Battling chronic and sometimes inexplicable pain is something we all want to avoid. In the event of dealing with this challenge, however, we would all prefer to be in the care of a doctor passionate about helping patients navigate and heal from chronic pain. Thankfully, there are many exemplary members of the medical community who are seeking to do just that.
Chronic pain management is a specialization that requires dedication, compassion and adaptability to perfect, which explains Dr. Praveen Mambalam best.
Dr. Mambalam grew up in an environment with many physicians and knew from an early age he wanted to help people as a doctor as well. He initially specialized in anesthesiology, which later gave him a better understanding of the effects of opioid use in chronic pain management. Throughout his medical school years, he made several specialization changes before realizing that working in pain management was what he wanted to do.
“Ten times over, I would choose the same route to get to the same ending because chronic pain is my passion,” Dr. Mambalam said.
His passion for communicating and working with patients to formulate the best care plans led Dr. Mambalam to become fundamental to the shift in pain management towards open communication with patients and holistic health plans. Dr. Mambalam likens his approach to medicine to a quarterback working with his team to develop the best game plan.
The Quarterback with a Plan
Approaching a patient’s pain history and prior treatments like a jigsaw puzzle has helped Dr. Mambalam creatively determine the best course of action. He says each patient’s unique care plan is “like a thousand-piece jigsaw puzzle: it’s going to start differently every time putting together fragments, but ends with a big picture.” This analogy has fed into his view of his job as “quarterback for pain” management. He analyzes each patient’s distinctive problem and past treatments and therapies, and develops a game plan to tackle it. Dr. Mambalam notes he typically needs about three to six months to formulate and develop an optimal game plan for his patients to follow.
Part of being the quarterback is requiring and facilitating communication between each member of the patient’s care team. This goal has revealed the unique need for a multidisciplinary approach to pain management.
“Multidisciplinary pain management is the name of the game,” according to Dr. Mambalam.
This approach includes a more holistic view of healing patients and even considers their mental fortitude, as well as their physical health. Dr. Mambalam observed that employing psychiatrists to help patients communicate and cope has been a useful development in the field.
Discovering new ways to tackle the problem of pain in different patients has led pain management specialists to move away from the need to prescribing opioids with advancements in interventional therapies.
“There’s a lot more regulation on opioid prescribing even for pain management physicians in the setting of long term pain management,” Dr. Mambalam noted.
The advancements in interventions and increased regulation on opioids has led to a paradigm shift in the field of pain management.
The Shift in Pain Management
Dr. Mambalam said he has been working in chronic pain management while going through this fundamental shift. Developing new ways of examining pain conditions is a big part of the multidisciplinary advancement in the field. He involves himself in this advancement process by constantly participating in ongoing research that involves new procedures and investigating new and safer medications. Staying up-to-date on current therapies and how and why they work is another important part of the multidisciplinary approach.
Chronic pain management is also shifting its methodology on how to measure pain. Traditionally pain is measured by asking the patient to score their experience of pain. However, this can often be subjective and inconsistent.
“Pain specialists are now focusing on more functional measures such to study pain and pain treatments,” Dr. Mambalam said. “We’re restructuring their whole thought process for doctors and patients.”
Advances are focusing less on medications and more on patient-controlled devices that can measure function. Neuromodulation is a developing field within pain management that focuses on therapies that modulate the nervous system’s perception of pain. This, alongside multidisciplinary approaches, help patients neurologically restructure how they think, react and function with pain.
“If the patient has the opportunity to control their pain at home in a safe manner, that is actually quite powerful and useful and effective at managing pain,” he said.
Being autonomous with chronic pain management allows doctors to tackle the problem of chronic pain through a variety of different disciplines. This way, doctors can step away from the conventional pain management route of prescribing opioids and consider alternatives that work for each unique patient; additionally, the continuing shift in the pain management discipline aids doctors by providing flexible options for care.
“I Believe You, and I Want to Help”
Relating to and communicating with patients is a big part of Dr. Mambalam’s practice. He encourages his peers to be “patient with our patients” because he knows a good rapport with patients goes a long way in formulating and executing the best care plan. Having good relationships with patients gives doctors the ability to understand each unique case better.
This approach requires compassion and communication, which are fundamental and admirable aspects of the medical community that doctors like Dr. Mambalam live out daily.
Being understanding and open to communication is a two-way street. It’s vital to convince patients to work with their doctors and follow their “quarterback’s” game plan. The multidisciplinary approach to pain medication gives specialists new ways to tackle chronic pain and develop new and improved treatments, exercises, and medications.
The shift in chronic pain management to being more balanced and considering alternatives to opioid prescriptions is made possible through dedicated and passionate doctors like Dr. Mambalam. He firmly believes the future is bright for patients living with difficult chronic painful conditions!