The Changing Face of Interventional Medicine - The University Of ...

Medical Advancements atThe University of Kansas HospitalInterventional Rehabilitation Medicine:The New Face of Pain ManagementRaj Mitra, MD, Chair, Rehabilitation Medicine9An accurate diagnosis, efficiencyand continuity of care – that’s whatinterventional pain managementbrings to the field of physicalmedicine and rehabilitation.Traditionally, physical medicineand rehabilitation enter into patientcare following a surgical procedure.Interventional rehabilitation medicinespecialists at The University of KansasHospital are evolving our approachto rehabilitation to benefit patientsacross the spectrum of disease. Indoing so, we have developed the largestinterventional rehabilitation programin the region. As we continue to growthis subspecialty, we are positionedto serve as a resource for the medicalcommunity and patients throughout theregion, especially those with complexhealth issues.Across the spectrum of diseaseInterventional rehabilitation medicineis helping a diverse patient population,from recreational athletes with sportsinjuries to cancer patients sufferingwith swallowing and chewing difficulty.Regardless of the health concern, theapproach is the same. By focusing oncollaboration, accurate diagnosis andreasonable, conservative care, we offertreatment that helps patients findrelief or improved function throughminimally invasive options. It is anin-depth approach taking into accountphysical exams, imaging and labstudies. and multiple viewpoints fromspecialists to determine treatment.We use this approach not merely forthe sake of using an intervention, butalways to serve the patient and, whereappropriate, to break the cycle ofrecurring pain and future treatments.Interventions may include:• Medication management• Customized physical therapy fromtherapists specializing in spine care• Pain management injections• Interventions using fluoroscopy• Alternative medicines andtherapies, such as acupuncture,aquatic therapy, alternative painmanagement and transcutaneouselectrical nerve stimulation, orTENS.For example, adhesive capsulitis maybe treated surgically which includesrecuperation and rehabilitation.Alternatively, an interventional shoulderprotocol provides an effective option.A suprascapular nerve block is followedby an injection of an intra-articularsteroid and an injection of an anestheticagent with brisement normal salinevolume dilation. The shoulder is thenmanipulated to break adhesions.Patients quickly experience improvedshoulder abduction and flexion and asignificant improvement of motion.Comprehensive careThe Marc A. Asher, MD,Comprehensive Spine Center providesa range of patient care and facilitiesunequaled in the region and rarely seenacross the nation. Here, specialists fromorthopedics, neurosurgery, physicalmedicine and rehabilitation, speech andphysical therapy and anesthesia worktogether under one roof providing acomprehensive perspective on spinalcare. The University of Kansas Hospitalhas the only fellowship for spine andpain interventions in the region.From joint injections to cyst aspirationsto epidural injections to radiofrequencyneurotomy, interventional rehabilitationspecialists rely upon a range of toolsto disrupt pain signals, improvemovement, and help patients avoid therisks of both surgery and medications.In our women’s health program,interventionalists from rehabilitation,radiology, neurology, orthopedics andanesthesia work together to restoreInterventional case studyA female patient presented atThe University of Kansas Hospitalsuffering chronic pelvic pain. Afteran MRI, the interventional teamdiscovered the veins in the pelviswere dilated and diagnosed pelviccongestive syndrome. Working withradiology, the team embolized theseveins and, for the first time in 12years, the patient is pain free, can sitand participate in physical therapythat was previously too painful.KUMedInnovationsSummer2013_X.indd 96/13/13 10:09 AM