Pain Management for ‘Your Best Life’

Pain management is a key part of the comprehensive care provided by physical medicine and rehabilitation (PM&R) physicians at Good Shepherd Rehabilitation. By integrating physical therapy, medications and non-invasive procedures, PM&R physicians address the growing need for effective pain relief in both acute and chronic conditions — from carpal tunnel syndrome to lumbar spine issues.

Vivan Shah, MD, is an outpatient PM&R physician (physiatrist) at Good Shepherd who specializes in pain management and interventional spine care. He completed an Interventional Spine and Musculoskeletal Medicine Fellowship at OSS Health in York, Pa., before joining Good Shepherd.

We asked Dr. Shah to provide an overview of comprehensive pain management and how it benefits patients.

What is pain management?

Dr. Shah: Pain management is a specialized field of medicine focused on relieving pain and improving quality of life — especially for individuals living with chronic pain.

What is your role in pain management at Good Shepherd?

Dr. Shah: My role is to bring advanced pain management strategies to Good Shepherd’s patients, further enhancing the organization’s outstanding rehabilitation care. With each patient, my goal is to restore maximum function and help them live their best life.

What type of patients do you treat?

Dr. Shah: Most of my patients are seen on an outpatient basis for musculoskeletal or nerve-related pain. For instance, I might treat a retired man with a painful shoulder and arthritic knees who still wants to play golf. Diagnosing and treating lumbar spine pain is my specialty. I also consult with inpatients experiencing neuropathic or musculoskeletal pain — such as knee pain — that may be limiting their progress in physical or occupational therapy.

What conditions do you treat?

Dr. Shah: My specialty is spine pain. I treat patients with pain in the cervical (neck), lumbar (lower back), and sacroiliac (SI) joints, as well as the tailbone and facet joints. I also address pain from head to toe —hips, shoulders, knees, elbows, wrists, hands, feet, legs, and ankles — due to conditions like arthritis, injuries, repetitive strain, or pinched nerves.

How do you diagnose and treat pain?

Dr. Shah: I begin with a physical exam and a review of the patient’s pain history. I also assess gait, footwear, and daily-use devices. Next steps often include imaging with ultrasound or X-ray. Electrodiagnostic testing, such as EMG or nerve conduction studies, may be used to evaluate nerve and muscle function. Once we identify the pain source, I develop a treatment plan that may include physical or occupational therapy, medications, bracing, orthotics, or ergonomic changes. When appropriate, I also offer image-guided injection treatments using fluoroscopy or ultrasound, including:

• Cervical/Lumbar Epidural steroid injections
• SI joint injections
• Shoulder, Hip, knee procedures
• Knee genicular nerve blocks
• Medial branch blocks (spine)
• Lumbar sympathetic blocks
• Intercostal (chest) nerve blocks
• Trigger point injections
• Carpal tunnel injections
• Facet joint injections
• Ganglion impar (tailbone) injections

Good Shepherd also offers radiofrequency ablation — a minimally invasive procedure that uses heat generated by radiofrequency energy to temporarily disrupt specific spinal nerves responsible for transmitting chronic pain signals, particularly from the facet joints.

What’s new in pain management at Good Shepherd?

We offer a weekly clinic utilizing ultrasound for both diagnosis and treatment of pain.

What is the future of pain management at Good Shepherd?

Dr. Shah: I’m working to expand our pain and spine care services based on best practices from the fellowship program I trained in. We’re also exploring advanced options like peripheral nerve stimulation and regenerative medicine — both of which show great promise. While there’s no single cure for many sources of pain, Good Shepherd is committed to delivering leading-edge care that relieves symptoms, restores function and supports our patients in optimizing their lives at home and at work.

To request an appointment with Dr. Shah or learn more about his pain management expertise, call 610.776.3278.