YRMC – THE PATH TO MANAGING PAIN
Riding a horse … hiking a mountain … climbing a flight of stairs , chronic pain can restrict people from their favorite activities as well as their day-to-day routines .
Steven R . Galper , MD , Pain Medicine Physician , Psychiatrist and Neurologist at YRMC PhysicianCare , taps into this as he works with people experiencing chronic pain . Getting to know the patient and his or her journey is critical to addressing chronic pain , according to Dr . Galper . He draws on the advice of the founding father of modern medicine , Sir William Osler , who encouraged physicians to , “ Just listen to your patient ; he is telling you the diagnosis .”
During their first appointment , Dr . Galper listens as patients describe their pain , its cause and how it has been addressed in the past .
“ Pain management improves lives by giving structure to a treatment plan ,” said Dr . Galper . “ I ask new patients , ʻWhat is the pain stopping you from doing ? ʼ The patient could respond , ʻI want to ride my horses , but I canʼt tolerate it because sitting kills my back . ʼ Okay , letʼs get to work on that .”
Together , Dr . Galper and the patient identify an objective , functional goal that will assist in measuring progress . For example , returning to horseback riding three times a week , for one hour per ride , in six months . Dr . Galper also conducts a full neurologic physical examination . Many people who suffer from chronic pain have never undergone such an examination . Depending on what he learns from the neurologic exam , Dr . Galper may recommend blood work and magnetic resonance imaging ( MRI ) for the patient . With all of the information in hand , Dr . Galper collaborates with the patient – and his or her primary care provider – to create a comprehensive treatment plan . While they are individualized to each patient , all of Dr . Galperʼs care plans include three important components :
• Mind-Body Work – Cognitive behavior therapy – a short-term , goal-oriented psychotherapy treatment – takes a hands-on , practical approach to problem solving . The goal of cognitive behavior therapy is to change patterns of thinking or behavior that are behind an individualʼs difficulties .
• Movement – Building strength is important to managing pain . Depending on the patientʼs resources and other factors , Dr . Galper recommends physical therapy or provides exercises for patients to pursue on their own .
• Medicine – To address a patientʼs medical needs , Dr . Galper may prescribe a non-steroidal anti-inflammatory
for inflammation ; a neuropathic medication for nerve pain ; and a muscle relaxant for spasm prevention . Dr . Galper does not prescribe opiates as a first-line medication for patients with non-cancer pain . “ If you think about pain , it is biology , environment , nature and nurture ,” said Dr . Galper . “ You live at this intersection of whatʼs going on in peopleʼs bodies and whatʼs going on in their minds . Some pain starts in your body and some pain is caused by whatʼs happening to you emotionally . It feels the same , but the thing is emotional pain should not be treated with opiates .”
While this is a challenging fork in the road , it suits Dr . Galper and his multidisciplinary background as a board certified pain medicine physician , psychiatrist and neurologist . It also suits the many patients heʼs helped overcome chronic pain during his career .
“ Youʼve got to meet people where they are and work with them ,” he said . “ Because , their pain is very real .”
For an appointment with Dr . Galper , speak to your primary care provider or other physician . If you would like more information , contact Dr . Galperʼs office at ( 928 ) 445-1232 .
8 September 2017 pccnews