Although Mary Anne Angst makes
light about the meaning of her last
name, pain was no laughing matter
for the retired 61-year-old of Garden
City, who has suffered with chronic
back pain for the past four years.
Until recently, she hadn’t enjoyed a
full night’s sleep in almost a year.
Like many Americans who suffer
with chronic back pain, Mrs. Angst
was tired of not being able to walk,
sit or sleep comfortably. After
attempts to obtain relief through
physical therapy left her feeling frustrated
and still in pain, Mrs. Angst
turned to a team of specialists at
Winthrop-University Hospital for help.
Mary Anne Angst (left) is enjoying the
relief from her back pain so much that
she recently challenged her sisters Jane
Tuck (center) and Lorraine Kelly (right)
to a round of golf.
An initial evaluation and x-ray
examination by James D. Capozzi,
MD, Chairman of the Department of
Orthopaedic Surgery at Winthrop,
revealed arthritis of the spine. Dr.
Capozzi referred Mrs. Angst to pain
management specialist Edward S.
Rubin, MD, a board-certified anesthesiologist
and the Director of Chronic
Pain Medicine at Winthrop.
Dr. Rubin has extensive experience
in pain management, having completed
a fellowship in Pain Medicine at Weill
Cornell Medical College and training
at Columbia University, the Hospital for
Special Surgery and Memorial Sloan-
Kettering Cancer Center. Working in
collaboration with Winthrop’s
orthopaedic surgeons to help patients
manage their pain, Dr. Rubin specializes
in the treatment of pain in the joints and
spine, chronic pain of the low back and
neck, and muscle pain related to sports
injuries. He emphasizes the use of nonnarcotic
techniques when appropriate.
“Pain management is a multidisciplinary
specialty,” said Dr. Rubin.
“I am committed to providing patients
with the latest interventional techniques
that target the source of pain,
and creating a treatment plan that
focuses on improvements in functionality
as well as quality of life.”
Mrs. Angst’s arthritis is in the lumbar
(lower) spine. To treat it, Dr. Rubin
recommended radiofrequency ablation
– a minimally invasive technique that
uses heat to destroy nerves that transmit
painful signals to the brain. This
outpatient procedure, which can provide
relief for back, neck and muscle
pain, involves the insertion of a probe
to deliver a controlled amount of heat
to the painful nerve.
“By applying radiofrequency energy
to the source of pain, the pain-causing
nerve tissue is essentially destroyed,”
said Dr. Rubin. “Radiofrequency ablation
is not a permanent solution to pain
but the results can last approximately
six months to two years. What’s more,
treatment can be repeated with no risk
to the patient.”
Just two weeks after her initial
consult with Dr. Rubin, Mrs. Angst
traveled to Winthrop’s Ambulatory
Surgery Center (ASC) on Zeckendorf
Blvd. in Garden City to undergo the
first step in her treatment – a diagnostic
nerve block. This short outpatient
procedure involves the injection of
local anesthetic onto a specific nerve
or group of nerves to determine the
site of pain.
In Mrs. Angst’s case, Dr. Rubin targeted
the facet joints – small posterior
joints on either side of the spine –
which are often the cause of back pain.
“Low back pain can be generated
from any number of areas within the
spine, so it must be approached systematically,”
said Dr. Rubin.
As she left Winthrop’s ASC on
January 13, Mrs. Angst was thrilled –
not only with the compassionate care
that she had received but also with the
“I felt relief instantaneously and
knew that this was the answer for
me!” she said. One week later, Mrs.
Angst returned to the ASC to undergo
the radiofrequency ablation procedure.
Performed much like the diagnostic
nerve block, this procedure involves
the insertion of thin needles under
x-ray guidance into the region of the
facet joint. Once the needles are in
place, the patient receives a local
anesthetic and radiofrequency stimulation
That day, Mrs. Angst left the ASC
confident once again that radiofrequency
ablation was the solution that
she had been waiting for.
“I am so happy with the results,
that I told my friends about my success
and now some of them are looking into
it for themselves,” she said.
Today, weeks later, Mrs. Angst
continues to revel in the joy of what it
feels like to be pain-free. What’s more,
she’s getting back to doing some of the
things that she enjoys most – like playing
golf with her sister
“It’s been heaven! Life is normal
now!” she exclaimed. “And, the biggest
plus –” added Mrs. Angst, “I’ve slept
through every single night!”
Dr. Rubin offers a variety of interventional
pain management treatment
options – ranging from epidural cortisone
injections to high-tech spinal
cord stimulators and high power laser
therapy – to treat patients with acute
and chronic pain.
For more information about the
wealth of pain management services
available at Winthrop, call 1-866-
Vol. 20, No. 1
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