Putting the ‘Multi’ in Multimodal Care for Patients with Pain

March 28, 2022

While many people talk about the mind-body connection as part of optimal care for patients with pain, Arizona physician Whitney James, MD, has gone a step further, developing her own program to make that the guiding principle in how she treats patients.

In her own words, Dr. James discusses her practice philosophy and how she built a strong team to help her put her vision into practice:

So often, in my neurosurgery training, I would see a patient who was still in pain and not have anything to offer them. I knew that even though I couldn’t help the patient with a neurosurgical solution, the patients would have done so much better if we had something else to offer them.”

“With my knowledge of neuroanatomy, I knew that the sensation of pain was really being processed and registered in the brain, and I became very interested in the neural circuitry that amplifies or lessens incoming pain signals to the brain. I was also aware that neural circuitry in the brain was the seat of suffering, and that, perhaps, if that neural circuitry could be naturally modified, we could significantly impact and improve patients’ quality of life.

“I built my practice after seeing and learning from other interventional pain physicians, educators and—this might seem odd to some—some very talented and experienced yoga instructors. Over the course of several years, I worked to combine the best of medicine with the best of other multidisciplinary approaches.

Dr. James shared what she did in her practice to make some of these changes.

“We emphasize the “multi” in a multimodal approach to patient health and wellbeing that is unique to the individual patient. This includes rooting the program in breath work, and we have had many patients over the years tell us, “Thank you for teaching me how to breathe! I can’t believe it took me until my 6th or 7th decade of life before learning this!”

Other patients have told us that our multimodal approach has significantly helped them move, eat and sleep better, stress less and find meaning and purpose in their lives, despite their illness and dis-ease. We have also had many patients tell us that they have been able to tap into a feeling of joy in their lives again.  As practitioners, it’s very rewarding to see our patients take a more proactive role in their healthcare, respond better to allopathic therapies, and have better short- and long-term health outcomes. 

“It’s been my experience that patients with chronic pain are best treated with a multimodal treatment plan. This may include a combination of physical therapy, talk therapy, medications and even surgery. No two patients are alike, so each patient’s treatment plan must be individualized to her or his unique physiology and experience. What doesn’t tend to work well with chronic pain patients is a single angle approach. Practitioners really need to be able to create multifaceted treatment plans in order to be effective in improving patient outcomes and quality of life. 

“Unfortunately, integrative care therapies are minimally reimbursed by insurance, if at all. For providers like myself, we believe in these therapies so wholeheartedly, and we have the objective data to back them up, that we find creative ways to ensure our patients continue to have access to them. I am very inspired by the Department of Veterans Affairs’ commitment to providing integrative healthcare for our veterans, and I am hopeful that their example will help pave the way for all Americans to have access to integrative, whole person care.”

Contact Dr. James to learn more.

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