Ignoring back pain, even when it’s minor, could lead to something worse. After all, seeing a doctor for an evaluation does not imply that surgery is necessary, said Dr. James Deering, a pain doctor and anesthesiologist who joined Novant Health Spine Specialists - Ballantyne in August.
“Making an appointment in no way, shape or form commits someone to anything,” Deering said. “I view myself as an expert there to provide information about the options to help treat pain, and then let the patient guide the ship.”
Deering, an Air Force veteran, spent two months in 2017 operating on combatants in an Iraqi war zone. (See sidebar.) His passion for physiology and critical care was the vehicle for pursuing a career in Anesthesiology and treating interventional pain and spinal problems that don’t always require surgery.
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At Novant Health Spine Specialists - Ballantyne, minimally invasive options include X-ray-guided joint injections, ablations and nerve stimulations.
“It’s the full gamut of neuroscience under one roof,” Deering said. “By treating patients with chronic pain, I get to establish relationships with patients and follow them long-term, rather than having a quick hello and goodbye. That is very gratifying for me.”
You treat pain. What core issues are your focus?
Back and neck pain make up the core of the practice. That can include issues related to arthritis that affect the joints, degeneration in the discs, as well as other pain generators. Oftentimes pain is coming from nerves in the back or the neck, getting compressed by things like bulging discs and causing radiating symptoms.
What type of patients are you seeing most often?
We treat patients who have had back or neck surgery who continue to have those kinds of symptoms with pain. I see people in their early 20s with an acute issue, like a sports-related incident that have never had surgery before, all the way up to patients in their 90s who have had a myriad of surgeries and are struggling to perform normal daily activities and take care of themselves.
Do you find that people are hesitant to make an appointment because they worry their pain might require surgery?
People sometimes jump to that conclusion and I believe this is a common source of anxiety. I think that if you have a problem and it’s persisting, it can be informative and really give you peace of mind to have an answer to what’s going on. And oftentimes that answer falls far short of having to have any type of surgery.
So that means surgery is the last resort?
In many cases, Yes. And that’s where I fit into the picture. My goal is to keep folks out of the operating room as much as possible. I view myself as a bridge to help evaluate patients, get their pain under control and Avoid surgery when possible. If surgery is required, then my role is to assist with any residual pain that may persist after surgery is performed.
And would that be a similar situation with back pain, that it could be arthritis-related?
Arthritis is one of several possible pain sources in the back or neck. We try to treat this pain conservatively with physical therapy, diet modification and home exercise programs. If these methods do not work, we may consider targeting arthritic areas of the spine for a non-surgical, nerve ablation procedure.
What questions should patients be asking you?
The most pertinent question is, ‘What can I be doing day-to-day to improve the pain and my function long-term?’ Having a healthy lifestyle can go a long way in preventing chronic pain. Also, I think discussing an individual patient’s treatment expectations and establishing attainable goals is vital to long-term success.
On the battlefield
Following his residency at the University of Virginia, Deering served active duty for three years at Wright-Patterson Air Force Base in his home state of Ohio. It was during a deployment to the Middle East that he treated patients in Mosul, Iraq.
Deering’s mobile forward surgical team worked out of a tactical assembly area, stretching across an area about the size of a football field. The doctors treated few U.S. military personnel; most patients were coalition forces and local Iraqis fighting alongside them in their effort to drive ISIS out of northern Iraq
“I never left our small base,” he said. “The medics would do what they could in the field and then bring them back to us in the tent that served as our emergency room and operating room. The majority of the casualties were young Iraqi fighters who were not fortunate enough to have body armor or armored vehicles.
Deering treated gunshot wounds, burns, and amputations from explosive-device blasts, among other injuries. And there wasn’t much time.
“You have a golden hour to stabilize severely injured people before evacuating them to a higher echelon of care and before the outcomes become worse,” he said. “Our goal was to stabilize them, load them into an ambulance or a helicopter, and get them out of there as quickly as we could.”
