When headaches take over your life, it can be impossible to function. For close to two years, Jennifer Sotomayor’s headaches prevented her from working, sleeping and doing much of anything. The source of the problem was her cervical spine, something she learned at the Emerson Spine Program, thanks to a careful, thorough evaluation that was followed by successful treatment. The Billerica resident, 31, says life is good again.
By June 2015, Ms. Sotomayor’s condition was getting worse. “My headaches were waking me up at least six times a night,” she recalls. “I was sleep-deprived, had no energy and was in too much pain to do anything. The pain got so bad that I went to the hospital a few times.”
Ms. Sotomayor (pictured at right) previously had fallen down the stairs, hurting her back and suffering a concussion. She was subsequently told she had fibromyalgia, but she doubted that was the case. “I read that you need to rule out several other conditions before diagnosing someone with fibromyalgia,” she says.
She was impressed with Arthur Lee, DO, chief of physical medicine and rehabilitation at the Emerson Spine Program, when she went for her appointment last summer. “After Dr. Lee examined me, listened to my medical history and looked at my MRI, we talked about my neck and shoulder pain. Then he said ‘I don’t think this is fibromyalgia.’”
“As physiatrists, we consider a patient’s symptoms from the spine point of view,” Dr. Lee explains. “I drew the link between Jennifer’s neck pain and headaches. From examining her and studying her MRI, it appeared that the facet joints in her neck were causing her headaches.”
He prescribed a brief course of precisely targeted therapeutic spinal injections in her neck, performed with imaging guidance, to bring down the longstanding inflammation and decrease her pain. “My headaches improved by 80 percent,” says Ms. Sotomayor. “Before, my head felt too heavy for my neck. But now I feel stronger, have energy and sleep through the night.” Dr. Lee also determined that her lower back was stiff, so a few weeks later he gave Ms. Sotomayor a therapeutic injection in her sacroiliac joint. And he determined that her shoulder required surgical repair, for which he made a referral. She had surgery in January.
Physiatry care: careful evaluation and conservative treatment
Ms. Sotomayor benefited from Dr. Lee’s careful, thorough assessment. This is the hallmark of physiatry care, which he and James Spinelli, DO, provide at the Emerson Spine Program, which includes Robert Whitmore, MD, a neurosurgeon. Physiatrists specialize in providing conservative (non-surgical) treatment to individuals with back pain. “The vast majority of patients with back pain respond to non-steroidal anti-inflammatory medication, a therapeutic pain injection or some form of exercise or physical therapy,” says Dr. Lee.
“Most patients who come to us in pain, even with a disc herniation, will get better on their own,” notes Dr. Spinelli. “Exercise is an important cornerstone of treating back pain. In some cases, it is all a patient needs. It often doesn’t matter what kind of exercise they do, as long as there is extension of their lumbar spine.” The program’s physicians often send patients to Emerson’s Center for Rehabilitative and Sports Therapies.
In some cases, a spinal therapeutic injection will provide sufficient pain relief to allow an individual to get moving again and, importantly, exercising. Drs. Lee and Spinelli say they have a track record of easing the anxiety of those who fear having a needle placed into their spine. “We use education and models and do demonstrations, which is reassuring to patients,” says Dr. Lee. “And we know how to relax people. We’re able to put 99 percent of anxious patients at ease.”
Dr. Spinelli says he works with patients who are nervous about having an injection. “I ask the patient whether or not they want to be made aware of each step in the process,” he says. “Some people want to know what’s going on, while others prefer to zone out. We offer mild oral sedation if someone is anxious.”
After treatment, life is good
After recovering from her shoulder surgery, Ms. Sotomayor had a second injection in her sacroiliac joint. She was glad when her treatment was over. “I’ll take short-term pain in order to get rid of chronic pain,” she says. “Today, I can go to the park with my boyfriend and my dog; I couldn’t do that before. I can clean the apartment, and I make a list of things I need to do each day — and get them done. Next I’ll go back to work; I’m getting excited about that.” Ms. Sotomayor formerly was employed as a health care outreach worker.
“Before I met Dr. Lee, I was hopeless,” she says. “Other doctors just looked at one symptom, and I never received the correct diagnosis. You could say that Dr. Lee didn’t look at the tree, he looked at the whole forest.”
Ms. Sotomayor stands out as having a complex case. But in the hands of an experienced, insightful physiatrist, she finally received the treatment that eluded her for two years. “I’m glad to see how Jennifer has regained her health,” says Dr. Lee. “She’s an intelligent, motivated patient who wanted to get her life back. I think she’ll continue to do well.”
For more information on the Emerson Spine Program, please call 978-287-3194.