Pain is simple yet complex. It can be physical or psychological or both. It alerts us to illness or injury, yet it can punish our systems and paralyze us in agony or fear.
For Dr. Khuram Sial, pain is a passion and a profession. It is a pursuit that has positioned him in a young, rapidly-evolving medical specialty. It has also landed the 40-year-old physician in the hub of a fast-growing region that is now attracting a wide range of medical specialists.
“Ten, 20 years ago – even today – people don’t know that pain management exists,” Dr. Sial said during a recent interview in his office that is located along the border of Temecula and Murrieta. That office, which is just inside Murrieta’s boundary, is one of three that the American Spine & PainMed Group operates in the Inland Empire.
“Primary care doctors are often too busy to handle complex pain issues. They may not be aware of all the minimally-invasive procedures we can perform to help people. The treatments have exponentially expanded. There is a lot more we can do than we could five or 10 years ago.”
Today, Dr. Sial said, pain specialists focus on an array of conditions that were once seen as unavoidable after-effects of various illnesses and diseases. And now, he said, a greater understanding has emerged over the role that inflammation plays in many of those underlying injuries and diseases.
Strategies and treatments exist, he said, for pain caused by surgery, strokes, headaches, arthritis and other joint ailments, fibromyalgia, traffic accidents, workplace and sports injuries, drug dependencies, pinched nerves, sciatica, herniated discs and other back, neck and spine problems.
“Pain management is kind of a combination of disciplines. It’s cutting edge,” Dr. Sial said. “It’s a young and growing field. Before now some anesthesiologists would dabble in it. Now it’s become its own specialty.”
The field of pain management has also drawn increased scrutiny in recent years.
The Wall Street Journal published a detailed, lengthy article in October 2012 that was headlined: “Prescription for Addiction.” That story cited figures from the Centers for Disease Control and Prevention that indicate more than 15,000 Americans now die annually after overdosing on prescription painkillers called opioids.
That death toll is higher than heroin, cocaine and all other illegal drugs combined, the newspaper reported.
In November 2012, The Los Angeles Times launched a series of occasional stories on the “epidemic of prescription drug deaths.” The first story in the series said the use of pain-killing drugs quadrupled between 1999 and 2010, and narcotic painkillers are now among the most popular prescription drugs in the U.S.
The Times story noted that the seeds of a turnabout in medical thinking about pain management were planted in the 1980s. At that time, influential physicians argued in trade journals that it was inhumane to ignore suffering in many types of medical patients. Those emerging perspectives coincided with efforts by drug makers to win approvals for new formulations of pain medicines, according to that story.
Both newspapers profiled numerous people whose efforts to ease the grip of pain had prompted them to spiral into drug abuse and death.
It was during that era of potential treatment promises and problems that Dr. Sial entered the pain management field.
“Many of these bad outcomes – including addiction, medication abuse, overdoses and even death – are stemming from the illegal use of narcotics from the streets or physicians who are not properly trained in pain management,” he said. “We need more fellowship-trained pain management physicians who rely on multi-disciplinary strategies other than such large doses of opiates.”
Dr. Sial’s parents emigrated from Pakistan to the United States in the early 1970s. It was a business observation that prompted Dr. Sial and his siblings to pursue medical careers.
Dr. Sial said his father, a civil engineer, once observed that his doctor friend was always busy despite the economic ups and downs that jostle construction, manufacturing and many other industries.
It was through sports – specifically tennis, weight lifting and water polo – that Dr. Sial became interested in pain’s causes and remedies. He retained that interest after he graduated from high school in El Cajon, obtained his undergraduate degree in biochemistry from the University of California, Riverside, and then went on to attend medical school.
All the while, Dr. Sial would crisscross sparsely-populated southwest Riverside County communities as he returned home to visit his parents, siblings and other members of his extended family. Highway 79 “was just a lonely, two-lane road” back then as it wound its way from Temecula to Hemet, he recalled.
Dr. Sial often thought about the area’s growth potential during his residency at Baylor College of Medicine and while he completed his interventional pain fellowship at Harvard Medical School’s Beth Israel Deaconess Medical Center.
“This was a booming (geographical) area at that time,” Dr. Sial said. “There was a huge need for doctors in this area.”
It was that opportunity, as well as the area’s quality of life, that prompted Dr. Sial to move his growing family to Murrieta and open his main clinic there.
“It’s a beautiful area,” he said. “The schools are great. It’s a good environment.”
Dr. Sial’s wife, who is pregnant with their second child, manages their medical offices. He has privileges to practice medicine at Rancho Springs Medical Center in Murrieta, Inland Valley Regional Medical Center in Wildomar, Corona Regional Medical Center in Corona and San Antonio Community Hospital in Rancho Cucamonga.
Dr. Sial said he uses a range of approaches and techniques to ease and eliminate pain. They include blocking nerves, physical therapy, inflammation reduction strategies, spinal cord stimulation, medicines, massage therapy and relaxation techniques, biofeedback, “trigger point” muscle treatments and psychological measures.
He has a special interest and expertise in spine, back and neck pains and disorders.
Dr. Sial sees about 100 patients a week, and he estimates that about 90 percent of them experience improvements without surgery. Many patients improve rapidly, an uplifting change for people who are gripped by prolonged pain or experience a steady drumbeat of painful spasms.
“That instant gratification is great because the patient feels better and that makes the doctor feel good,” Dr. Sial said.
Dr. Sial can be reached by calling (951) 734-7246. His Murrieta office is located at 39765 Date Street. Additional information is available at www.painmedgroup.com.