Business of health: Working to manage pain

CEDAR RAPIDS - More than 50 million Americans experience chronic pain, and 45 percent of the population will seek medical help for pain at some point in their lives, according to the National Institutes of Health.

As a result, pain management has become a relatively new subspecialty in the medical world, and local hospitals have created pain centers to help patients deal with chronic pain.

'We treat young adults through seniors who most commonly are dealing with pain centered on the spine,” said Dr. Tork Harman, who through his role at Linn County Anesthesiologists PC works at both Mercy Medical Center's Interventional Pain Center and St. Luke's Interventional Pain Clinic, both in Cedar Rapids.

The centers provide procedures for patients dealing with back, neck and spine pain, in addition to pain caused by cancer and other chronic conditions.

Harman explained that patients come to the hospital pain clinics through referrals by outside providers - either primary-care physicians or specialists.

Harman said they place a big emphasis on continuing education as more specialized treatment procedures are developed for the pain-management field.

'Our emphasis is interventional,” said Harman, noting that while injections are a common treatment opiates are avoided as much as possible.

He said his team's goal, in working closely with spine surgeons, is to minimize or avoid the need for surgery.

'We try to get people back to work as quickly as possible because we know patients do better when that is the case.”

The University of Iowa Hospital also has a pain medicine clinic that has a multidisciplinary approach to treating patients.

'We offer comprehensive pain care, from medicine and physical therapy to psychological treatments, injections and surgery if needed,” said Dr. Rahul Rastogi, the new director of the clinic, who emphasized the importance of that comprehensive care approach.

'If treatment is not done in tandem, it is not as effective,” he said. 'Pain is often multifaceted suffering which takes a multifaceted treatment approach. And we try to give that understanding to our patients because knowledgeable patients do better.”

Meanwhile, at Cedar Rapids Pain Associates, the range of patients often can be a bit broader than at the hospital pain clinics, according to Dr. Jeff Mitchell, that facility's clinic director and chiropractor.

For chiropractic services, he said, 'we see everyone from newborns to senior citizens. We treat adults with chronic and acute pain and those who just wish to stay at their peak performance level.”

He noted that their younger patients are often seen due to an injury of some sort - a car accident or work injury - while the baby boomer population is being seen for issues such as degenerative disc disease in the spine or a worn out hip or knee joint.

As with the hospitals, Mitchell said they use a multidisciplinary, team-based approach to the prevention, diagnosis and treatment of musculoskeletal pain.

'Having two nurse practitioners, an anesthesiologist and a chiropractor working together under one roof to get people out of pain is unique,” Mitchell said. 'This approach allows for greater continuity of care for our patients. And it allows us to offer a variety of treatment options ranging from conservative to more medically advanced.”