Living with Pain? Here’s How We Can Help

Meet Dr. Smith: Your Partner in Pain Relief

Living with pain can be frustrating, exhausting, and sometimes even isolating. That’s why having the right specialist on your team makes all the difference. Teton Valley Health Care is pleased to have Dr. Daniel P.W. Smith, fellowship-trained interventional pain management specialist, on our team.

Dr. Smith earned his Bachelor of Science in Business Management, with a minor in Biology, from Brigham Young University Idaho. He received his Doctor of Osteopathy from A.T. Still University, Kirksville College of Osteopathic Medicine, and was chief resident for an anesthesiology residency at University of Missouri-Kansas City. He then completed a fellowship in interventional pain medicine at the University of California-Davis, one of the national centers of excellence for his field.

From a young age, Dr. Smith always knew that he wanted to be a doctor. He even shadowed an anesthesiologist in middle school, which gave him valuable insight into a career in medicine and pain management. Helping his patients find relief from their pain brings Dr. Smith a tremendous sense of joy and satisfaction.

Pain Management Explained

Dr. Smith sees patients for chronic and acute pain management. Chronic pain is defined as pain that lasts for more than three to six months or continues beyond the expected healing time for an injury or illness. It’s a persistent, long-lasting condition where the nervous system continues to send pain signals, sometimes even after the initial cause is gone. Acute pain, on the other hand, is short-term. It usually lasts only a few weeks to a couple months and typically resolves with healing from the injury or illness.

Dr. Smith explains, “The main goal of pain management is just that — management. For chronic pain, completely eliminating discomfort is rare. However, in cases of more acute pain, such as disc herniation causing a pinched nerve (often called sciatica), full relief is possible over time. My focus is always on improving a patient’s function. When function improves, pain often decreases as a result.”

The most common pain Dr. Smith sees is lower back pain, followed closely by neck pain and joint pain. If you’ve been struggling with pain for a while, you are not alone—and you don’t have to manage it by yourself.

Pain Management Is More Than Just Medication

Many people think “pain management” means getting prescriptions, but in reality, that’s only a small part of what Dr. Smith can do. Pain is complex.“I try to take a multifactorial and multimodal comprehensive approach to treating and managing pain. I do not believe that any one particular facet of treatment is effective by itself in most cases,” says Dr. Smith.

Using different approaches helps give his patients a more complete and well-rounded treatment plan. Some of the conservative management options he uses include:

• physical therapy
• massage therapy
• chiropractic care
• holistic medicine
• mental and emotional support.

Some cases require more interventional solutions such as:

• medication management
• injections
• nerve blocks
• stimulation
• minimally invasive procedures.

“I am a firm believer that standard Western medicine is not the answer for every situation, nor do I believe that holistic approaches are the answer in every situation either. I do believe that a comprehensive approach utilizing both traditional and holistic medical therapeutic options

should be utilized. For instance, acupuncture has been around for thousands of years. It has been scientifically proven to demonstrate improvement in certain types of pain, and I do believe that this is something that can be utilized with improvement of pain.”

Creating a Plan That Fits You

Every patient is different. That’s why he always starts by listening to your story. What your pain feels like, how it affects your life, and what your goals are. Knowing that each story is different means that each treatment plan is created just for you. He may look at your past imaging or

order new tests like X-rays, MRIs, or CT scans to get the full picture. Sometimes ultrasound imaging may be required, and other procedures such as electromyography/nerve conduction studies can be performed when a cause of nerve-based problems is difficult to figure out. He

may also work closely with orthopedic surgeons or spine specialists to make sure we create the best plan for your needs.

How Does My Provider Know What Will Treat My Pain?

“The answer to this question can be summed up in one-word: Experience.” Dr. Smith explains, “The education that a pain specialist receives is not only geared toward treatment, but more importantly in diagnosing and differentiating the different types of pain. This is what sets apart a  pain specialist from any other provider who merely performs procedures.” A careful history and combination with physical examination findings and images will typically provide him with enough information to determine and differentiate different types of pain. Determining which types of surgery, physical therapy, injections, and medication management are most appropriate is part of the art of what he does. If the world were a simple place, physical therapy would fix the majority of what he sees, and he is a firm believer that physical therapy can be quite helpful for each patient. If physical therapy is not as helpful as we would have hoped, interventional management with injection therapies will typically be the next option. However, surgical solutions may be considered if symptoms are more severe or if patients are experiencing weakness or numbness which may indicate a more significant problem that requires a surgeon’s attention.

How We Measure Progress

“The easiest way to know if a treatment is working is simple: Are you feeling better? Are you able to move more, do more, or enjoy life a little easier?” says Dr. Smith. “I am old-school, so one helpful tool is a pain diary. Jot down your pain level each day (0–10) and any changes you

notice whether it’s good or bad. This helps guide your care over time. You can create this on anything you’d like but a pen and paper will do the trick!” Follow up visits also help measure progress and depends on each individual patient. Sometimes patients need to be managed on a monthly basis for medications alone depending upon the risk and the type of medication that is being utilized. However, once the pain has been relieved with some sort of interventional solution, follow-up is often on an as needed basis.

What’s New in Pain Care?

Pain medicine has come a long way. Some of the newest and most exciting treatments include:

• Spinal cord and peripheral nerve stimulators – small devices that help block pain signals.
• Minimally invasive procedures like the Intracept procedure for low back pain.
• Emerging therapies such as stem cells or platelet-rich plasma (PRP), which are still being researched but show promise for certain types of pain.

“Most of these devices and procedures are covered by individuals’ insurance. Other procedures such as stem cell treatments and platelet rich plasma treatments have been utilized for years, however, we are trying to gather more scientific information in order to have these types of procedures covered by insurance, and more importantly figure out which patients and which types of pain will respond better to these types of therapies.” Dr. Smith explains.

Setting Realistic Goals

“One of the most important things I share with patients is this: the goal isn’t always zero pain—it’s better function and a better quality of life,” says Dr. Smith. “For some, especially with acute pain like a herniated disc causing “sciatica,” complete relief is possible. For chronic pain, we often focus on getting you back to doing what matters most to you—with less pain along the way.”

Typically, he works together with the patient at the first visit to set expectations and boundaries. He has found that the majority of his Teton Valley patients are highly motivated and come with expectations and goals before he even sees them, and at that point his input helps the patient understand what goals are achievable/feasible.

When Should You Revisit Your Plan?

“Pain! If pain has been managed in the past but is no longer as controlled as it used to be, this is a good indicator that adjustments need to be made, or further treatment needs to be considered.” explains Smith. “Otherwise, adjustments in your treatment plan may need to be considered based upon side effects. If something changes, or you are experiencing problems with medications or the treatment that has been given, this would be an indication that change is necessary.”

Moving Toward a Pain Free Life

Chronic pain can feel overwhelming, but there is hope. “By combining different approaches—both traditional and holistic—we can often find a way forward that helps you move better, feel better, and get back to living your life.”

To book a pain management consultation, please reach out to our Specialty Clinic at 208.354.2383.