Patient given new hope, relief for chronic back pain from Beacon outpatient physical therapy team

Stefain Holmes

Stefain Holmes had nearly given up hope of getting relief from the back pain that had plagued her since 1996, when her car was violently struck by a drunk driver.

She sought care many times, but doctors told her they couldn’t find a physical reason for her lingering pain. Meanwhile, it kept getting worse, especially one spot in the center of her back.

“If anybody even touched it, it would make me just tumble to my knees. I had pain that radiated down my legs as well,” Stefain said. She tried physical therapy, but it didn’t work. One provider prescribed Vicodin for her, but she didn’t feel comfortable taking it long-term without an alternative in sight.

“For over 10 years I tried to get answers. After a while, I stopped taking the Vicodin and had to just push through the pain. I just felt hopeless,” she said. But with three daughters for her and her husband to care for, as well as her mom, who was disabled, she had little choice but to keep going.

Every few years, Stefain would talk to another provider about her pain. She wouldn’t make any headway and would give up again. It broke her heart one day when her grandchild hugged her from behind as she was doing dishes.

All she could think of was the pain.

Dr. Alyssa Erskine, Three Rivers Center for Family Medicine.

One more try

The cycle continued until 2023, when she saw a new provider: Alyssa Erskine, DO, Three Rivers Center for Family Medicine. Dr. Erskine listened carefully to Stefain’s story and asked if she’d be open to trying physical therapy again. Stefain said yes; after all, she had nothing to lose.

Dr. Erskine referred her to Nitin Udhawani, DPT, a physical therapist with Beacon Outpatient Physical Therapy at Three Rivers Health. Udhawani has a special understanding of pain, especially chronic pain, that’s backed by both research and experience.

During Stefain’s very first appointment with him, she could tell that this time, things would be different.

“I was really shocked, because he really listened to me and cared. That right there made all the difference in the world,” she said. He taught her some breathing techniques during that first visit that enabled her to do exercises that were too painful for her before.

He also taught her about the brain’s influence on pain perceptions. “He gave me videos to watch about your mentality and how that correlates to pain,” she said. “He really breaks it all down. It’s more than just physical therapy. He helped me understand my pain.”

Nitin Udhawani, DPT, physical therapist, Beacon Outpatient Physical Therapy, Three Rivers Health, and Stefain.

Living with pain

“Living with pain is different from having pain,” said Udhawani, explaining that prolonged pain also brings anxiety. Areas of the body that need more relaxation instead become more tense. The body’s protective response backfires: patients start to guard the part of their body that hurts, which leads them to bend and move in awkward ways. That can cause even more pain.

Eventually, people living with chronic pain withdraw from activities they used to engage in. “That’s when people get stuck,” Udhawani said.

The body needs to move in order to be healthy, he says. As a physical therapist, he seeks out the reasons why a patient hesitates to move and addresses their concerns one by one. He spends a great deal of time listening to his patients’ stories.

“We may have to challenge their belief system, change their narrative,” Udhawani said. “When these patients come in, we talk about ‘What do you think about your pain?’ We discuss what pain means to them and reframe their experience to reduce their fear.”

“Changing your understanding about pain can change the extent of your pain as well,” he added. But that doesn’t mean that his patients’ pain is not real. “Whoever has pain, the pain is genuine. It’s 100 percent real. There is no fake pain.”

A gentle process

With Stefain, reducing her pain meant gently reassuring her while taking things slowly. She was able to perform all the exercises Udhawani suggested, strengthening and retraining her body while simultaneously examining her thought processes.

“I wrote down what he said. I did the exercises with the breathing technique. By the next week, I felt like I already had relief,” Stefain said. “I didn’t go there to doubt. Nobody could do it for me. I felt like he was leading me in the right direction.”

“After my sessions, I immediately call my daughters and tell them what happened. They’re so happy, they’re so proud of me. It means the world to me,” she said.

Before seeing Dr. Erskine and Udhawani for help, she had bad thoughts about her future. She feared that she’d be in a wheelchair like her mother. But instead, she says she feels amazing.

“I don’t feel like I’m walking around on eggshells, waiting for the next pain to appear,” Stefain said. “He helped me to see that even if the pain comes, it will go away. God is my savior, but Nitin Udhawani is, too.”