CONNELLY, MICHAEL C.
NGOIE, KARINE N.
NORTON, JEFFREY A.
RICCARDI, RICHARD R.
The NENA Division of Pain Medicine consists of specialists with advanced training in the evaluation and treatment of a variety of painful conditions. Pain specialists are physicians who most commonly begin training in anesthesiology and physiatry, complete a Fellowship in Pain Medicine, and then focus on treating patients with pain.
NENA patients experiencing pain benefit from development of a treatment plan that is the result of collaboration among specialists in Pain Medicine, Neurology, Neurosurgery, Orthopaedic Spine Surgery, Physical Medicine and Rehabilitation, Rheumatology, Psychology, and Psychiatry. We serve the needs of patients suffering from various persistent painful disorders. Pain is a diverse, multidimensional problem, as varied as the individuals who suffer from pain. Treatments for pain can range from physical modalities (physical or occupational therapies) to interventional injection therapies, to medications, to collaboration with our surgical colleagues. Patients will experience optimal outcome when needs are addressed by an integrated team.
NENA physicians support programs at a number of regional pain management centers, including: the Northeast Rehabilitation Pain Clinic at RIVERWALK in Lawrence, MA; the Pain Center at Northeast Rehabilitation Hospital in Salem, NH; the Pain Center at Lowell General Hospital, in Lowell, MA.
Pain management programs are designed to meet the physical, psychosocial, and vocational needs of the patients they serve. This physician-directed service uses a multidisciplinary approach to address the various issues associated with pain. The ultimate goal is to increase function and diminish pain and its influence over daily activities. Each patient is encouraged to assume maximal individual responsibility for his or her own well-being.
Why and when would a patient see a “pain specialist”?
The pain specialist can play a number of important roles in the evaluation and treatment of a patient's pain:
- As a first step in the evaluation of pain, the pain specialists may complete a workup and initiate the entire treatment, or may collaborate with other specialists, or direct patients to another specialty when appropriate.
- Following assessment by neurosurgery for non-surgical management of spine pain, such as a disc herniation or spinal stenosis. For example, most patients with disc herniation will not require surgery and can be treated with physical therapy, medications and injections.
- When a specific procedure is needed, such as an injection, a referral may be made to the pain specialist for an evaluation and, when indicated, a follow-up procedure.
An appropriate referral to the pain division would be a patient with persistent pain who has failed to respond to standard treatment. Our pain physicians work in conjunction with other specialists at NENA to foster a multidisciplinary approach to manage the complexities of the patient in pain.
Conditions Treated By The NENA Pain Specialists
NENA pain medicine specialists treat a variety of conditions, including:
- Chronic back and neck pain related to degenerative disc disease, sciatica, herniated discs, spinal stenosis;
- Pain related to vertebral compression fractures may be treated with newer interventional techniques, such as kyphoplasty;
- Neuropathic pain such as diabetic neuropathy, peripheral neuropathy, reflex sympathetic dystrophy (RSD) or complex regional pain syndrome, and pain due to shingles.
Treatment Options: The Example of Back Pain
Back pain alone affects millions of Americans. For many patients, physical therapy is the key to relief. Patients receive guidance in stretching as well as strength and conditioning exercise for “core” muscles in the back and abdomen. With direction to independent exercise, patients often benefit from learning that they do not need to fear activity.
Pain from a herniated disc is often managed without the need for surgery. Guided by x-ray, pain specialists are able to inject cortisone along the painful nerve root. This can be very helpful in easing pain in a majority of patients.
When surgical evaluation is needed, collaboration with NENA neurosurgeons and our orthopaedic spine surgeon is facilitated for patients in one location. Physicians can communicate about patients at the point of care, and patients have the security of knowing their doctors are working together.
The Mind-Body Connection
The mind and body are connected. Pain is stressful and draining. Other sources of stress can make it worse. Our goal is to see you as a person and recognize when to ask more questions. For some patients, treating a depressed mood is the key to success dealing with chronic pain. For other patients, learning different approaches to stress, or relaxation strategies can be very helpful. In these circumstances, collaboration with NENA's psychiatry and psychology staff may be beneficial.
Opioid medication, such as morphine and oxycodone were once commonly used for a variety of pain conditions. Experience with this approach has been mixed. Opioid use is now prescribed in limited circumstances. Referrals made only for the prescribing of medication started by other physicians are not accepted. We are not addiction specialists, and do not treat opioid addiction.
The goal of treatment by the NENA Division of Pain Medicine includes management of a patient's painful symptoms, restoration of function, and improvement in the patient's quality of life. This is accomplished in the collaborative environment of New England Neurological Associates that offers treatment suited to each patient.