About the Expert
About the ExpertDr. Mahesh Mohan has practiced medicine in the fields of spine and joint pain and improving function for over two decades. He is a triple board-certified pain doctor. He completed his pain medicine fellowship at Case Western University and his physical medicine and rehabilitation residency training at Washington University. Dr. Mohan has worked as an orthopedic surgeon at prestigious hospitals in India for nearly a decade.
Q&A
How has the field of pain management evolved?
We have a much better understanding of how to treat pain. Some of the main advancements we now use to treat chronic pain are interventional. There is more data in support of advanced treatment options like spinal cord stimulators and radiofrequency ablations.
Another change is regarding opiates. Opioids are necessary at times but should be used with supervision from a pain management expert. Pain management experts can isolate a patient’s problem, find the root cause, and determine the treatment with other modalities for a better outcome.
Are interventional procedures a first step before surgery?
Surgery is perhaps needed for pain management 1 in 25 times. In the late 90s and early 2000s, there was a tendency to do spinal fusions or other surgical procedures. Now, there is much more focus on interventional procedures. I treat patients’ pain with improving core strength, physical therapy prescriptions, epidurals, neuro blocks and radiofrequency ablation. I also treat patients with spinal cord stimulation and spinal cord implants. Our clinic works with all area hospitals.
How do you determine a treatment plan?
We treat a range of patients, from younger adults who may have had a sports injury to older adults with arthritis. My biggest tool is a comprehensive evaluation before beginning any type of treatment. I consider family history, their medical history, a physical examination, and how long they have been having their pain.
Sometimes MRIs or X-rays are necessary to find out the origins of their pain. Is it spinal stenosis? Is it arthritis? Narrowing that down is one of the biggest challenges. I’ve seen patients who have been in pain for 10 years, and they may have a mix of pain issues, from arthritis or surgeries or scar-tissue pain. Other patients cannot move because of their pain. We work with many patients who are going through physical therapy, and we are a part of getting them on their feet again.
Injections or epidurals are typically a 10-minute procedure which brings down swelling and promotes healing. These injections can relieve pain anywhere from 1-6 months. Every patient is different, and that’s why we spend a great deal of time with them to determine their treatment plan.
Many people are fearful of getting help for their pain. What advice would you give someone about getting treatment?
I understand patients may have had negative experiences. My staff and I take the time to really listen. We have the latest technology and the least invasive ways in which to treat pain. If needed, we can add sedation to procedures. Preconceived notions regarding needles to their back or neck — we understand their hesitations.
We give our patients options, flexibility, and customization. We’re very patient-centric. Our clinic is different in that respect. We don’t adhere to rigid protocols. We are open on Saturdays, and we work with their insurance plans. I have to earn my patients’ trust. It is an awesome experience when I can help someone with their pain. It is life-changing for them.
