A happy ending to the ‘story behind pain’

For more than 20 years, pain was an unwelcome presence in Stacy Collins’ life, intruding on her work, invading her sleep and throwing up barriers to activities she once enjoyed.

“My pain was a 12 on a scale of 10,” she recalled. “I had almost given up hope that I would ever be free of it.”

Her neurologist referred her to ChristianaCare’s Comprehensive Pain Center, which takes a holistic, multidisciplinary approach to managing pain. The goal is to get to the root cause of the pain and treat it rather than mask symptoms with medications. Since the center opened in June, it has utilized opioid-sparing techniques to improve overall patient wellbeing and functional outcomes.

Collins and her pain specialist, Raj Maniam, M.D., had an in-depth, hour-long conversation about her pain. How was it impacting her life? And what were her treatment goals?

“There’s a story behind chronic pain and we take the time to hear the whole story behind that pain,” he said. “Pain isn’t just an injury or illness. It’s multifactorial, involving nutrition, sleep hygiene, mental health, environmental influences and people you surround yourself with.”

At the Comprehensive Pain Center, the team includes interventional pain physicians, behavioral health specialists, integrative medicine physicians, pain psychiatry and a chronic pain-focused nutritionist. Services also include acupuncture and osteopathic manipulation which involves using manual techniques to alleviate myofascial pain.

Dr. Maniam reviewed all of Collins’ medical history, lab results, and prior therapeutic interventions to create a comprehensive treatment plan with her input. Based on that review and their conversation, he recommended the Chronic Pain Rehab Program, a novel specialized physical therapy program that is part of ChristianaCare Rehabilitation Services, which maintains a close, collaborative relationship with the Comprehensive Pain Center.

“When Dr. Maniam explained what my problem was and how physical therapy could help, it opened my eyes,” Collins said. “Finally, I understood what was wrong with me. I was so relieved, I cried.”

Collins began working several times a week with DeAndre Caldwell, DPT, ATC, Cert. MDT, TPS, Physical Therapy Program Manager and Therapeutic Pain Specialist at ChristianaCare Rehabilitation Services in Smyrna.

“He explained the treatment in a way that helped me to understand my body and my pain,” she said.

Caldwell says focused physical therapy is helping patients to make great strides in alleviating pain without medications.

“This is a different style of physical therapy, one on one, and based on what we hear from each individual patient about their pain,” he said. “These newer approaches are helping us to get better results, even in people who have tried physical therapy before.”

Collins, who was injured in auto accidents in the 1990s, had been hampered by chronic pain for years. The pain became unbearable when she tripped over a bicycle and hurt her neck. The 44-year-old mother of two could no longer do her job as a waitress. She couldn’t practice soccer with her younger son.

During her sessions with Caldwell, Collins learned further about how the nervous system was contributing to her pain and gained the motivation and confidence to do gentle exercises that were aimed specifically at improving her function and decreasing her pain. As her body started to feel better, she also started doing yoga.

She also learned to adjust her attitude toward pain. That reduced the stress that had been making her pain worse.

“Now, when I stub my toe, I turn it around and say ‘the pain is not going to last forever.’ Then I get back to a happy place,” she said.

Today, pain is no longer ruling her life. On bad days, she gauges her pain level at 4 and is confident she can manage that level of discomfort. She enjoys playing with her son. She continues to do the exercises she learned at physical therapy.

Her success embodies ChristianaCare’s values of excellence and love.

“The people I worked with are dedicated to their patients. They love their patients,” she said.

Caldwell says the personalized, multidisciplinary approach is improving outcomes for many people who feared they were out of options.

“Some people have been through multiple surgeries and some have been on opioids for years,” he said. “I have seen patients who can barely walk because of their pain flip and turn their lives around.”