Episode 3: Today, Dr. Jason Lewis, Medical Director at Kentucky Pain Associates joins us to discuss various pain management issues, including opioid treatment, risks and the safeguards KPA has put in place to protect its patients.
Dr. Lewis grew up in Kentucky. He went to college in Colorado and returned to attend the medical school at the University of Louisville. He focused on anesthesiology and pain management. He later completed a fellowship, in Vermont, in pain management. He’s board-certified in anesthesia and also board-certified in pain management.
As we discussed in Episode 1, with Kurt Reibling, Kentucky law requires a pain management practice to now be owned by a physician and have a board-certified pain management physician on staff.
Medically Speaking, What Is Pain Management?
There are numerous, medical aspects of Pain Management. In broad terms, pain management is a branch of medicine helping people to live with pain and to improve their quality of life. KPA treats patients typically injured in car accidents, motorcycle accidents and workplace injuries.
Pain is classified in two categories. Acute pain lasts from 1-90 days. It’s usually caused by some type of trauma, including post-operative pain. Chronic pain is defined as pain lasting beyond 90 days.
Interventional Pain Management
This is a method of pain management involving injection therapies. Commonly people think about epidurals or cortisone injections. Actually, there’s much more to this area. Other options include radio frequency ablation, neuromodulation, pain pumps, etc.
Physiatry
This is the practice of physical medicine and rehab. This is a different specialty and practitioners are part of pain management, but the approach is different from anesthesiology.
Doctor Lewis goes on to describe various factors related to pain and the various classifications/categories.
Getting Evaluated for Pain Management at KPA
During your first visit to KPA, the staff will perform an extensive evaluation to document and assign the proper classification of your pain, its location(s), the timeline involved and many other issues. This helps the medial staff to determine the proper treatment options to discuss with the individual. It’s a very customized approach, based on the needs of that specific person.
In Episode 2, we had a very comprehensive discussion of KPA’s new diagnostic capability for detecting brain injuries. Dr. Lewis explains how traumatic brain injury has often been undiagnosed or underdiagnosed. It’s actually fairly common for anyone who’s experienced an automobile accident.
The Pain Management Treatment Continuum
KPA takes a conservative approach to pain management. Dr. Lewis explains how going directly into surgery may be overly aggressive. In many cases, surgery should be treated as the last resort. There are other treatments that may successfully treat the condition.
Physical Therapy or Chiropractic Care can be useful, especially in the case of an automobile collision. Other options could include massage therapy and acupuncture. There are every-day activities such as getting good sleep, good nutrition, avoiding alcohol and tobacco. Stress management is also helpful.
Medications for Pain
These are made up of opioid medications and non-opioid mediations, such as anti-inflammatories. You might have the option of muscle relaxants or neuropathic medication and other. You and your physician should monitor these closely to ensure your safety.
Interventional Options
The next step in the treatment continuum include the interventional pain management options. As we previously discussed, this includes injections, nerve blocks, epidural steroid injections, spinal cord stimulations, radio frequency ablations.
The final step in the continuum is surgery.
Spinal Cord Stimulation
This is an advanced type of procedure. KPA performs a lot of these. You may be familiar with a pacemaker. The spinal cord stimulator is very similar. It consists of a battery pack and wires. The wires are inserted into the patient’s back. The stimulator cancels out or disrupts the pain signals from your back or legs. It changes the patient’s perception of pain.
This procedure can work for people who have already had back surgery. Those experiencing residual pain or neuropathy, CPRS, phantom-limb syndrome, spinal cord injuries, etc.
A spinal cord stimulator can last between 5 and 10 years. It depends upon the frequency of use and the battery life. If it runs out of battery power, it can be easily replaced during outpatient surgery.
DRG Stimulation
This refers to dorsal root ganglion stimulation affects a nerve bundle that functions as the gateway from the nerves in your legs to your central nervous system. It’s a specific kind of spinal cord stimulation.
Regenerative Medicine for Pain Management
The research and development of regenerative medicine for pain management is growing. Dr. Lewis explains that it harnesses the body’s natural ability to heal. Cells are extracted from the body and then injected directly into the area experiencing pain. It can reduce inflammation and help to regenerate damaged tissue.
Common situations for regenerative medicine include sports injuries, orthopedic procedures and with motor vehicle accidents.
Opioid Treatment for Pain Management
No discussion of the medical aspects of pain management would be complete without addressing this issue. While opioids have become a hot topic, especially due to the risks and illegal use, opioid treatment for pain management can be extremely effective. Opiates have been around for centuries. In the 1930s methadone was invented. Bayer laboratories later invented heroin. Most recently, federal and state governments began aggressively regulating the prescription and use of opioids.
As a result, there are now many rules regarding monitoring and compliance. These safeguards are an integral part of opioid-related treatment. KPA focuses on these safeguards to ensure there’s a medical necessity for opioid treatment. As the Medical Director, Doctor Lewis does a lot of training with the KPA medical staff and the patient.
Kentucky Pain Associates takes a very conservative approach to treating its patients. This also applies to the dosing of the opioid medications. Again, Dr. Lewis is board-certified in pain management and fully understands how these medications function, when/how they should be prescribed and how to safely manage the risks associated with this family of drugs. KPA maintains a high-level of communication and monitoring of patients using opioid medication for the treatment of pain. In the proper environment, these medications can have a very positive impact on an injured individual’s quality of life.
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Want to Set Up an Appointment with Kentucky Pain Associates?
We offer 3 locations to serve you:
LOUISVILLE: 222 South 1st Street, Suite 300, Louisville, KY 40202
ELIZABETHTOWN: 1107 Crowne Point Dr., Suite 100, Elizabethtown, KY 42701
LEXINGTON: 101 Prosperous Place, Suite 300, Lexington, KY 40509
Feel Free to Contact Us via the website or by calling (502) 855-3919. We also provide a telemedicine option (video call) for people outside of those areas.
Remember, work injury or MVA? Think KPA!
