Between the cane, the slight limp and the squint-eyed scowl, there was little doubt whom Bruce Hirshman, DO, was suggesting as he stood before physicians and physical therapists at the Methodist Pain Management Center in Flowood.

 

He was dressed up for than their amusement. Rather, it was an illustration of just how challenging their role can be when it comes to pinpointing a problem of pain.

 

"Many painful conditions are not initially clear and often are from a variety of different sources," Hirshman said.

 

"A large part of our professional time is spent dissecting out various disease states to arrive at the correct diagnosis — much like the days that Dr. House spends on TV, eliminating various diagnostic clues until the correct choice becomes evident."

 

Coming on board to lead the center in October, Hirshman brings a broad background to the challenge. While his main role is providing interventional pain-management techniques such as steroid injections and nerve blocks, he is also trained to use hands-on manipulation techniques to ease patients' chronic back and neck pain.

 

Hirshman is board certified in anesthesiology, pain management and osteopathic manipulation. He comes to the Jackson area from Michigan, where he had followed his two daughters during their college years. Once their studies took them elsewhere, he was ready to return to a more temperate climate.

 

Hirshman spent most of the last two decades practicing both pain management and primary care in Key West, Fla. Originally from New Jersey, he received his medical degree from the Michigan State University College of Osteopathy.

 

His training included an internship at Riverside Osteopathic Hospital in Trenton, Mich., a residency in anesthesiology at the University of South Florida College of Medicine in Tampa, and a fellowship in pain management at the University of Michigan School of Medicine.

 

His educational background emphasized a whole-person approach to treatment, serving him well in the pain-management field.

 

"We offer interventional and multidisciplinary approaches to the treatment of chronic pain," he said. "We seek to establish an accurate understanding of what the pain generators are and then attempt to correct the problems that cause the pain. That usually involves interventional techniques as well as physical therapy, psychological support and osteopathic manipulative medicine."

 

At the center, affiliated with Methodist Rehabilitation Center in Jackson, Hirshman typically spends his mornings performing injections to his patients' nerve, joint or muscle points. His interventional techniques also include the use of radiofrequency, a lesioning of nerve points that are causing pain.

 

His afternoons are generally spent doing patient evaluations and seeing patients in follow-up, as well as doing osteopathic manipulative medicine. In between, he works in time for his administrative duties, as well as consulting with colleagues in physiatry and physical therapy.

 

During his career, he's taken part in pain-management medicine's evolution from an approach based chiefly on physical therapy and psychotherapy. The interventional techniques arrived in sharper focus in the 1990s, and today are benefiting from the latest generation of imaging technology.

 

"With that benefit, our techniques have become much more precise, and we are able to much more precisely pinpoint those pain generators," he said.

 

Looking ahead, he and fellow pain-management specialists like their colleagues in other fields will be focused on not only new techniques for treatment but also on the question of their proven effectiveness.

 

"Pain medicine must more completely adhere under the rubric of evidence-based medicine," he said, "meaning that we limit our activities to those therapeutic behaviors that have been documented to improve patients' pain symptoms."

 

At the Methodist Pain Management Center, Hirshman and his colleagues provide a blend of services combining pain management, physiatry, obesity management, physical therapy, psychological support services, prosthetics and orthotics all under one roof.

 

"We're one of the only interventional pain centers that also treats headache," Hirshman said. "But we spend most of our time treating back and leg pain, as well as pain resulting from pinched nerves displayed as arm or leg pain."

 

Also treated are patients suffering with pain related to conditions like fibromyalgia or inflammatory bowel disease. The center also works with physicians at the main Methodist Rehabilitation Center to help treat spasticity in head-injury patients.

 

"Most of the time, we improve patients' pain, but do not eliminate it," Hirshman said. "But occasionally, we hit a home run and totally relieve someone's severe pain in one or two visits, returning them to work and a productive life."

 

Outside of work, as Hirshman has settled into life in Mississippi, he's appreciated the close proximity of cities like Memphis, Tenn., and New Orleans, with their opportunities to enjoy great music. He also spends time taking part in outdoor athletics, particularly running, walking and bicycling.

 

An avid fisherman, he spends whatever free time he can find enjoying that pursuit either out west, in Key West or in Central America.