29 Oct 2020 Taking great pains: Conway Regional physicians use multifaceted approach

by John Patton

For Heath McCarver, MD, relieving pain is a way of life. McCarver, a pain management specialist with Conway Regional Advanced Pain Management Center, finds purpose and satisfaction in helping patients find relief from pain. 

Having lived in Central Arkansas for 20 years, McCarver sees about 750 patients per month at the pain management center and expects that number to grow to as many as 900. “It has to be the most prevalent issue in society,” he said. “Everyone has pain somewhere, of some kind, and it can be treated.”

McCarver began seeing patients with different types of pain on a part-time basis shortly after completing a residency in anesthesia 14 years ago at the University of Arkansas for Medical Sciences. Three years ago, he decided to begin a full-time pain management practice and joined Conway Regional a year later. “Transitioning from anesthesiology to pain management was an easy transition,” he said. “You are already helping patients deal with surgical pain.”

Pain management physicians at the Conway Regional center specialize in the evaluation, diagnosis and treatment of different types of pain, including acute and chronic pain. In addition to pain in joints throughout the body, they treat migraine headaches, fibromyalgia and Reflex Sympathetic Dystrophy (RSD) syndrome. They also provide nerve blockers and medication management for cancer-related pain.

“A lot of my patients are back patients, especially lower back,” he said. “I also get neurosurgery and orthopedics patients.” Another group is migraine headache patients. 

“So many people have migraine headaches, and there are multiple reasons for that,” said McCarver. “Some of it is cultural, dietary, hereditary, even social.” He noted that the type of pain treated in the United States is often different from that found in other countries because of the lifestyle of many Americans.

Many patients come to see him due to dietary factors. “Joint pain is related to weight. It has an effect. You also have to factor in the effect of carbohydrates (sugar) on the inflammation process in the cells of the body,” McCarver said. “So many people are realizing that vascular and heart issues are related to inflammation in your arteries. Inflammation in the body restricts blood flow. The same condition causes diabetic neuropathy, which is what I deal with, along with vascular disease, heart disease and strokes.”

Some of his patients are seeking relief from orthopedic back pain that is related to their joints. “There is really no surgery for the joints, and the only treatment that we have is Radiofrequency Ablation (RFA), which ablates (deadens) nerves for a permanent solution.”

In general, McCarver stresses a multifactorial approach for treating pain. “There is rarely ever one way to get rid of pain. It usually requires a combination of techniques including medication. If you approach it from several different angles, usually you can find a combination that gives relief.”

Breaking the cycle

Pain management specialists strive to break the pain cycle.

“Reduction in pain is compounding because if you reduce pain, the patients get more active,” McCarver said. “If patients get more active, they feel better, their mobility increases, they exercise and they weigh less. Sometimes, it all starts when we get the pain to a tolerable level, and that compounds the benefit. For instance, you may say, ‘I can’t get rid of all of my back pain.’ No, but if I can get you to where you can go to the gym or you can go out walking every night, you start losing weight and feeling better, then your back gets better, and the meds work better. Everything is better.”

RSD syndrome

One of the most challenging conditions to treat is Reflex Sympathetic Dystrophy (RSD) syndrome, a disorder that causes lasting pain, usually in an arm or leg. It begins after an injury, stroke or even a heart attack.

As an example of how RSD affects the body, McCarver said, “So you fix your ankle, and six months later, there is nothing structurally wrong, but it’s swelling and it’s hurting all day. It’s nerve pain, typically from an orthopedic injury.” He has had young patients who are bedridden after an ankle injury.

The pain results from a nerve related conduit that goes between the spine and the injured area that keeps sending signals to the body that it is still injured. “There is treatment,” he reassured.

Myths?

There are myths about pain management. “One is that pain management is all about opioids. In fact, it is becoming less and less about opioids,” he said. “Another myth is that people are stuck with pain. Pain is very common, but it is also uncommon that we can’t find relief. We can get rid of pain, at least to a much more functional level.”

Takeaway

McCarver: “Pain’s not something you have to live with. We can help get rid of pain. You don’t have to hurt.”

New physicians

Chris Maranto, MD, and Mikio Ranahan, MD, joined the Advanced Pain Management Center at Conway Regional on Sept. 1. 

“I am excited to begin this journey with the Conway Regional family,” said Ranahan. “I look forward to providing pain management services to the community and helping patients return to living fulfilling lives with less limitations.” 

Maranto echoed his colleague’s sentiment. “I am eagerly anticipating the opportunity to provide quality pain management care and to build a practice as part of the Conway Regional team, which serves patients both here in Conway and throughout the region.”

Both Maranto and Ranahan received their anesthesiology residency training at the University of Arkansas for Medical Sciences. Maranto went on to complete a fellowship in interventional pain management at the University of Alabama in Birmingham. Ranahan completed pain management fellowship training at the University of North Carolina at Chapel Hill. 

The Conway Regional Advanced Pain Management Center is at 525 Western Ave., Suite 304. For more information, call 501.358.6560. 

“Expanded access to pain management services is a need that exists throughout the communities we serve, and we are beyond excited to welcome Drs. Maranto and Ranahan to the Conway Regional team,” said Rebekah Fincher, chief administrative officer for Conway Regional.