A Holistic Approach to Pain Management, Episode 44



today we're discussing how to treat chronic pain medications have been the go-to treatment of course but there are other options available that provide relief without the consequences of prescription addiction on today's show we'll be joined by a doctor a deal Huck and a BMS board-certified fellowship trained pain medicine specialists on the medical staff of Texas Health Presbyterian Hospital Plano you'll tell us about some alternative pain management options that follow a more holistic approach and that's coming up welcome to the well being DFW podcast each week Scott Sam's will cover a different topic on improving health and well-being in our North Texas communities he will host interviews with physicians on the medical staff of Texas Health hospitals I'm Scott Sam's thank you for joining us today many of us have experienced chronic pain at one time or another in our lives and there's usually a quick solution medication it's fast does the job but in light of the opioid epidemic medical professionals are re-examining their approach to treating patients who are in pain our guest today will talk about pain management options that provide relief without the possible consequences of addiction dr. Adel Huck is an ABMS board-certified fellowship trained pain medicine specialist on the medical staff of Texas Health Presbyterian Hospital Plano he'll talk about some pain treatment alternatives that rely less on the medications and follow a more holistic approach to pain management doctor thanks for being with us again my pleasure doctor last week we talked about opioids and the negative consequences following up on our conversation now if opioids are causing such a problem why don't you just cut back on the number of opioids that doctors prescribe because a lot of people think that way am i right or am I wrong tell me what's going on there well opioids are being overprescribed no question about it not only are they being overprescribed but they are being mis prescribed they are being used for indication that they really should not be used for hence this is what led us to the current opioid epidemic now when we talk about just cutting down opioids for people with pain that's one way to do it but you're not addressing the issue patients are still suffering from pain a lot of these patients have been on opioids for years to be very frank it is not humane to just get them off they're gonna go into withdrawals which truly is an emergency so there has to be a methodical stepwise approach on how we address this how do you do that so if I see a patient who's been on any opioid out there 10 12 pills a day you may think that's an unrealistic number but trust me we see this on a daily basis first of all nobody should be taking 1012 pain pills a day however if they come to our clinic what my approach is I talk to them education is where it starts these medications have a negative effect from head-to-toe it can affect your immune system it affects your endocrine your hormone system it affects the neurological system all this data is out there we know that these medications long term have a negative effect so once we are done educating the patient you have to do what is medically right so the approach we employ to wean somebody down is basically take them down 25 to 35 percent of their current regimen over two weeks then you go down another 25 35 percent for a couple of weeks till they come down to something that is more manageable if someone wants to avoid opioid medication just totally avoid it to treat chronic pain what are some recommended alternatives if I have a patient who does not want to be in opioids I am totally fine by that so once again the alternatives to opioids will depend on what the pain issue is one of the most common pain issues that any adult will experience is neck or back pain so if we get a patient with the neck or back I mean the first thing we do besides getting a good history physical examination is to find out why they're hurting is that a mechanical issue is it a structural issue so they need to have some imaging done we can do that over here once we get the imaging done we'll discuss that with the patient depending on what it shows we can offer a number of therapies most commonly when you're talking your run-of-the-mill neck pain back pain issues treatment starts with medications such as tylenol advil motrin and then you offer physical therapy aqua therapy or even chiropractic use we do this for three to four weeks and then we'll reassess the patient let me just back up for a second if the patient is having neck pain back pain with what we call some red flags such as if they have an arm or leg weakness if they have bowel or bladder changes that may be a true emergency well we can take care of that here as well because we have direct access to a neurosurgeon on staff here so to answer your question if they don't want to be on opioids we prefer that that's the way to treat pain nowadays and it just depends on what the pain issue is and why they're hurting doctor I've heard of some very effective pain management options out there including some that rely less on medication what are some of these comprehensive pain management plans and what do they consist of so generally speaking when we get patients at our facility complaining of chronic pain we really do a complete a-to-z evaluation obviously we do imaging studies we may do some other studies to diagnose why somebody's hurting but more than that we want to look at their lifestyle because a lot of times lifestyle modifications gonna address chronic pain as well simply speaking somebody if they can lose 10 15 20 pounds that goes a long way we have a dietician on staff who can offer some dietary suggestions we employ physical therapy aqua therapy chiropractor on site to determine how to tackle the chronic pain one other thing that I want to highlight our philosophy our approach at Texas Health pain relief and wellness center is focused on the individual patient we have talked about journal guidelines on how to address pain in a generic setting but it really starts with the individual patient it really starts by talking to them we try our best to tailor a custom plan for that specific patient to avoid patients from going to multiple offices for various services at Texas Health pain relief and wellness center we have assembled essentially a one-stop shop you can come in you can get your medical evaluation by me a pain medicine physician you can have follow-ups with our nurse practitioner you can see physical therapy chiropractic services aqua therapy potentially speak to a dietitian in the same setting at the same place yes what about people with mental or behavioral health issues what can they do I'm so glad you asked that question we have found that almost majority of the patients who are suffering from chronic pain also have coexisting mental and behavioral health issues so at the Texas Health pain relief and wellness center we also have access to psychologists to psychiatrist therapists to address that piece of the puzzle as well and that's a big piece oh absolutely doctor there are kinds of pain back pain though probably the most widespread about 80 percent from what I understand of the people will have some kind of back pain at some point in their lives a lot of them will take ibuprofen and they'll take tylenol they'll get one of those roll-on things you know that you can roll on your back but they'll get a heating pad they'll they might try something else and that may work for a few weeks or a few days when that doesn't work though they need to come to see a professional right absolutely we all experience back aches neck pain issues there is absolutely nothing wrong in trying to take care of this at home in the initial phase in the acute phase as long as there's no contraindications one can try Thailand or nonsteroidals such as ad will maybe apply some heat therapy a heating pad do some home stretches there's a high probability that your back pain will get better with these conservative measures however if it lasts longer than two or three weeks my advice is to seek a professional opinion evaluation ruled out something more serious are you seeing any changes within health systems to offer alternatives like you are doing here to pain relief to get away from the opioids absolutely generally speaking physicians health systems health facilities have realized that opioids are not the long-term solution they're actually the problem overuse excessive use has led us to where we are at texas health pain relief in wellness center we offer many alternatives such as physical therapy aqua therapy lifestyle modifications addressing somebody's behavioral mental health issues in addition to that we can also offer interventions if somebody is having back pain that goes into their leg something that we call refer as sciatica or if somebody is having neck pain and the pain goes down their arm this is due to a pinched nerve now we can give somebody a pain pill to take care of that very temporarily ignoring all the risks associated with opioids or we can try to do injection therapy and try to cool down the nerve if we can cool down the nerve reduce the inflammation reduce the irritation by doing injections the patient should feel some relief as well so there is definitely a change in approach to chronic pain and opioids are less and less a component in it obviously a doctor plays a huge role in helping a patient manage his or her pain but it's important that physicians and other clinicians work together like what you do here at Texas Health pain relief and wellness center in Plano so just like anything in life teamwork is very important and that's exactly what we employ here we approach each patient with an individualized care plan in a very collaborative manner if the patient needs to see a pain physician and a neurosurgeon there's constant communication both specialties know what's going on with the patient not only that our Center will help expedite a follow-up appointment and the entire team under the Texas health pain relief and Wellness Center will know what's going on with the patient this truly is catered towards the patient care that will do it for today I'd like to thank dr. Huck for joining us two weeks now two podcasts thank you sir we appreciate it Texas Health is partnering with you for a better North Texas to hear more wellbeing DFW podcasts visit our website Texas Health or ghast I'm Scott sands thanks for being with us

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