-by Bob Fitch, Farming Families magazine
Dr. James Jeltema’s role in life is helping patients manage pain. By the time they get to him, people are usually suffering severe or chronic pain. He said the best medicine is always preventive care.
“Like your tractor or car, if you don’t take care of things under the hood in the offseason, then when it’s harvest time you’re going to be in trouble because things are breaking down and not working,” he said. In rural areas when harvest is done, many doctors and surgeons see an uptick in activity as farmers catch up on their medical needs, whether it’s just a checkup or seeing the dentist, eye doctor, colonoscopy, or addressing pain.
Jeltema is a doctor of osteopathic medicine at Orange City Area Health System. He is a native of Orange City and graduate of Unity High School and Northwestern College. He attended medical school at Des Moines University and did a residency in anesthesia in Lansing, Michigan. He also had a year-long pain management fellowship in Detroit before returning to Orange City about five years ago.
Much of the treatment Jeltema provides is injections for neck and back pain, be it for general arthritis or more reticular or sciatica-type problems. “We cooperate with our sports medicine group here; we do a lot of ultrasound-guided injections. I do some of those for different joint-related issues, whether it’s shoulders, knees or hips.” The doctors in Orange City Area Health’s Pain Management Clinic and Sports Medicine & Musculoskeletal Ultrasound Clinic work closely with the skilled team in the Physical Therapy Department. Together, they cover a broad range of symptoms and situations to address chronic and acute injuries “so people can get back to what they love to do.”
Jeltema is also engaged in medication management. “There’s a of different medications we can utilize along with the injections and physical therapy. Patients may also benefit from working closely with our clinical psychologist to cope with the mental stress of dealing with chronic pain. So we have a nice rounded, multimodal approach,” he said. Epidural steroid injections might be considered for low back or neck pain and pain shooting down legs or arms.
Care is taken with pain medications. The strongest opioid medications are typically reserved as a last resort for acute post-operative pain or cancer-related pain. “We try to avoid those if we can and take more of a multi-modal approach with anti-inflammatories, Tylenol, gabapentinoids, or different TCAs or topical medications.” (TCAs are tricyclic or tetracyclic antidepressants.)
Another procedure he performs commonly is radiofrequency ablation, which treats arthritis in the back and your neck. While this procedure doesn’t get rid of arthritis, it tries to get rid of the nerve that’s sending signals to the brain that there’s arthritis in the joints.
Whether it’s injection, medicine or radiofrequency ablation, treatment before and after often includes physical therapy exercises and stretching, Jeltema said. “I understand most farmers are very active and do a lot of physical work. When I say people might need physical therapy, it doesn’t mean they’re lazy or out of shape. Physical therapy targets your specific area of injury. You might work out four times a week, but that doesn’t necessarily target the specific muscle groups where you need to manage pain.” Physical therapy can help improve patient’s strength, flexibility, and function which helps decrease their pain and reduce the chances of re-aggravating their injury.
The Sports Medicine & Musculoskeletal Ultrasound Clinic at Orange City Area Health System focuses on innovative non-surgical treatment for orthopedic problems caused by a variety of conditions ranging from sports injuries to chronic overuse. The clinic features ultrasound-guided diagnoses and minimally-invasive treatments for injuries of bone, muscle, tendons, ligaments, and joints. Musculoskeletal ultrasound provides real-time images to help diagnose and treat injuries while being safe, painless, and free from radiation exposure. It can help patients avoid surgery, while also offering faster recovery time and return to activity. Dr. Jeltema circled back to the importance of preventive care. “If something hurts, that’s your body’s way of telling you there’s something wrong. But, even when you’re feeling good, you should be seeing your primary care doc at least annual for a checkup, regular lab tests and other kinds of preventive care.”
