While ‘family practice’ is an established field in its own right, in many respects medicine is always a family affair. No matter whether we’re young or old, the treatment of medical conditions can affect our whole families, frequently having implications beyond just the patient themselves. At Louisiana Pain Specialists, however, the term ‘family practice’ has another meaning. Originally founded by Dr. Tarun Jolly in order to serve Louisiana patients encountering issues in pain management, Louisiana Pain Specialists is proud to welcome a member of its own Jolly family as a new full-time physician on staff. This summer, Dr. Neil Jolly, brother to Tarun, will be joining the practice, and bringing his expertise to help treat those suffering from chronic and acute pain.
Dr. Neil Jolly arrives at Louisiana Pain Specialists with a great deal of experience and cutting-edge training. Born and raised in the greater New Orleans area, he moved to Texas and graduated from the University of Texas at Austin with honors, remaining in Texas to complete his M.D. and internship at UT Medical Branch in Galveston and UT Southwestern-Austin. He then trained at the Yale School of Medicine to receive his residency degree in anesthesiology, moving finally to North Carolina where he completed his interventional pain fellowship at the well-respected Carolinas Pain Institute/Wake Forest Baptist Health system.
Recently, Louisiana Pain Quarterly spoke to Dr. Jolly to get to know him better.
LPQ: What got you interested in pain management?
NJ: My desire to become a pain physician was simple. I asked myself this question: what medical specialty encounters a wide variety of medical problems, attempts to provide patients with a more active and enjoyable lifestyle, and can put a smile on both the patient and physician at the end of the day? What attracts many of us to become physicians in general is the aspiration to help others through a career that is both rewarding and challenging. Pain affects people of all backgrounds, all lifestyles, and all ages. I look around and see family members, friends, and peers that are all affected by pain, afflictions that at times limit their ability to enjoy life. After training in pain management, I can make a difference in my patients’ lives, and this is what is most fulfilling.
Dr. Neil Jolly and his brother Dr. Tarun Jolly. “We have the ability to share our expertise together and design treatment plans that will benefit our patients the most.”
I was exposed to the specialty of pain management at an early age through my brother Tarun Jolly, which provided me a head start in this field when compared to my colleagues. Now, the two of us have the ability to share our expertise together at Louisiana Pain Specialists and design treatment plans that will benefit our patients the most.
You’ve just finished your residency and fellowship. How has the field changed since you completed your training?
The field has changed dramatically, and for the better. A decade ago, patients and even physicians were unaware that ‘pain management’ existed, meaning that patients often dealt with suboptimal pain control. Now, however, we are increasingly aware of the severe consequences of untreated pain, resulting in a massive amount of published research paving the way for new therapies. A great example is spinal cord stimulation (also called neuromodulation), a minimally invasive therapy that provides excellent relief of various pain conditions affecting the spine and extremities. When it was first introduced, neuromodulation was used only as a treatment for leg pain. Today, however, we have discovered that it can be life-changing for patients that have chronic pain in their neck, back, arms, legs, and even various head pain syndromes! Other examples of
advancements in pain management include the use of smaller needles, smaller incisions, and more precise imaging – ultimately meaning safer, quicker, and more effective procedures for our patients.
Without a doubt, new technologies are a major part of the field. But are traditional approaches still valuable in pain management? For patients new to technology, how do older forms of diagnosis and treatment still enter in?
Great question. As mentioned earlier, perhaps the most active research in pain management focuses on neuromodulation. In this procedure, we implant very small wires that stimulate a patient’s spine through tiny electrodes, which in turn prevents the perception of certain pain signals and can ultimately relieve or even eliminate chronic pain. These treatments by far have been the most impressive development in the field. Additionally, radiofrequency lesioning, an old technique that has become more advanced, can essentially dissect a painful nerve very quickly to provide relief in many areas including the back, neck, hip, knee, foot, and head. With new research identifying exactly which nerves cause certain types of pain, this lesioning has become far more effective, providing us the ability to identify appropriate targets and perform precise interventions.
Traditionally, we consider the ‘old-fashioned’ approaches to pain management to be medications, exercise, physical therapy, and dieting, which are all extremely important components in treating a patient’s pain. We call this a multi-modal approach, which simply means that we include interventions, as outlined above, alongside medications and conservative treatments such as physical therapy and dieting to treat our patients. Research has backed this idea for years, that patients get better using more than one treatment plan rather than just one alone. While there is concern about prescribing certain medications safely, my duty as an ACGME-trained pain management physician is to find the right medication(s) for my patients and prescribe them at the right dose, keeping patient safety in mind. Certain conditions – such as nerve-related pain or joint-related pain – will require supplemental medications to provide more complete relief. But we combine this technique with other approaches such as exercise and dieting to give our patients the widest path to pain relief.
What types of procedures do you perform?
I can perform safely and effectively everything from simple joint injections in the office, to highly specialized procedures including minimally invasive spinal cord neuromodulation. Pain management is not a field where one can provide expertise by implementing only one or two approaches. Instead, we as pain physicians must utilize every piece of technology and knowledge we have in order to provide our patients the best opportunity for success. This means that I apply ultrasound guidedimaging as well as fluoroscopy to guide my treatments for precision and safety, and I always stay current through a variety of courses offered nationally and internationally when new devices or FDA treatments are approved.
“I can perform safely and effectively everything from simple joint injections in the office, to highly specialized procedures including minimally invasive spinal cord neuromodulation.”
Fluoroscopy is a core part of treatment options nowadays. For those who aren’t familiar with it, can you describe how it works?
Fluoroscopy is essentially an x-ray that is conducted in real-time. For instance, as I prepare an injection for a patient, we have them lie down on a flat table. Then we use a machine called a ‘C-arm’ (called that because of its shape) to show live X-ray images of the patient’s targeted area as I insert the
medication through a tiny needle to the area causing pain. Using fluoroscopy, we can even show patients pictures immediately after the procedure to confirm that we achieved the desired result. Finally, by targeting the precise area of pain, we need only use a small amount of medication as we deliver it directly to the correct location, as opposed to taking medications orally or through an IV. Not only is fluoroscopy one of the fundamentals of performing pain procedures, but it also provides patients the satisfaction that their physician can deliver medication with minimal side effects. Technology has brought us a long way!
How do you, as a practicing physician, regard the evolving state and federal regulations regarding pain management?
With the recent media attention on the potentially dangerous side effects of certain pain medications, regulations have arisen that limit physicians on what they can and cannot prescribe for their patients. What this means is that pain physicians – in particular those that have completed an accredited pain fellowship with the ability to attain board certification – should now be the primary consultants when it comes to treating pain. I am confident in utilizing all the methods currently available to provide the best treatment plan. By monitoring the use of certain medications and tailoring treatments to each patient’s needs, our patients are satisfied knowing that we keep their safety as our top priority. I know that all of us will remain at the forefront of this field by offering new and advanced treatment options to our patients as soon as they are approved and safe to use.
“I am committed to bettering the health and lives of my patients through compassion and diligence.”
You emphasize physical exercise as a key part of preventive pain management. Are you active yourself?
I played basketball in high school, and in my earlier years I played just about every sport you can imagine. I still stay active with friends on the weekends – if there’s a gym with a court nearby, chances are you’ll find me there. I also enjoy skiing when and where possible. I take pride that I never took formal lessons and instead just learned to ski through simple observation. It’s still one of my more enjoyable pastimes.
Let’s get to know you a little better. First, why practice in New Orleans?
This one is easy. I was born and raised here through high school. Once I left for college in Texas, I never left sight of New Orleans. My goal has always been to return home and be around the food, the sites, and most importantly the people I love. I do have an extensive “Jolly” family in the greater New Orleans area, but I also have friends with whom I have stayed in touch and a community that I would like to serve positively. Much of who I am today comes not from my training across the nation, but rather how I was raised right here in New Orleans. Plus, who would ever want to live in a city without Mardi Gras or the Saints?
Can you tell us about yourself?
Of course! I’m recently married to my wonderful wife, Rena. She’s a nurse from New York, so even as attractive as New Orleans is, I’ve had to do my fair share of convincing to help her understand that the Deep South has as much charm as does New York. I think so far she loves it.
Growing up, math was my favorite subject. Numbers always came naturally to me, perhaps from my father who is a lifelong accountant. Professionally and personally, I live with a philosophy in mind that comes from the great Dalai Lama: “Our prime purpose in this life is to help others. And if you can’t help them, at least don’t hurt them.” Finally, after thirteen years of training outside of New Orleans, I take pride in returning back to serve a community in a city that I call home. I am committed to bettering the health – and ultimately the lives – of my patients through compassion and diligence.