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Restoring Function through Pain Management

Rick Pellant, DO, heads the Physical Medicine Department at The Pain Treatment Center of the Bluegrass.

LEXINGTON Rick Pellant, DO, practices Physical Medicine & Rehabilitation (PM&R) at The Pain Treatment Center of the Bluegrass (PTC), a multidisciplinary pain and rehabilitation clinic in Lexington. The PTC currently has 14 healthcare specialists from various disciplines including anesthesiology, neuroimaging, neurology, palliative care, internal and family medicine, addiction and behavioral medicine, and physical medicine & rehabilitation and physical therapy.

Pellant graduated in 1999 from the West Virginia School of Osteopathic Medicine. He has five additional years of post-doctoral training, including a rotating osteopathic internship, a three-year PM&R residency and an interventional pain fellowship. Instead of referring patients to pain management doctors like the physicians he shadowed, he thought, “Why can’t I do this myself?” and continued his education in pain management methodologies.

Pellant, who rotated between West Virginia and Pennsylvania for his education, at first seemed an unlikely candidate for practicing here in the Commonwealth. Through his service in the Army while stationed in Germany, however, he met a Kentucky-based orthopedic surgeon, Robert Knetsche, MD, who convinced him that Kentucky provided many opportunities to practice physical medicine and rehabilitation and pain medicine.

“Increasing function is the key to both osteopathy and physical medicine.”—Rick Pellant, DO

Treatment Plans for Pain

Pellant says he starts his treatment plan by evaluating the patient’s chief pain complaint within the context of their medical history and previous courses of action. “Complaints may point me to the problem, but they are not actual diagnoses,” he adds. If a physical exam confirms either his suspicion or the patient’s, he can then make a differential diagnosis.

Pellant focuses on his knowledge on structure and function to assist in the diagnosis of painful conditions and to facilitate a course of treatment. “Increasing function is the key to both osteopathy and physical medicine,” he says. He prefers non-invasive approaches and patient education, empowering patients with independence from countless doctor visits and expensive procedures. He even teaches patients the best home-based therapies for pain that are easy enough to practice every day. “The quicker we can get patients mobile again, the faster we can stop the pain syndrome.”

Though acute and chronic pain management techniques may overlap, Pellant admits that chronic pain takes special care. “My approach to chronic pain is to take a step back and look at what treatments have been done. I start with the minimally invasive modalities and see if the pain score has improved. If not, I only proceed to a more aggressive approach if I determine that the benefit outweighs the risk.”

Physical Therapy and In-Clinic Solutions

The Pain Treatment Center of the Bluegrass expanded when they constructed a new physical therapy area and hired a physical therapist, Jason Goumas, PT, CSAS. By doing so, the practice could operate a full-service pain clinic, without outsourcing patients to specialized physical therapy facilities. Pellant argues that in-clinic physical therapies can prevent pain pathways from forming while soothing inflammation. For example, physical therapy serves patients who must transition back to normal mobility — even when it’s uncomfortable — especially after surgery or a cast removal.

“The addition of physical therapy makes our department more complete,” Pellant adds. “Jason, as a physical therapist, brings a unique skill set and fund of knowledge to assist in the patient’s healing progress. No matter where the patient is, we have many different minds from various backgrounds; and because of our unique multidisciplinary approach, we can collaborate,” Pellant explains.

A Tertiary Pain Care Practice

Pellant considers The Pain Treatment Center of the Bluegrass a tertiary care clinic because they have the resources to handle most procedures and treatments. Pellant believes many referring providers erroneously perceive the PTC as a clinic of last resort, but he argues that they should be the first clinic consulted when pain strikes. He states that patients of The Pain Treatment Center of the Bluegrass benefit specifically because of its non-university setting and intimate feel. “We are smaller, and patients have direct access to providers and don’t get lost in a large network of physicians,” he says.

The Pain Treatment Center of the Bluegrass proudly serves thousands of patients throughout the Commonwealth within their comprehensive facility. Pellant also assists the Somerset, Kentucky, community from a satellite clinic office every Thursday.

In the future, Pellant strives for one overarching goal — earning a CARF (Commission on Accreditation of Rehabilitation Facilities) accreditation for The Pain Treatment Center of the Bluegrass. If successful, they would become the first pain clinic in Kentucky to receive that honor.