SpineTeamSpokane - a Center of Excellence in Washington

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SpineTeamSpokane: A TEAM APPROACH TO CARE
Four out of five Americans will have an attack of back pain during their lifetime. Many people are doomed to endless visits to the back doctor. That's because once you have your first back pain attack, you are four times more likely to have a recurrence. If you have back or neck pain, we are now in a position to help.

Pain relief through a focus on function
Pain is a signal from the body to the brain that something is wrong. Either the back is too weak, too inflexible, something lifted was too heavy or the wrong body mechanics were used. Unfortunately, those doctors who focus exclusively on pain symptoms can recommend a course of treatment that is the exact opposite of what the individual needs to recover from the back problem.

Years ago, for example, doctors treated back pain with bed rest and heavy drugs to mask the discomfort. It was found, however, that this type of treatment was actually damaging to the back, because it caused muscles in the back to get weaker, in turn, causing more strain and pain. Patients became more dependent on drugs and grew more inactive and disabled.

In fact, pain relief actually can come through movement. Low-impact sports like walking and swimming are the good ways to make the back feel better and stronger.

Pain is the number one reason people seek out a physician. Back and neck pain in particular will affect 80% of Americans at some point in their lives.

What is pain medicine?
Pain medicine is a specialty unto itself. Its areas of expertise include the prevention, evaluation, diagnosis, treatment and rehabilitation of pain. Pain can be caused by a variety of things, from cancer, trauma, systemic problems, muscle and ligament strains to back and neck pain. Within the specialty of pain, providers specialize in niches — like back and neck pain — to gain a better understanding of what can cause a pain complaint, and the most current ways to relieve pain.

Who typically specializes in back and neck pain management?
Back and neck pain is addressed by a variety of specialists, from orthopedic spine surgeons and neurosurgeons, to nonsurgical providers like physiatrists, anesthesiologists, chiropractors, acupuncturists and therapists. Pain management represents a specialty within the spine field that focuses on those patients who cannot otherwise be treated with common surgical or nonsurgical options. For example, there are many patients that are not appropriate for surgery, and where other nonsurgical treatments have failed. These patients are then often referred to specialists in pain management.

Historically, pain management was the domain of anesthesiologists who had advanced training in how to do intricate injections around the spine.

Over the last 10 years, however, the specialty of Physical Medicine & Rehabilitation has also provided spine fellowships that attempt to provide in depth training in lumbar and cervical injections. So today, it’s common to see anesthesiologists and physiatrists working together with spine therapists to help spine patients recover from pain.

Because of the delicate nature of the spinal cord, those physicians performing pain relieving injections around the spine typically need a C-arm that provides an internal picture of the spinal vertebrae, enabling the physician to guide the needle to the precise location for pain relieving medication. The goal of most injections is to relieve pain symptoms long enough to get the patient moving again, and into some functionally oriented therapy program. Generally speaking, movement and pain relief are the desired goals from injection therapy. So today, the most advanced spine centers focus on getting the person back to activity, recognizing that movement in itself can play a role in relieving pain symptoms.

What does it mean to be board certified in pain medicine?
To be board certified in pain medicine, a physician must go above and beyond regular training. The American Board of Pain Medicine gives an exam annually in the pain medicine field to candidates who qualify to become board certified in pain medicine. If candidates meet the required score on the examination and other credentials, they are presented with a certificate and deemed Pain Medicine Specialists. Most physicians who seek board certification in pain medicine are typically anesthesiologists and physical medicine physicians (physiatrists).

What is the difference between a spine center and a pain management center?
A spine center typically focuses on those patients who are moving progressively toward a resolution of their back and neck pain problem, either with nonsurgical options like therapy and injections, or spine surgery.

Those patients who cease to make progress with these options — in that they suffer from “chronic” pain symptoms that persist for more than six months or a year — typically require specialists in “pain management.” These pain specialists focus on other pain treatments, which can include more complex injections around the spine, the implantation of spine cord stimulators that can mask the pain signal to the brain, or the implantation of drug pumps that provide a regulated source of medication to relieve pain.

Other specialists in a pain center can include psychologists who have advanced training in biofeedback to help patients manage their pain without dependence on drugs.

Because successful pain management involves a focus on movement, a pain center may also have occupational therapists, vocational counselors and social workers who all play a role in the successful recovery from chronic pain.

In any event, the pain management patient has DISTINCT and special needs that require that patient to be referred out of a spine center and into a center that specializes in pain management.

Spine Team Spokane is a spine center, rather than a pain center. Our goal is to find nonsurgical or surgical treatment options that help the patient recover from their back and neck pain, so they can return to activity. Where patients cease to make progress at SpineTeamSpokane, we will connect the patient with an appropriate pain specialists for these other pain treatment options.

Need more information on back and neck pain?
Click here to view resource books on spine problems, what causes back pain, what causes neck pain and when to see the doctor.