Relief From Back Pain Allows Bride to Enjoy Wedding Day

For a while, it seemed that Kelly Montgomery’s life revolved around pain. As a student nurse anesthetist, she prevented it. But after a back injury, it was her own pain that needed attention.

Montgomery has always been very active. “I had just started a new workout routine when I first hurt my back,” she says, “but physical therapy did the trick.” Then, she was working in the operating room when she reinjured her back.  “This time it was so much worse,” she says.

She returned to her trusted physical therapist, Mike Schmidt at Duke Physical Therapy. But this time, therapy and pain medication weren’t enough. Complicating matters was Montgomery’s upcoming wedding. “He could see the panic in my face,” says Montgomery. She didn’t want to be in pain on her wedding day. Schmidt didn’t want her to, either. 

Neither did Anand Joshi, MD — the Duke interventional spine specialist Schmidt referred Montgomery to. After an initial exam, Dr. Joshi immediately suspected a herniated disc. An MRI confirmed it. “She was having debilitating pain that was also radiating down her leg,” says Dr. Joshi. “So it was a double whammy.”

Dr. Joshi is part of the Duke Spine Center, which brings together a wide range of specialties — surgical and nonsurgical. “She was using physical therapy and medication to treat her pain, but as her wedding drew closer, the pain continued,” he says. “She was going on a cruise. It wasn’t the time for pain like this.”

Still, Dr. Joshi wanted to stick to a conservative, nonsurgical approach. He recommended an epidural steroid injection. “This was part of an overall coordinated course of treatment,” he says. “It’s not a one-trick pony. We want to reduce the pain so that you can get back to being active. It complements physical therapy and medication.”

The epidural Montgomery received was similar to the kind a woman might get to quell the pain of labor. “We don’t go as deep, and we use X-ray to precisely guide the catheter,” says Dr. Joshi. “It’s not really surgery, but we do it in the operating room because it accommodates the X-ray. We numb the skin where we insert the needle. It takes about five minutes.”

Montgomery says she felt better immediately after the injection. Dr. Joshi says that’s not unusual. “It’s fairly typical to feel better immediately because of the anesthetic. The steroid that kicks in a few days later provides longer lasting pain relief,” he says. “I chose this treatment for her in part because it tends to help people within a week. I wanted to make sure that she felt better on her wedding day.”

Three weeks later, home from the honeymoon cruise, Montgomery received a second injection, as part of the treatment course.

“I’ve been slowly healing since and exercising,” says Montgomery. “Dr. Joshi thinks my prognosis is excellent. It just takes time. Baby steps.”

Montgomery advises others unfortunate enough to have chronic back pain to ask questions, stay informed, and find a provider they trust. “For me, that was Dr. Joshi. He has been exceptional.”