By the time patients see Dr. Kevin Shute for the first time, they’ve been in pain for a while.

Dr. Kevin Shute

Shute is an anesthesiologist who specializes in pain management at Novant Health Pain Management Clinic – Thomasville. When a patient’s physical pain is moderate to severe, and has turned chronic – present for three months or longer – they’re referred by their primary doctor to a pain management physician.

That’s where Shute comes in.

Chronic pain affects thousands of people every year and is one of the leading causes of missed work. Long-term pain also can lead to fatigue, depression, anxiety, frustration or poor sleep.

Pain can affect every region of your body, and, initially, a patient’s primary care physician determines the strategy to alleviate the discomfort. Or, a patient may self-treat with over-the-counter medications if the pain is mild and chronic (for instance, arthritis). But what if the pain remains severe and lingers? What signals that it’s time to see a pain specialist?

“If it is not going away to the point that it’s interfering with your activities, daily living and your livelihood,” Shute said.

Shute said he sees more patients with chronic low-back pain than any other, followed by neck, knees and hips.

How your pain is treated

Novant Health’s ongoing efforts include a focus on safely and appropriately prescribing opioids for pain management, as well as offering alternative therapies. Several beneficial treatments can serve as alternatives to opioids. These approaches include physical therapy with exercises, over-the-counter medication options, mindfulness-based strategies like yoga and meditation, and therapy.

In the mid-1990s, some in the medical profession took a unilateral approach to treating pain by prescribing opioids. It resulted in doctors overprescribing and a nationwide opioid crisis developing a few years later. Novant Health providers are committed to protecting patients from opioid misuse.

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“I may have a patient on pain pills from four different classes of medications, that all treat pain somewhat differently, and none are opioid medications,” Shute said. “We know there are multiple pathways within the brain and spinal cord and even within the peripheral nerves, that pain travels, and we can target each one of those pathways with different classes of medications.”

Patients battling pain can take different treatment paths. For instance, if pain is in a weight-bearing point (hip, knee or foot), it’s often caused by being overweight, which also makes surgery riskier. Shute will design a plan for the patient to lose weight, enlisting the help of bariatric specialists.

“We talk very openly with patients about weight loss in a very supportive way, not being offensive or dismissive,” he said. “We go step by step to make slow and steady changes in your diet.”

Taking several approaches to relief

Shute said the pain management clinic benefits by being part of a larger multispecialty medical group at Novant Health. That means patients can receive involvement and support – depending on their treatment – from physical therapists, occupational therapists, psychiatrists, psychologists, surgeons, nutritionists and geriatric specialists.

“We absolutely take what is referred to as a ‘multimodal approach’ to treating chronic pain,” he said.

Some patients deal with chronic pain in several parts of their body simultaneously. A treatment for them could involve, for example, a mix of medication, lifestyle modification (diet, exercise), dry needle insertions and other methods, Shute said.

“We offer a wide range of therapies to not only identify the cause of your pain but also minimize its effects,” Shute said.