Complex Pain Syndromes & Neuropathy
If Dr. Cohn’s three decades of experience have taught him anything, it is:
The vast majority of the underlying causes of chronic pain are REAL, findable, mechanical and/or inflammatory, and treatable!
Even those patients with terrifying diagnoses such as ‘Fibromyalgia’, CRPS/RSD, and Neuropathic pain/Neuropathy/Neuralgia or Myofascial Pain syndromes frequently benefit and many are even cured of their pain with proper diagnosis – usually via an accurate, detailed medical, injury, and pain history and properly performed osteopathic neuromusculoskeletal exam. Much of the time, even the most myseterious and intractable pain syndromes turn out to have mundane, easily treatable, but previously undetected causes.
Thanks to the pioneering research of Dr. John Lyftogt of New Zealand and others, most of these 'complex' or poorly defined pain syndromes have been found to have a single underlying common basis: neurogenic inflammation of sensory nerves.
Neurogenic inflammation can have multiple originating causes, but the majority of problems tend to arise from nerves being pulled too hard, stretched, or chronically rubbed, usually over bones or as they enter or exit 'tunnels' of muscle or fibrous connective tissue. Once the inflammation of the nerve starts, it may never recede on its own. In fact, the entire nerve - all the way back up to the origin of the nerves in the spine - may be inflammed and thus involved in chronic pain generation.
In cases like Complex Regional Pain Syndrome (CRPS) also know by many other names such as Reflex Sympathetic Dystrophy (RSD), it is theorized that these inflamed nerves on one side of the body (which are known to communicate with nerves from the opposite side of the body within the spinal column) may, via the inflammatory chemicals they secrete, sensitize the nerves on the opposite side of the body or even at different levels in the body. This is at least one of the mechanisms by which Dr. Lyftogt and colleagues theorize pain from a single injury may not only become chronic, but may spread to other parts of the body.
Knowing the mechanism by which the body not only maintains pain in one area but, may cause it to spread to the opposite side of the body (as frequently occurs in CRPS) or up or down the body, has allowed these physicians to determine effective forms of treatment. One of the most effective treatments appears to be either injecting simple sugars like glucose or mannitol around the effective nerves (known as NeuroProlotherapy - which Dr. Cohn prefers to call PAInT - Perineural Anti-INflammatory Therapy) or using methods like ultrasound to drive these simple sugars into the area around the nerves. It has been shown to quiet the nerves and reduce or eliminate the neurogenic inflammation. In Dr. Cohn's experience, sometimes treating only the original injury will stop the pain even on the OTHER side of the body.
Following are just a few examples of some of the types of complex pain syndromes with which Dr. Cohn has had significant success:
While Fibromyalgia may also arise via neurogenic inflammation, it may also arise from other causes such as chronic inflammation from food sensitivities or as a consequence of chronically loose (hypermobile) ligaments. For more information on how loose ligaments or tendons can cause pain, please refer to Dr. Cohn's booklet, ‘Treatments For Chronic Pain’. This book discusses treatments for pain that actually work. You can get this booklet as a free gift. Please refer to the bottom of our HOME PAGE.
Dr. Cohn can help determine the appropriate testing, if necessary, and the proper course of treatment.
CHRONIC DISC INJURIES
Disc injuries are most easily treated immediately after they occur.
- RULE #1: For spinal disc herniations that cause only pain, but no loss of reflexes or muscle function, SURGERY IS A LAST RESORT !!!
- RULE #2: DO NOT USE ANY ANTI-INFLAMMATORY MEDICATIONS IF YOU ARE DIAGNOSED WITH A DISC HERNIATION!!
- RULE #3: IF YOU HAVE PAIN, BUT NO LOSS OF REFLEXES OR MUSCLE FUNCTION, and YOUR DOCTOR RECOMMENDS IMMEDIATE SURGERY,
- SEE RULE #1!
- SEE DR. COHN!
Moreover, if you experience or have experienced multiple disc herniations, you may actually be suffering from an infection which spreads up and down the spinal column causing 'discitis.' Discitis weakens discs and may lead to substantial disc bulges or herniations. Contrary to popular medical wisdom, the treatment may be neither surgery nor laser therapy. It may be as simple as antibiotic therapy. An MRI may be helpful in determining the possibility of this infectious spread from disc to disc and may guide Dr. Cohn to provide definitive treatment.
Spinal stenosis, or narrowing of the canal in which the spinal cord (nerves) reside can have numerous causes from enlargement of something called the ligamentum flavum which runs down the inner surface of the canal, to boney narrowing or overgrowth, to impingement from disc bulges and herniations. Sometimes the treatment is very difficult, requiring surgery. Sometimes surgery is not an option. Sometimes the treatment is a combination of non-surgical therapies such as OMT (Osteopathic Manipulative Treatment) and Sweet Caudal Epidural injection to reduce neural inflammation and reduce scarring.
FAILED BACK SYNDROME (failure of surgery to relieve back pain) & ARACHNOIDITIS
This is actually an area of special interest to Dr. Cohn. He has had significant success in relieving patients of back pain which either was not relieved at all by back surgery ... or which occurred as a RESULT of back surgery.
Most patients who have had back surgery which has failed to get rid of their pain or which has resulted in complications are usually (and rightfully!) hesitant to undergo another 'corrective' surgery. Thankfully, Dr. Cohn has a different view of the true causes of back pain - especially in the post-surgical patient. Although altered anatomy from surgery can make it difficult or impossible to undo the damage done by surgery, Dr. Cohn has had some success in finding the actually cause of pain (often previously undiagnosed by prior physicians) and in treating patients who have had scar formation in or around the spinal cord, a condition known as 'arachnoiditis.' This scarring can occur as a result of surgical trauma, infection, or after a disc herniation. Dr. Cohn can frequently help determine the presence of arachnoiditis, its cause, and devise a treatment regimen to help remove the scarring and/or its pain-causing effects.