Shana Margolis, MD, began practicing at the Shirley Ryan AbilityLab around the time the lakeside pain management center became the only American Pain Society–awarded Center of Excellence in the Chicago area.
“I started at the pain center in 2009, just after they got the award. We received that award as a center that provides interdisciplinary, evidence-based care for patients,” Dr. Margolis said.
The AbilityLab Pain Management Center, formerly the Rehabilitation Institute of Chicago, treats patients with a multitude of pain conditions, including low back, neck and arthritis pain, fibromyalgia and complex regional pain syndrome. Interdisciplinary treatments strive to improve emotional and physical well-being by way of traditional modalities and strategies that include sleep modification, pacing, biomechanics, posture and relaxation.
“’Pacing’ means spreading out activities throughout the day to do more,” Dr. Margolis explained. “Patients tend to overdo it and pay the price by being in a lot of pain for the next few days. How do you spread out activities to manage pain, be functional and get more accomplished? We look at the patient as a whole person, not just as a back or arm.”
The center takes an interdisciplinary approach that includes physical therapy (PT) and occupational therapy, pain psychology, nursing, physicians and biofeedback therapists—all working as one team to manage patients. The team meets once a week to discuss each patient, and “we constantly call and email each other to make sure we’re working as one team,” Dr. Margolis said. “We co-treat. So, if the patient has a fear of movement, perhaps, psychology will see them when they’re in PT to work on different strategies.”
She describes physical and emotional pain as “interrelated,” stressing the need to treat both when trying to improve function. “When a patient comes in with chronic low back pain, they’re evaluated by one of our pain psychologists and physicians. We come up with a treatment plan, based on how their pain affects them—what they’re able, not able to do—and what other psychosocial factors are related.”
Programs range from one-half day for six weeks to a full day for four weeks—”where it becomes the patient’s full-time job to learn to manage pain,” Dr. Margolis said. Generally, patients attend a combination of group and individual sessions. Patients find the program from their physician’s referral, on their own or by word of mouth, with Dr. Margolis saying a common way is simply, “‘My friend told me about you.’”
The center’s core mission is to develop long-term strategies to facilitate pain management, health maintenance and a balanced lifestyle. Patients, in turn, regain the ability to perform work and leisure activities, and resolve the emotional and psychological consequences of chronic pain by treatment programs that support families and maximize pharmacotherapy.