A Specialized Approach to Neck and Back Pain – Dr. Scott Raub Takes a Holistic Approach to Optimizing Patients’ Lives
Severe and prolonged neck or back pain can be a scary experience, but Dr. Scott Raub focuses on ways to optimize people’s lives by treating pain sources, working with limitations and maximizing potentials.
As a physiatrist at Vail-Summit Orthopaedics & Neurosurgery, he specializes in accurately diagnosing musculoskeletal conditions through a range of clinical exams, images and other diagnostic tests. Then, he treats them through nonsurgical interventions, which includes multiple modalities, ranging from injections to physical therapy.
Many times, the cause of spinal pain is difficult to pinpoint given the density of nerves, particularly because pain can originate from more than one area. Dr. Raub specializes in determining the sources of pain, partially by discovering what provokes and improves symptoms through physical exams and diagnostic tools, such as x-rays, MRIs, live fluoroscopic imagery and electrodiagnostic testing, when appropriate.
“An MRI frequently doesn’t tell exactly where the pain is coming from — it doesn’t have a red arrow saying, ‘this is what hurts.’ We use it in conjunction with physical and history exams,” he said. “Then, from there, we come up with a plausible diagnosis for the pain generator.”
Dr. Raub sees a lot of patients after they’ve already tried physical therapy, chiropractic adjustments and multiple medications. He’s quick to point out that the vast majority of spinal conditions do not require surgery. Rather, he takes a collaborative approach, often incorporating spinal injections and a community of back pain experts (physical therapists, massage therapists, chiropractors, personal trainers, etc.).
“My philosophy is really trying to improve symptoms,” he said, describing his multimodal approach. “I always emphasize that injection results are never a permanent solution because they are not changing or improving the anatomy. It’s important to educate people that once you get into a treatment algorithum for spine pain to set realistic expectations.”
Through this holistic (and realistic) approach, Dr. Raub works with patients to optimize their activities while incorporating reasonable compromises, such as taking time to regularly exercise, and lowering risks, like avoiding crowded ski runs or reducing speed when biking or skiing.
“One of the important things that you have to tell people is, ‘You don’t have a sinister problem that you’re going to die of.’ The vast, vast majority of people will improve. It involves demystifying the pain and validating that there’s a reason for your back pain, but reminding them that this is not something that’s going to put you in a wheelchair,” he said. “There are things we can do to improve the situation.”
He encourages patients to be part of the solution, both behaviorally and mentally.
“There needs to be buy in from the patient in addition to the prescribed treatment,” he said.
That means not only doing exercises to strengthen core muscles and practice proper body mechanics, but also modifying lifestyle risks (such as smoking, overweightness or a sedentary lifestyle) and setting realistic expectations. For example, a 65-year-old can’t demand to return to a 20-year-old body capable of bouncing around in the terrain park with back pain.
That said, Dr. Raub does support a youthful attitude; he calls it a “powerful tool for achieving positive outcomes for spinal patients.”
In fact, the mountain region’s active community is what drew him to join VSON as the first physiatrist in Eagle County in 1999, after completing his residency training in physical medicine and rehabilitation and pain management, and then completing his fellowship in sports medicine in 1994.
“It really has been the best part of my life — living and working here,” he said. “The people I interact with are excellent — they’re sophisticated and educated people who age well and are very active. The patients I get to take care of are fascinating people. They’re here because they want to be here.”
As a skier and outdoor enthusiast himself, Dr. Raub understands the high priority his patients place on maintaining an active lifestyle, so he, and the entire team at VSON, focus on getting people back to doing what they love.
“At VSON, we have top-notch, sub-specialty trained doctors that have the ability, intellect and technological skill to work in the big city if we wanted to but value the mountain lifestyle,” he said. “Our patients get big-city care in a small-town environment.”
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