When Dr. Saloni Sharma looks into the eyes of patients suffering from chronic pain, she’s eager to help them find alternatives to the typical treatments they’ve undergone for months or even years. It’s why she founded the Orthopaedic Integrative Health Center at Rothman Orthopaedics in Bryn Mawr, which opened its doors in October of this year.
While there’s no quick fix or magic bullet when it comes to orthopedic care, there are myriad options and alternatives that show great promise when it comes to decreasing inflammation and intense pain. The center doesn’t replace conventional orthopedic care. It aims to boost and optimize it.
Board certified in physical medicine, rehabilitation and pain management, Sharma serves as medical director at OIHC. She’s also a licensed acupuncturist with 10 years of experience. Traditional orthopedic medical care focuses on a single joint or a specific area of the body — and that’s still universally recommended. But the center also takes a hard look at the whole person. “The idea is to address issues such as activity level, sleep, stress and nutrition,” Sharma says. “All those things clearly impact inflammation and pain levels. They also impact someone’s ability to recover from orthopedic injury and surgery.”
OIHC has honed in on World Health Organization findings that 80 percent of diseases can be prevented with diet, exercise, stress reduction and other lifestyle changes. “We’re focusing on helping our patients make some of those changes— doing so in a customized way,” says Sharma. “We’re integrating mindfulness, lifestyle medicine and conventional orthopedic care for the best results. I’ve definitely seen the benefits of such a comprehensive approach.”
One goal is to help surgical and non-surgical patients minimize stressors on the body to aid in recovery. Another is to reduce opioid use and misuse, which skyrocketed during the COVID-19 pandemic. “We see this as a way to address injury and pain without narcotics and other medications, and to look at the whole person,” Sharma says. “As far as I know, there’s nothing else in our region—or in the country—that’s focused on orthopedic integrative health.”
Many of Dr. Ari Greis’ patients are open to new ways of looking at—and taking responsibility for—their overall health. For some, it may be the last option they have. “They’ve tried everything readily available, including surgery and injections, and may have used opioids and other medications for years,” says Greis, a physical medicine and rehabilitation specialist at Rothman and the pain management physician for the Philadelphia Eagles. “They’re looking for alternatives. Now more than ever, they’re understanding the mind-body connection and recognizing the benefits of self-care.”
OIHC offers acupuncture, physical therapy, massage, yoga, meditation, medical cannabis, nutritional guidance and more. “This is almost like a pilot program,” Greis says. “We monitor the outcomes so when we find what’s beneficial, we expand it to other regions and parts of the practice. It’s about figuring out what works the best and making it available to as many interested patients as possible.”
Greis notes that more and more of his patients are speaking up about the anxiety and stress they deal with on a regular basis and how it affects their mood and bodies. “I see it every day in my clinic when I update an MRI or an X-ray and the pictures look the same but the pain is worse. Oftentimes, patients have a story to tell that has to do with the trauma in their lives,” says Greis. “When you see the mind-body connection, you understand that more Advil or cortisone injections aren’t going to be the answer. It’s about realizing that there’s more than just physical pain. Today’s relaxation techniques, breathing exercises and mindfulness meditation are analogous to massage therapy, yoga and other alternatives from years ago.”
Greis is also the director of the Medical Cannabis Department at Rothman. “One of the biggest things I can do for patients is to explain that a flare-up of pain is not going to last forever,” he says. “They need a game plan.”
Registered dietician Phyllis LoDuca has worked with dialysis patients and college students, for corporate wellness programs, and even in supermarkets. Right now, she couldn’t be happier with her role at OIHC. “I feel like it’s a dietician’s dream to work so closely with Dr. Sharma, a doctor who believes that nutrition makes such a difference in the life of a patient,” says LoDuca. “You have to eat to survive. But we also use food to mourn and to celebrate big events in life, so there’s a strong emotional connection.”
At Rothman, LoDuca is focusing on how food affects the body. “What causes inflammation? How can we make foods that might not be the best for you fit? And how can we add more nutrition to your diet to help relieve some of the pain and inflammation?” she poses.
In a typical busy medical practice, doctors may tell patients to change their diet or lose weight. But they might not refer them to a dietician. “Dr. Sharma knows there’s an abundance of research that links what you’re eating to how it affects your body,” LoDuca says. “This is especially the case with inflammation in patients with uncontrolled diabetes or hypertension.”
Every patient treated by Sharma follows up with LoDuca to make sure they’re successfully reaching their goals. Many times, LoDuca will review patients’ diets and discover that they’re eating all the right things—only not in the right quantities. Or perhaps they’re missing some key nutrients. “Everyone can benefit from nutrition counseling,” she says. “We want to make sure our patients are getting all the support they need to really try to curtail the pain they’re feeling.”