don’t feel like the doctor or therapist believes or understands them. Patients appreciate someone who will listen to their experience and acknowledge that their experience is real and makes sense. Sometimes we can really help people feel like they got a part of their lives back because we helped them put their pain on the back burner. That’s a nice thing to work for.

How do I schedule an appointment for physical therapy?

We require a referral from a physician, nurse practitioner, or physician’s assistant prior to scheduling. Please contact the New Patient Coordinator at 404-603-4203 or email at painreferrals@shepherd.org to provide your referral and to inquire about scheduling an appointment.

Pursuing Possible with Shepherd Center

To support patient stories like this, please consider contributing to Shepherd Center's Pursuing Possible campaign. Click here to learn more. 

Founded in 2000 as the Shepherd Spine and Pain Institute, it was renamed the Dean Stroud Spine and Pain Institute in 2007 after Dean Stroud, the grandson of the late Bill Erb, who was a longtime supporter of Shepherd Center. Stroud passed away in a boating accident in 2004, after which Erb made a generous gift to Shepherd Center in Dean’s memory. In addition to this gift, Erb’s company, ERB Industries, has continued its company-wide employee giving program benefitting the Spine and Pain Institute to this day.

“Shepherd Center is always evaluating programs that will allow us to better serve our patient population,” said Sarah Morrison, PT, MBA, MHA, president and CEO of Shepherd Center. “We found that our patients with spinal cord injuries, brain injuries, multiple sclerosis or other neuromuscular concerns often experienced chronic pain, but we did not have a team solely focused on treating that under our own roof. Opening the Spine and Pain Institute was a natural fit for Shepherd Center that allowed us to expand the comprehensive care our patients receive.”

Chronic pain can be very complex and have significant impacts on a person’s physical and mental wellbeing. Since its inception, the Spine and Pain Institute has used a multidisciplinary approach to medicine geared toward treating both the physical and emotional components of pain.

“Everyone experiences pain in a unique way,” said Erik Shaw, D.O., physiatrist and medical director of the Dean Stroud Spine and Pain Institute. “Our goal is to look at each individual and customize our treatment plan to maximize their quality of life as much as possible.”

The multidisciplinary team works together to diagnose each patient and identify appropriate rehabilitation and advanced non-surgical interventions and/or medications. The team includes interventional and rehabilitation physiatrists, a nurse practitioner, experienced nursing staff, psychologists, a physical therapist and case managers. This approach allows the team to ensure patients receive the best care possible for the treatment of their pain. This focus on improving pain in turn improves patients’ quality of life.

“We take a holistic approach to care and try to understand how to make the patient better,” said Barbara Butkus, nurse manager of the Spine and Pain Institute. “There is such a variety of treatment options today. Nobody should have to live with chronic pain.”

Looking ahead, the Spine and Pain Institute aims to expand access to its care. In April 2020, along with several other outpatient clinics at Shepherd Center, it launched telehealth medical, rehabilitation and psychological services visits for established outpatients in response to the COVID-19 pandemic. Telehealth visits make it possible for medical providers and patients to virtually see and hear each other, providing better interaction and ensuring there are no gaps in the care of patients’ pain management.

In addition to initiating virtual telehealth across the hospital’s continuum of care, Shepherd Center is working on a strategic fundraising campaign over the next five years to expand the physical footprint of the hospital. The expansion will allow it to offer more services and see more patients.

“I am very excited about the prospect of the physical expansion of this unit,” Butkus said. “The excellent care we give is known throughout the community, but there is a wait time to get a visit with our providers. The wonderful support from donors, management and Shepherd Center’s boards will allow us to treat more patients in the future.”

The Spine and Pain Institute is also pursuing innovative research to advance pain management and treatment.

“There are a lot of opportunities at Shepherd Center for contributing to research in pain treatment,” Dr. Shaw said. “We have implemented treatment combinations that have helped the unique cases we see and plan to continue to pursue these novel therapies in the future.”

One specific field of study the Spine and Pain Institute hopes to advance is spinal cord stimulation. With this technology, a small wire with electrodes stimulates nerves and helps block pain signals so patients can improve their comfort throughout the day.

“Spinal cord stimulation has the potential to help manage pain for our patient populations at Shepherd Center,” Dr. Shaw said. “Our team has the opportunity to work on exciting, innovative treatment options that haven’t been pursued before.”

The Spine and Pain Institute would not function without the support of the teams who work tirelessly on behalf of Shepherd Center’s patients.

“The success of what we do depends on everyone working together and advocating for the patient,” Butkus said. “The staff’s enthusiasm to learn and care for patients makes the Dean Stroud Spine and Pain Institute the best in its field. I look forward to what the future holds.”

Written by Damjana Alverson

Headaches can be described as a throbbing, pounding, burning, even gripping pain. At the very least, they are always bothersome and inconvenient.

There are many different types of headaches.

• The most common type is the tension headache, which is an aching, pressure-like feeling generally on both sides of the head or the nape of the neck. The exact cause is uncertain, but high stress levels can contribute to the onset of tension headaches.
• Another type of headache is known as the cluster headache, which is a very painful sensation focal to one side. It is excruciating pain, generally lasting from 15 minutes to three hours.
• Sinus headaches have symptoms that include sinus pressure, nasal congestion and watery eyes. Often, sinus headaches are accompanied by an infection with green or yellow nasal drainage.
• Migraine headaches can cause pain for hours to days and may be accompanied by nausea, vomiting, and sound and light sensitivity. This type of headache may call for a combination strategy, including medicine, self-help remedies such as natural herbs and supplements, and lifestyle changes to manage migraine pain.

A variety of factors can trigger headaches. These include weather, certain foods, alcohol consumption, smoking cigarettes, stress, poor diet resulting in a lack of nutrients, insufficient levels of minerals and/or electrolytes, inactivity leading to poor metabolism and lack of energy, just to name a few.

Lifestyle changes can help manage headache frequency and pain. Recommendations include:

• Regular exercise to promote good blood flow and cardiac function;
• Balanced diet to maintain homeostasis;
• Good sleep hygiene to promote restful sleep;
• Taking supplements, such as magnesium, ginger, butterbur and feverfew, that may help reduce headache frequency and pain;
• Stress management techniques, such as periodic massage therapy to release toxins from the body and promote muscle tension release;
• Daily meditation and biofeedback breathing techniques to promote relaxation;
• Smoking cessation in consultation with a physician;
• Limiting alcohol consumption to rare to moderate use;
• Starting your day 15 to 30 minutes earlier, allowing time to mentally prepare for the day instead of hitting the floor running;
• Keeping a headache diary to help better manage and possibly reduce the occurrence of headaches by helping to identify triggers, as well as any discoverable patterns and frequency.

Two notes on taking supplements:

• Magnesium is a supplement known to possibly help regulate levels of the brain chemical serotonin and replenish the body’s natural supply of magnesium, which can be deficient due to poor absorption from one’s diet Topical creams are available to promote better magnesium absorption, resulting in maximum benefits.
• Articles, such as one listed on TheHealthSite.com, cite ginger as a natural home remedy that can provide instant headache relief. The ginger root is known to block prostaglandins, stimulate muscle contractions and control inflammation.

If you are like many people who suffer from headaches, you know how unpleasant this pain can be. Lifestyle adjustments just might be the change needed to make a big difference in your quality of life.

More information on the Shepherd Pain Institute is available here.

MONIQUE GAILLARD, RN, CRRN, is a nurse in the Shepherd Pain Institute. She has been a nurse for more than 19 years, working in cardiac care, medical surgical care, telemetry, geriatrics and, for the past eight years, pain management. She says, “Having the opportunity to work with this unique patient population with many rare disorders, it is evident to me that pain can be a very debilitating experience, which involves many dynamics that require a collaborative approach to management.”