Case Study: Leading Interventionalist Makes the Move to mild® and Helps Patient (67) Find Lasting Relief
mild® Provider, Dr. Shawn Puri | Double Board-Certified Anesthesiologist and Pain Medicine Specialist | Relievus Pain Management
This case study highlights a female patient, age 67, with debilitating back pain that prevented her from completing tasks of daily living and decreased her quality of life. Despite multiple interventions, including epidural steroid injections (ESIs) and medication therapy, the patient continued to experience chronic pain. Dr. Puri, a leading pain medicine specialist at Relievus Pain Management, decided to make the move to mild® and help this patient find the lasting relief she was looking for.
Patient History: Pre-mild®
The patient’s history showed degenerative disc disease and symptomatic lumbar spinal stenosis. The patient had anxiety and depression. Treatment history included ESIs, facet injections, and various medication therapy including chronic opioid therapy. The patient had no previous surgical history and was not a surgical candidate.
Symptoms of Neurogenic Claudication
The patient experienced back and buttock pain and was unable to walk or stand long enough to complete daily tasks. She remained in forward flexion to relieve neurogenic claudication symptoms.
The patient experienced limited mobility and severe pain (9-10/10 pain score).
The patient set goals of:
- Housework and laundry
- Showering without assistance
MRI Findings
An MRI was performed, which found multiple levels of stenosis and several spinal comorbidities.
L3-4 and L4-L5
- Disc protrusion, ligamentum flavum hypertrophy, severe spinal stenosis
Procedure Details
Dr. Puri treated 2 levels using the standard approach with MAC sedation.
The Results
After the mild® Procedure, the patient was able to walk and stand twice as long. Her pain score went from 9-10/10 to 3/10 and she is now able to complete activities of daily life, including getting in and out of the shower and doing laundry without assistance.
The patient feels much happier and shares that her days are “much better.”
Listen to Dr. Puri discuss this case study.
Key Takeaways
“The patient’s mood has improved; she doesn’t use her cane, and walks up and down the stairs with greater ease. She is overall more comfortable.”
“The biggest takeaway from this case is to move to mild® sooner instead of performing repeat epidural steroid injections. This patient was already in my practice and was being overlooked. Now that we can offer mild®, we need to establish an algorithm so patients can consistently be screened and offered an opportunity to achieve the relief and functional improvement they deserve.”
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