Physical Medicine And Pain

In your practice of physical medicine, what is the most commonly ignored symptom?

The most common physical symptom that is ignored by patients is, by and large, pain. There's a myth out there that there's a certain amount of pain that people experience normally, and it's just not true. For instance, older folks think that as you grow older your body isn't functioning appropriately and this causes pain, and they have to live in pain. That's just not true. There's almost always some identifiable source of the pain that can be treated, even if your'e 94 years old. My recommendation is, if you're experiencing some pain that's not going away, you don't understand why you're in pain or if the pain is getting worse, seek out a rehab doctor. A physical medicine and rehab specialist. We're the best at evaluating and diagnosing the sources of pain and coming up with a treatment plan to make it go away.

What are some new treatments for chronic pain?

There are new treatments for treating pain. Pain management is an area of medicine that's still evolving. One of the newest and most exciting ways of treating pain is the use of botulinum toxins for pain. There are two botulinum toxins that are licensed for use in the United States, and both of those have shown promise in treating certain types of pain. So what you want to do is you want to find a physician who is experienced in the use of those toxins and then have them evaluate your particular situation and see if you would be a candidate for the use of a botulinum toxin. In my practice I have used them very effectively to treat some folks with particular types of chronic pain such as neck pain, back pain--some people with headache have responded well to botulinum toxins--myofascial pain, pain related to spasticity. There are many, many uses for botulinum toxins.

What is a "botulinum toxin" and how is it used in physical rehabilitation?

A botulinum toxin is a chemical that is found in the bacteria Clostridium botulism. It's been identified and used in medicine since the forties. It hasn't really become popular until the last ten years or so, where it's now being used for cosmetic purposes that it's being injected into people's faces to minimize or eliminate wrinkles in their faces. And this is why it has become a household compound. But it really has been used in medicine since the mid-forties for many therapeutic reasons.

What is "myofascial pain"?

Myofascial pain very simply stated is muscular pain A physician will want to try to identify why you have myofascial pain in that muscle and then determine the appropriate type of treatment for the myofascial pain. That may be oral medications. It may be physical therapy. It may be modalities such as heating packs or ice packs or ultrasound, or e-stimulation or even injecting the muscle with a botulinum toxin.