The Pain Center of Arizona

A new approach to care, a cure for pain Steven M. Siwek, M.D.

For nearly eight years, Darlene Meyer, 74, suffered from trigeminal neuralgia, a disorder of the fifth cranial (trigeminal) nerve that causes episodes of intense, stabbing pain in the areas of the face where the branches of the nerve are distributed-in her case, under her left eye. The electronic-shock-like pain was appeased only through a host of medications. "I tried everything," she said. "The drugs worked for a while and then the pain would kick in again." Meyer doesn't know how she acquired it, doctors aren't entirely sure what causes it, and treatment options vary. Soon after diagnosis, Meyer found herself on a carousel of treatments. She tried seeing a neurologist, then an acupuncturist, a naturopathic doctor, a chiropractor, and another neurologist, and though they helped, the pain persisted. She opted out of surgery and tried Gamma Knife therapy instead, but the results weren't what she had hoped. Meyer just about gave up. "There were times I wanted to die," she says. "I didn't know where to turn."

Then she met Steven Siwek, M.D., Medical Director of The Pain Center of Arizona, and she says he was the light at the end of the tunnel. "He gave me my life back," she said. Dr. Siwek opened The Pain Center of Arizona in October 2002 with the intent of doing just what his patients claim… giving them back their "life." In Meyer's case, Dr. Siwek treated her with a series of trigeminal nerve injections over the course of a month and the pain dissipated. "He has done so much for me," Meyers said. "I can't even express the difference he has made."

Dr. Siwek is creating the model for the new standard of care in pain management by adopting a multidisciplinary approach to care. This new approach includes a networking of physical therapy, psychological counseling, surgical evaluation, and other forms of therapy while maintaining close contact with the primary care and referring physicians. Like Meyer, the millions of Americans who suffer from chronic pain have tried doctor after doctor in search of a treatment that will work, but more physicians and more medication are not the solution. "Going from specialists to specialist in search of a cure for the pain is a model that has been pretty well proven to be a failure," said Dr. Siwek.

In a typical scenario, the patient with chronic pain sees a pain doctor for a few injections, then is referred to a physical therapist for therapy, then maybe a chiropractor for manipulation, and what ends up happening is the patient goes around the carousel of therapies, which, quite often, end up going nowhere. "Instead of making several short stops along the road to relief, the patient needs one center, one physician or one group to manage the pain through a multi-modality approach," said Dr. Siwek.

A multi-modality approach is used at The Pain Center of Arizona where pain is managed by a combination of injections and therapy, a variety of medications and treatments and, if necessary, physical therapy and psychological counseling. Pain management is not resolved through a one-time shot and medication is only one of many strategies used to treat pain.

Dr. Siwek admits there is a flawed perception of pain management in the medical community, which is, "if it works, great, and if it doesn't, then the patient is out of luck." That is the perception of pain management he is trying to change. He is offering patients with chronic and even acute pain choices, solutions, and an end to the dizzying carousel ride.