Don Counihan, Jr., D.C., a board certified chiropractor, has over 20 years of experience working with patients suffering from pain. In 2007, he joined a group of like-minded physicians who wanted to create a better way to help patients manage chronic pain.
The traditional method of evaluating pain relies upon the use of a subjective numerical pain scale: from 0 to 10, how bad is the pain? This method doesn’t just lack validity and objectivity; it lacks, at a very basic level, any meaning whatsoever. We all experience pain differently—dull, sharp, numbness, tingling, burning, etc.—and pain thresholds, which already vary, can be affected by our emotional and psychological state.
Objective tools and interdisciplinary approaches are being combined to provide better and more realistic care for individuals suffering from chronic pain. Boston PainCare Center and its director of physical assessment, Dr. Counihan, are part of the vanguard of this research and methodology.
"Our comprehensive interdisciplinary pain care center focuses on functional rehabilitation and quality of life for people whose lives have been altered from living with chronic pain," says Counihan. "Patients who come to us have already been through treatment plans aimed at alleviating pain, and nothing has worked. Therefore, pain reduction is not our primary goal. We developed a comprehensive and interdisciplinary treatment plan geared towards improving quality of life to the highest level it can be."
The experts at Boston PainCare Center include a pain specialist, neurologist, pulmonologist, chiropractor, physical therapist, psychologist, internist, nurse practitioner, clinical social worker, and many more. And in a truly interdisciplinary approach, each of these specialists has a role in the treatment of each patient. In fact, treatment plans are not developed by a single doctor, but by a team of doctors.
"Doctors only see with the eyes of their training," says Counihan. "When they come together as a team, the ego is pushed aside. All of their opinions are valid, and one doesn't trump the other. This team approach helps eliminate medical bias, and the patient gets the best care."
Along with the interdisciplinary approach, Boston PainCare Center also provides each patient with a comprehensive evaluation. At the initial visit, each patient receives a traditional medical evaluation, a psychological evaluation by the appropriate professional, and an objective measurement of the patient’s physical ability using JTECH Medical's instruments and software.
"Our three-stage comprehensive evaluation provides us with an overview of the patient's physical abilities and any emotional or psychological barriers that may have arisen from living with chronic pain," says Counihan.
Primary care physicians tend to evaluate pain based upon a single data point: the aforementioned numerical pain scale. With this one data point in hand, primary care physicians tend to refer their patients to a traditional pain center, where the patient is only treated for their pain. Yet, at this point, chronic pain already implies past attempts at alleviating that have not worked. And if the patient doesn't respond, they tend to leave the pain center feeling like a failure. Boston PainCare Center's initial evaluation results in over 50 data points that provide a foundation for treatment and which actually show the patient that the exam is different.
"The objective measurements help the patient overcome some of their skepticism about further treatment," Counihan says. "We have large screens in each of our exam rooms, and using JTECH's software and instruments, we can actually show them that the pain isn't just in their head: they see their strength deficit, any lingering injuries, and as treatment progresses, results. JTECH's objective tools are an integral part of our philosophy and foundation, and they provide a gateway for the patient to a new type of pain treatment."
This approach sets the Boston PainCare Center apart. Even amongst pain centers that utilize an interdisciplinary approach, the objective testing and focus on a patient's functional capabilities is not at the same level.
"Though pain is in our name, it is actually not our priority," says Counihan. "Our hierarchy of goals starts with a restoration of functionality. In fact, this is so important, we should probably call ourselves a 'function clinic.' Second on our list is improving quality of life. And third is the reduction of pain."
Though this hierarchy is not popular with patients, it is in their best interests. If a patient's pain is impacting their ability to perform daily functions, their quality of life is dramatically affected. And if this pain is chronic, then these two areas are the most realistic areas on which to focus a treatment plan.
"If pain centers focus on pain at the expense of function, then they will miss out on the possibility to treat the patient," says Counihan. "Chronic pain is, by definition, incurable. The patient needs to learn to manage the disease because that is what chronic pain is."
While the interdisciplinary and objective approach ensures the best treatment, Dr. Counihan attributes the success of his center to the people.
"What makes Boston PainCare Center unique are the right people. They are empathetic, outgoing, and resilient. Our clients can be emotionally draining: they are worn down, unhappy, and most of all, they are in pain. To succeed at our center, you have to be able to have fun at work, and have a passion for helping people."
To learn more about Boston PainCare Center and Dr. Counihan, please visit www.bostonpaincare.com.