Dr. Orlando Landrum's Alternatives for Pain Management

Orlando Landrum is a pain specialist serving South Bend, IN, and Elkhart, IN through his Cutting Edge Integrative Pain Centers. He also treats patients in all areas of Indiana, Illinois, and Michigan via telemedicine..Dr. Landrum is a member of the World Academy of Pain Medicine Ultrasonography and the National Medical Association. As a member of the Regenexx affiliate network, Cutting Edge Integrative Pain Centers is also Indiana’s first and only Regenexx-certified clinic

Q: What motivates you to study pain and how did you first get interested in it? 

A:  I had a mentor as a medical student who showed me how impactful it can be for patients who didn’t have anyone who believed in them or their story. How you can use your mind and hands to make an impact and give someone their life back when many other physicians may have dismissed them 

Q:  What challenges in treating chronic pain patients stand out to you and how can we start to solve them? 

A: There are frequently multiple underlying pain issues and they need to be prioritized according to greatest impact for the patient (with a patient centric focus on what activities are currently limited but would make the biggest impact on their quality of life /function).  

We need to understand how pain affects mood and influences patients' interaction with the world as a functioning member of society. We need to understand the impacts on mood, sleep and adaptability to stress and provide strategies/treatments to address all of the above. 

Q: Your pain center takes a holistic approach. Can you describe the benefits of that and how your center personalizes care to each patient? 

A:  We use a number of tech tools to give patients a voice . Not only with documenting their pain but also acknowledging their suggestions for how to initiate/modify their care. Not every patient can give implicit treatment options .However ; many patients understand viscerally what they FEEL because pain is experiential.This is a key component that is sometimes missed

For instance,  sometimes patients have done their research and understand their condition and potential options for choices of treatment because they have to be their own best advocate .  Many times health care providers don’t know the condition or the options and have to be educated.   I recently had a patient with cervical instability who knew everything there was to know about the condition . She knew how it could cause vertigo symptoms, changes in cardiac stability and heart rate speed ( both slow and fast ) and how it related to her EDS. She was able to detail the thought leaders in the field and the Pros/Cons to treatment. In having a conversation with her, we can have a mutual discussion about next steps and the immediate why behind each option and choice 

Versus, I had another patient that an explanation of things that bother her low back . It hurts when she stand/walks, bends forward and goes from a seated position to standing.  These explanations initially spark a common pattern recognition in most docs of  most likely etiologies ( causes of   x, y, z  specifically stenosis,  spinal disc pathology, or facetogenic pain ) . HOWEVER; the patient states she FEELs like the pain is in Her BONE.  Most providers would say no she’s not correct .  Because it doesn’t fit the pattern recognition choices or algorithmic options of treatment of standard care.  Unless, they might know of a new procedure called Intracept, which has revised the consideration for a potential source of pain as the bone ( specifically endplate ) The point is not the procedure but the limitation of thought can greatly hamper obtaining information and collaboration when a patient’s visceral understanding can not be immediately be supported  ( defies algorithmic understanding ) but is right on target and medical understanding has not caught up to the why and how just yet. 

We monitor patients : mood , sleep , depression , anxiety through self documented apps that allow for data collection. We use this to have cogent discussions with patients regarding traditional and integrative approaches for the most effective care plan. 

Q: What are you working on now that excites you most?

A: We are very excited about expanding treatment options using regen med and minimally invasive approaches.  Regen med because it is still in its infancy , however it has made major headway into consistently treating conditions such as joint arthritis, spinal disc bulges, rotator cuff tears,  tendon) tears, and peripheral nerve compression without the need for open surgery. 

While minimally invasive procedures like MILD, sonex , endoscopic discectomy, percutaneous si fusion and neuromodulation provide multiple treatment options that don’t require big harmful surgeries and provide benefit for many patients. 

Our practice is one of the few that does a mixture of both options and can help patients pick an individualized treatment plan that  helps them navigate the least invasive/ most efficacious option for them and helps them progress to other options as necessary . 

An example would be a spine disc bulge with resulting sciatica.  Assuming the patient has done exercise and conservative measures . It may then fit a pathway like the following ,  diagnostic epidural (using local anesthetic) , platelet lysate epidural with supporting prolotherapy, Platelet rich plasma treatment of the entire functional spinal unit , intradiscal injection of orthobiologic, ct guided percutaneous discectomy ,  endoscopic discectomy , prior to considering open surgery/fusion.