Top Docs 2009: The Specialists
You need good medical care. How do you know who gives it? We asked the doctors who of their peers they’d trust enough to recommend to a loved one. Here are their picks.
(To download the complete list of 2009 Top Docs, go to page 6 and click on the link.)
Research assistance by Jonathan Gainey
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Pain Management | Rachael Smith, DO
Construction workers, teachers and police officers tend to walk, bend, stand for hours and lift heavy objects. That can hurt. But severe pain can be debilitating to anyone, no matter what they do for a living or their age. So you don’t need to do manual labor to need a pain management specialist such as Dr. Rachael Smith of Delaware Back Pain and Sports Rehabilitation Centers.
“People will try to ice conditions or buy over-the-counter medications,” says Smith. “But when things progress, they’ll go to a family doctor or an orthopedic specialist. When things still don’t get any better, they come to us.”
Many patients develop serious back and neck damage from lifting the wrong way. Have a desk job? A recent study by the Occupational Safety and Health Administration found that more than half of the workers who used computers at least 15 hours a week reported musculoskeletal problems in the first year of a new job. Attribute some of those injuries to non-ergonomic chairs, which can place uneven pressure on the vertebrae and disks of the lower back.
The field of pain management is as broad as it sounds. “We manage various muscular and skeletal issues, as well as athletic and shoulder injuries, tendonitis or carpal tunnel syndrome,” says Smith. “We also find ways to prevent surgery or guide patients to a surgeon when appropriate.”
Pain can often be managed without surgery. Smith specializes in spinal injections, or shots of anesthetic in various areas of the spine to control pain elsewhere in the body. The shots have existed for decades, but “the way we’re doing them has changed,” Smith says. “Since more people are learning that this is one of the best ways to treat back pain, the training is more focused in this direction.”
Smith takes a multi-disciplinary, individualized approach. “We could develop a good rehabilitation program, arrange for chiropractic help or do various tests,” she says. “Medications are prescribed, and injections are done when necessary, but we treat the whole person and get them better based on evidence and guidelines.”
Can anyone be completely pain free? No one can say. But Smith’s goal is to get patients “to a place where they’re not hurting.”
The common complaints In order: back and neck pain, sciatic problems, and knee and shoulder pain.
Doctor’s orders Exercise regularly, eat right and stay at a good weight. “We know that being overweight can aggravate back and knee conditions,” says Smith. “Flexibility and stretching exercises prescribed by specialists can alleviate arthritic conditions, too.”