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Minimally Invasive Technique Offers Hope for Chronic Back Pain Sufferers

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.

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.
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.

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 immediate results.

�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 is administered.

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- WINTHROP.
Vol. 20, No. 1
Winter/Spring 2010

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