Pain, Pain, Go Away
Show these top pain doctors where it hurts—they can help.
Few things wring the fun out of life the way pain can. And as we age, we’re more likely to experience discomfort: According to a 2010 study, most people 65 and older have significant pain problems, yet their symptoms are underreported and undertreated. Why are so many older people suffering in silence? The study, which was published in the prestigious Ochsner Journal, suggests seniors often regard this misery as something they must simply endure.
But that notion is, well, painfully wrong. Throughout our area, talented pain specialists have made it their mission to give their patients relief. They’ve studied the intricate roadmap of our nerves, learning how to calm them. They’ve determined how to heal our very healing mechanisms themselves, should they go awry. With cutting-edge therapies and time-honored treatments, they address everything from aches to outright agony.
If you or an elderly loved one suffers from pain, here are five outstanding local pain doctors you need to know:
DONALD LISS, The Physical Medicine and Rehabilitation Center, P.A. (www.rehabmed.net) Englewood, NJ; Fort Lee, NJ; West New York, NJ; Riverdale, NY and Bardonia, NY
With five offices in New York and New Jersey, Dr. Liss’s practice is easy to reach from anywhere in the New York metro area. Yet patients travel from as far as overseas to see him and his colleagues. “I think the reason we’re still fairly unique is because we have both doctors and therapists under the same roof,” he says—in addition to physicians, the Center’s staff includes massage, physical, and occupational therapists, as well as physiatrists (doctors of rehabilitation and physical medicine). Dr. Liss himself is board-certified by the American Board of Physical Medicine and Rehabilitation.
The most common problems Dr. Liss sees “are spine-related—those probably account for 55 or 60 percent of our cases,” he says. The rest are widespread, from hip issues to knee pain. Treatment can range from massage to injections of anti-inflammatory medications. Short of surgery, “we have the ability to do almost anything,” says Dr. Liss. And he helps restore patients’ abilities as well. “I saw somebody just today who, on their first visit, could not lift their arm more than 90 degrees due to pain,” he recalls. “I had given the patient one pain-relief injection, and prescribed medication and physical therapy.” The result? “After just three weeks, the patient is 95 percent better,” Dr. Liss shares—quite a helping hand for a hurting arm.
JASON SIEFFERMAN Manhattan Pain Medicine, (www.manhattanpainmedicine.com)
Like many superheroes, Dr. Siefferman has two identities. By day, he tends to patients at the Manhattan Veterans’ Administration Hospital; by night, on Mondays and Thursdays, he sees patients at his private practice, Manhattan Pain Medicine. Though his private clients may not have been in the military, their own ‘active duty’ lives have taken a toll. Wherever it hurts, Dr. Siefferman will try to relieve it: “Anything pain-related, I treat,” he says, with anything from medication to bracing. In addition, he performs injections of medication into the spine, and can implant spinal-cord stimulators: “If someone has severe pain that is not going away with normal treatment, we can place small electrodes along the spine that block the pain signals, replacing them with a tingling feeling instead,” he explains. Another specialty of his, pulse-radio frequency, involves short-circuiting a nerve by zapping its pain signals with electricity.
“My niche has been getting patients off of high doses of opioids,” Dr. Siefferman adds—medications which are both potentially addictive and dangerous. “One patient was on huge doses of opioids after pain from multiple neck surgeries. We gave him injections to calm the pain, and weaned him off.” He credits his success with that patient, and many others, to his highly individualized approach. “A lot of times it’s just the issue of finding the right treatment,” he notes. “Each person is unique. That’s what really makes pain interesting to treat.”
ELENA OCHER, NYC Pain Medical Group (www.elenaochermedical.com)
Dr. Ocher treats all types of pain in her practice. But if you have persistent headaches, you’ll especially want to head her way. “Ours is a very unique group because we are operating for migraines,” she says. “We do decompression of cranial nerves to alleviate pain.” The procedure can also work for neck-related headaches and those caused by nasal diseases, she adds. But that’s just the start of the kinds of treatments she offers: Dr. Ocher can help with anything from groin and abdominal pain to aching caused by a knee replacement or diabetes. Her practice is also known for its skill at diminishing complex regional pain syndrome, a problem in which nerves become painfully hyperactive, often after an injury or trauma. “You have to know just how to enter the area where the nerve is located,” she notes.
Joint pain, such as that caused by arthritis or injury, is another area of focus for Dr. Ocher and her colleagues, which include two attending physicians, two nurses, and five medical assistants.
“Life is becoming more aggressive,” she notes, “And while we know how to treat things like hypertension and heart disease, we need to pay attention to treating pain issues too.”
YAKOV PERPER Astoria Pain Management (www.astoriapm.com)
Whether you have bad headaches, arthritis, or pain in your extremities, Dr. Perper has a treatment that may help you. Mostly, he performs injections in which he assesses the problem and/or administers medication. Don’t like needles? Hey, they’re better than knives. “A lot of my patients have been able to avoid surgery because of the injections,” notes Dr. Perper, who’s presented seminars at the London Pain Forum and other world-renowned professional gatherings.
Though Dr. Perper can perform all kinds of shots, from elbows to ankles, he’s particularly respected for his skill at injections to the spine’s first seven vertebrae. These so-called cervical spine injections, which can ease pain from arthritis, disk herniation, and other issues, “are among the most difficult,” he says. Done incorrectly, they can cause spinal-cord injuries, strokes, and other problems. Yet, says Dr. Perper, “I have performed thousands of these injections without complications.” Partly, he feels it’s due to his unique methods: Instead of lying face-down for the procedure, Dr. Perper’s patients remain seated in a special chair he invented. “I can bend the neck more, thus opening spaces in the cervical spine,” he notes. Generally, he performs these injections while using a fluoroscope, a type of mobile x-ray, for guidance. The relief can last for several weeks to months—or even forever: “Depending on the problem, it can be lifelong,” he says.
DOUGLAS SCHOTTENSTEIN, New York Spine Medicine (www.nyspinemedicine.com)
There are many pain doctors around, but few are also neurologists. Count Dr. Schottenstein among this elite group: “I’m one of only two hundred physicians in the country who is board-certified in both neurology and interventional pain management,” he says. He takes insurance, too, another relative rarity among top pain doctors. Small wonder, then, that he attracts patients from all age groups. “We have a fair number of kids from 13 on, and we also have patients in their late 90s,” he notes. He often uses MRIs or nerve tests to find the source of a patient’s problem, then employs everything from medications to surgical options, such as spinal injections, to treat the pain.
For those few patients who don’t respond to traditional strategies, Dr. Schottenstein offers newer, innovative treatments. One is Regenokine, in which some of the patient’s blood is removed, processed to concentrate its anti-inflammatory agents, then re-injected into the problem site. “We can use it to treat anything that ends with ‘itis,’ such as arthritis and bursitis,” Dr. Schottenstein says. The treatment—which insurance does not currently cover—is so sought-after for arthritis that he travels to Miami each month to administer it to some elderly sufferers there. But, Dr. Schottenstein stresses, most patients don’t need the costliest therapies: “We have so many wonderful, traditional tools that help people so much and are covered by insurance,” he explains. In fact, one of his most popular prescriptions is time, since many acute pain episodes resolve on their own. And when they don’t, he’s standing by. “I had a woman who came to see me when she was 82, because she’d been suffering from a pinched nerve for years. I gave her a single epidural injection, and it provided her with relief from the pain until her passing seven years later.” A story the woman’s son recently told Dr. Schottenstein gave him a good idea of how much he had improved her days: “Her son told me,” says Dr. Schottenstein, with an embarrassed laugh, “that she had a picture of me at her bedside for the last five years of her life.”
So there you have it: A few of the top names in pain management, and a few of the many treatment options they offer. If you’re suffering, take steps to address it—these doctors, and many others, are aching to help you feel better!
*Special thanks to Deborah Skolnik for helpng us put this article together and interviewing all these doctors!