Dr. Neal Frauwirth: The pleasure of managing pain
by William Wright Lifestyles Editor
Nov 25, 2012 | 3746 views | 0 0 comments | 46 46 recommendations | email to a friend | print
Dr. Neal Frauwirth
Dr. Neal Frauwirth
When he was a child, Neal Frauwirth would go with his mom and watch her heal people with her hands. The idea of being able to ease and manage the pain of others had such a profound effect on the youngster that he grew up and learned the most advanced techniques for pain management in the modern era.

Today, Frauwirth, who trained at several world-class institutions in New York, including Cornell University and Memorial Sloan-Kettering Cancer Center, is double board certified in intervention pain medicine and physical medicine and rehabilitation. He was the founding commissioner on the Tennessee Athletic Commission and served as a Goodwill Games physician.

But Frauwirth is also known as a rehabilitation physician, or physiatrists (phas-eye-a-trist), a medical doctor trained in the medical specialty of physical medicine and rehabilitation to ease, eliminate or manage pain. As such, he is a nerve, muscle and bone expert who treat injuries or illnesses that affect how you move. His focus is on the development of a comprehensive program for putting the pieces of a person’s life back together after injury or disease — without surgery.

When asked about the distinction between a physiatrist, a chiropractor and an orthopedic doctor in treating pain, Frauwirth explained, “Physiatrists have a very unique approach to the way they care for patients. We try to improve their life rather than just try to improve their condition. We do a treatment as a whole to try to maximize function and add quality to your life.”

Frauwirth, who is also an MD, said, “The most important thing to know about any doctor is their qualifications and where they come from. Chiropractors go to chiropractic school and they are trained specifically to a chiropractic approach to the spine. Pain management doctors, which is what I am, go to four years of college, four years of medical school and then they train in a specialty. Most of them are trained in either anesthesia or physical medicine and rehabilitation. Once they have completed their training they go for another year of fellowship in pain management. That’s a total of 13 years worth of training. We prescribe medication and we treat medical conditions by ordering different therapies and modalities.

“An orthopedic is a doctor who specializes in the musculoskeletal system surgically. So they approach problems from a surgeon’s perspective. They look at a problem, analyze whether or not it needs surgical treatment and then they assign it to either nonsurgical treatment or they try to fix it surgically. Their mindset is that they should try to use the most conservative process that they can but they have the ability to take that problem to a surgical solution. They are not pain management physicians. They treat painful conditions but they are not equipped to monitor, diagnose and follow up on all the modalities that are used in pain management. We have a broad area of expertise that enables us to treat a wide range of injuries.”

According to Frauwirth, physiatrists are nerve, muscle, bone and brain experts who treat injury or illness nonsurgically to decrease pain and to restore function. When it comes to treating work-related injuries, Frauwirth said there is a “mandated board of specialties,” and chiropractors and orthopedics are two of those specialties mandated.

“Unfortunately, physiatrists are often left out of that loop and we’re really the gatekeepers of musculoskeletal medicine,” he said. “We’re the guys who make the diagnoses. We see patients of all ages — experiencing a wide range of problems in the home, at work or with recreational activities. We help to successfully treat these problems by making accurate diagnosis. Why is that so important? If you put the right doctor with the right problem you get the right treatment. And when you get the right treatment you get better.”

Frauwirth, a sociable rehab physician who is passionate about his profession and the business of pain management, shared how he became interested in his profession.

He said, “My mother, Carol, was an occupational therapist and I saw her rehabilitate injuries as a child. I was always fascinated by the way she was able to heal people by putting her hands on them and healing them by touch, by moving them, exercising them and helping them to regain their ability to eat after a stroke or regain their ability to move after a spinal cord injury.

“It fascinated me to watch her over the years develop a relationship with people, because she would stay in these people’s lives for a long time and watch them get better. As a little boy I got to see people recover over a lifetime from devastating injuries — gunshot wounds, meningitis from mosquito bites, paralysis from diving off a high dive board — all of these people were patients that my mom was seeing. There were doctors that she worked with to help coordinate their care and I thought I would like to be one of those people.”

Frauwirth said there is a very high demand for pain management services because the population is aging rapidly and as the population shifts, more injuries manifest themselves later in life like osteoarthritis, degenerative disc disease and nerve problems.

“These conditions tend to accumulate over a lifetime,” he said. “As our population ages we’re seeing higher and higher demands to add quality to life and manage pain. It’s a highly sought after specialty because in addition to improving quality of life, we also provide treatment that other doctors can’t. We do interventional techniques, injections, spinal cord stimulators — a whole host of therapeutic modalities that other physicians aren’t really familiar with. We have tools that are unique to our specialty that help treat people in pain.”

The unique thing about physiatrists is not just how they take the time needed to accurately pinpoint the source of an ailment, but how they design a treatment plan that can be carried out by the patients themselves or with the help of the rehabilitation physician’s medical team, Frauwirth said. This medical team might include other physicians and health professionals, such as neurologists, orthopedic surgeons, and physical therapists. By providing an appropriate treatment plan, rehabilitation physicians help patients stay as active as possible at any age.

Frauwirth said, “There is a tremendous amount of information the public needs to know about pain management. This is one of the youngest and most exciting new fields that we have in medicine. As it currently exist, it’s only been around since 1990. So, in the history of medicine in this country, that’s a very young specialty. Pain management is a field that can add a lot of quality of life to people who are suffering. It’s my hope that I am going to be able to share my thoughts about pain management so that people can better utilize our services.”

Since advancements in medical technology will save more lives and therefore multiply the number of persons needing rehabilitation services, experts predict a rise in physiatric services and occupational therapists.

Frauwirth and his wife, Belicia, who is an occupational therapist, said they love their work and are happy to be located in Cleveland, where they have met many warm-hearted people who are delighted to have pain management specialists in the heart of their community. The couple have been married for 17 years and have four children, all daughters, ages 5, 11, 13 and 17. Frauwirth has been practicing in Cleveland for five years.

The Center for Pain Management is located at 65 Mouse Creek Road N.W. For further information, call 423-790-5671 or visit www.thecenterforpain.com.