By Jacob Mirman, MD
Nobody likes to be in pain. It is unpleasant, depressing and interferes with one’s life. We want it to be gone now!
Yet, pain is just a symptom of something being wrong in your body. It’s like the annoying “Check Engine” light on your car’s dashboard. Most of us, when we see this light, look into it further, consult a mechanic and get the engine fixed. I don’t know many people who would opt for punching the light out with a screwdriver and continue driving the car till it dies. Yet, somehow, many of us want to do a similar thing with their pain.
At Life Medical we work closely with each patient to develop the best possible approach for treating their pain. We make sure that patients understand all the options and consider all the variables; then we work together to develop a treatment plan.
Pain can be caused by a wide variety of problems. Before considering treatment options, we have to make a serious attempt at figuring out the cause of the pain. Once we understand the cause, or the underlying condition, we can start looking at the options.
Most options fall into one of three categories:
- Curative treatments; therapies that fully remove or at least reduce the cause of the condition
- Palliative treatments; treatments, that relieve pain without curing the condition
- Adoptive treatments; treatments which help the body compensate for its weakness producing relief of symptoms while the treatment is used. This is somewhere between curative and palliative treatments.
Some treatments fall into more than one category.
When developing the plan of care, the doctor and patient must understand the cause of pain, figure out if a full or partial cure is possible and come up with one or more therapies that will result in the best long and short term improvement without making anything worse. Therapies that have the potential to produce either full or partial cure must always be considered highest, followed by adoptive treatments. Purely palliative treatments should be used only if there is no risk of making the patient worse.
In an ideal world, we would limit our consideration to only the issues discussed above. But we don’t live in an ideal world. Unfortunately, financial matters have to be considered in the majority of cases. The costs of therapies range from free to unaffordable. The definition of unaffordable is different for everybody, so each patient’s financial situation must be taken into account in developing a treatment plan that can be adhered to and has a chance of succeeding. Some therapies are expensive but covered by medical insurance. Others may be cheaper, but not covered, and it may make them unaffordable for many. The doctor must be cognizant of these issues and has to discuss them with the patient in developing the plan of care. In many cases a compromise between the desirability of a particular therapy and its cost to the patient must be considered.
Doctors at Life Medical specialize in different treatment modalities. We all use the conventional approaches available at other clinics, but can usually offer some other, complementary approaches. In some cases the complementary approaches may be more effective, safer and less expensive than the conventional methods offered elsewhere. Sometimes they can be used in combination with the conventional methods.
All the doctors at Life Medical talk to each other and learn from each other. People often come to me to discuss their treatment options. Once I understand the case, I can suggest a plan of care which often includes some of the modalities offered at Life Medical, as well as some methods available from other practitioners in town.
We offer many different methods to treat pain. See below. Of course, it is impossible to list all effective methods in a short article like this. Sometimes, in a visit with a patient, other methods come to mind and may be discussed.
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Methods offered at Life Medical:
- Initial visit with a doctor. If you are not sure, which treatments you may want, schedule an appointment with me for the widest discussion of options. This is where we try to figure out the pathological cause of pain and develop the treatment plan. You’ll be examined. Some testing may be in order, such as blood or urine tests, x-rays, etc. The doctor will review outside records. Drugs may be used for palliation (symptom relief) on temporary or permanent basis. Drugs rarely offer any curative potential. The drugs may come from one of the conventional classes, like anti-inflammatory ones, narcotics, muscle relaxants, etc, or “natural” ones, like some herbal preparations, including medical cannabis (marijuana). This distinction between natural and synthetic medications is actually not particularly intuitive. Some synthetic drugs may be preferable to some of the natural ones in many cases. For example, cocaine and heroin are natural drugs too, and few people will argue that they are good for one’s health. As with all other modalities, the choice of medications depends on the condition being treated, the patient’s desires (hopefully based on solid understanding of all issues involved), finances, etc. The doctor’s purpose in this discussion, as with all medical visits, is mainly as an educator. The doctor must explain all options clearly in a way the patient can understand and make an informed choice. The doctor may also offer some other modalities for treatment and discuss them in detail. They may include chiropractic, acupuncture, physical therapy, psychotherapy, dietary suggestions, nutritional supplements, Bach Flower essences, homeopathy, microcurrent, magnetic therapy and other modalities, some offered at Life Medical and others requiring outside referral.
- Physical Therapy. This group of modalities include hands on methods and methods relying on use of some devices for treatment with varying forms of sound, electricity and light. You will initially see a physical therapist, and a plan of care will be formulated, agreed on by the physical therapist and the referring physician. Most of the time PT is covered by medical insurance. These methods range from palliative to curative and everywhere in between.
- Infratonic therapy
- Spinal decompression
- TENS; Transcutaneous Electrical Nerve Stimulation
- Therapeutic Exercise
- Low Level Laser Therapy
For more information about our physical therapy treatments CLICK HERE
- Chiropractic. Many times chiropractic treatments lead to improvement when the condition is due to misalignment. Like physical therapy, chiropractic methods range from palliative to curative and everywhere in between. Chiropractic is often covered by insurance.
- Acupuncture. Often acupuncture is useful in acute and chronic pain situations and can help to relieve pain. In some cases it is actually curative. Acupuncture is often covered by insurance.
- Invasive Therapies/Injections.
- Chronic Pain Injections
- Nerve Ablations
- Trigger Point Injections
- Regenerative Medicine
- Platelet Rich Plasma Therapy
- Adult Stem Cell Therapy
- Other Similar Approaches
- Homeopathy. This type of treatment addresses the underlying imbalance in a body that if foxed helps the body heal the condition that is causing the pain. In some instances it is extremely helpful, in others it is not.
For more information about homeopathy CLICK HERE
- Psychology. Treatments and exercises prescribed by a psychologist can be helpful in keeping the mind from focusing on the pain and therefore help alleviate the pain.
- Medical Marijuana. At Life Medical we provide evaluations and certifications for patients who may be eligible for the Minnesota Medical Cannabis Program. Cannabis seems to be hands down the safest and the most effective palliative medication for chronic pain. We have certified many patients for intractable pain and have seen them in follow up. The results exceed those of all drugs I know, both prescription and OTC, with no or almost no side effects. It is amazing.
- Many patients got off their opioids, including some of the strongest ones, after they started on cannabis. We feel it is a great alternative to opioids in cases of intractable pain. It also helps for anxiety, improves sleep, and tremendously improves the patients’ quality of life. The biggest issue with cannabis is its cost, ranging from $200 to $600 per month in most cases, not covered by insurance.
For more information about Medical Cannabis CLICK HERE
- Neuro Research Protocol. This supplement is good for any condition where pain is caused by an imbalance of the neurotransmitters serotonin and dopamine, including fibromyalgia, migraines, inflammatory bowel disease and other similar conditions. It can also help to treat emotional issues like depression and anxiety which can compound any conditions causing the pain. By addressing the emotional and the physical sides, Neuro Research supplements can offer a very positive outcome.
For more information about Neuro Research supplements CLICK HERE
- Miscellaneous Alternative Methods.
- Transcranial Electrical Stimulation: Interesting method developed by Russian physiologist Veleriy Lebedev. This type of treatment is covered by insurance.
- Magnet Therapy: this is often quite effective on painful joints. It is also very inexpensive
- The two supplements work pretty well in chronic pain. They are safe. While medical cannabis is often quite expensive in effective doses, these supplements are much less expensive, so may be a good alternative. They can also be combined with other treatments. Some of our patients who could not tolerate cannabis in effective dose (rare, but it happens) did well on Curcumin or PEA.
HERE IS AN EXAMPLE OF THE TREATMENT TYPES WE OFFER FOR A COMMON INJURY; ROTATOR CUFF TEAR
Rotator cuff injury is a very common and painful condition. Most conventional medical practices will only offer medications and/or surgery options. Sometimes steroid injections are done. The outcome of these is not great in many cases. This list below serves as a good example as to the large number of treatment options offered at Life Medical vs. a conventional medical practice. (Note: treatment types with * are commonly covered under insurance.)
Patients with rotator cuff injuries can benefit from these treatment types:
- Physical therapy
- Low level laser therapy
- Regenerative injection therapies (Prolotherapy and PRP)
- Acupuncture (palliative option)
- Medications (palliative option)
- Medical Marijuana (palliative option)
- Steroid shots
- Surgery if necessary
HERE IS AN EXAMPLE OF HOW WE CAN TREAT PAIN OF AN UNKNOWN CAUSE
A 60 year old woman came to see me who had pain in right side for several months. The pain was debilitating, and so sharp it took her breath away. A full conventional workup was done, but no cause found. Her original doctor prescribed opioids (narcotics) suggested for palliation. The patient did not want to take narcotics.
She had a normal exam in clinic when she came to see me. Given no obvious cause for the pain, homeopathy was chosen as initial therapy. Homeopathy is often very useful, especially when there is no explanation for some symptoms. The patient came in for a full homeopathic intake (not covered by medical insurance), which took about 2 hours. We discussed her symptoms and her life. She told me about some of her family issues. There is some stress. The main feeling she has is that she has been forsaken, not taken care of, alone. She cries a lot. Nonetheless, she had a good husband, good kids, and it appeared to me that her feelings were somewhat misplaced. In homeopathy we look for feelings that don’t quite correspond to the patient’s reality.
The remedies are often based on this understanding. In her case the homeopathic remedy Pulsatilla seemed right and I gave it. Within a month the pain was much improved, and in the next 6 months it resolved permanently. The patient also became much happier, stopped crying and her family relationships improved. This is a common outcome of treatment with well indicated homeopathic remedy. Homeopathy, when it works, is the most curative modality of all.
In summary, to treat pain well, the doctor must understand the cause of pain, if possible, as well as the patient having the pain on personal level. Then an effective combination of therapeutic methods can be figured out.
This is what we do at Life Medical. We work diligently to resolve pain.
Call 952-933-8900 to make an appointment, and we’ll do our best to help you.