I take a non-surgical approach, and my diverse training allows me to look at pain from many different angles. Physical Medicine and Rehabilitation training has taught me how to check the nerves, joints and muscles of the body. And in conjunction with my Osteopathic Medicine background, I employ a holistic approach to the body. In other words, by using a “hands on” approach, I can feel where muscle “tightness” or “spasm” may be the source of the problem. For example, knee pain can originate from an ankle, foot or low back problem; shoulder, elbow or hand pain can originate from a problem in the neck.
My very first step is to make certain that the problem is not stemming from a larger medical problem, such as cancer, brain or spinal cord injury, infection, immunity or hormonal imbalance. This “screening” is accomplished through a comprehensive history and physical examination. On occasion, X-rays or routine blood tests are necessary.
Then with the “current standard of care,” I make a diagnosis and begin treatments which carry the smallest risks. These treatments may include a prescription or over-the-counter medicine, and almost always, a personally tailored home exercise program. I believe in manual therapy, such as Osteopathic Manual Therapy, but may send patients to Chiropractors for adjustments, Massage Therapists, Acupuncturists, and Physical and Occupational Therapists. Sometimes, a small brace or therapeutic pillow may provide additional relief.
If these initial steps do not begin to resolve the problem, additional tests and treatments may be considered. Some procedures that I perform regularly are EMG and nerve conduction studies, trigger point injections and simple joint injections. I leave the procedures that carry more risk, including surgery, to other physicians, but keep up-to-date on these procedures, so I’ll know when to refer patients to others for evaluation.
Chronic pain may not be curable, but may be tightly controlled. Like most diabetes and high blood pressure, chronic pain may not always be fully curable, but may be controlled or “tamed,” with only mild flares on rare occasions. This may become a realistic goal.
-Jeffrey H. Chester, DO