Institute for Healing Arts Research : Director, Andrew Kochan, M.D.
Clinical Programs:
Acute & Chronic Pain Treatment Program

 Pain is defined as an unpleasant sensory experience. This definition does not take into account all the emotional, physiological, physical and sociological ramifications of pain upon the individual who is in pain.

Pain is usually divided into two broad categories- acute and chronic.

Acute pain is generally a biologically useful warning of impending or actual tissue damage. An example is the pain of touching a hot stove where you might get burned. It is usually well defined with clearly defined sensory receptors in the affected tissue (skin, bone, bowel, etc.). Examples of acute pain that are treated most commonly at the Center for Healing Arts Research include motor vehicle accidents, injuries from falls, arthritic pain, sports injury and shingles and scar pain.

Chronic pain is defined as pain that lasts longer than normally would be expected for a particular injury or problem or pain that persists more than three months. It is not biologically useful information. It doesn’t warn you of impending injury if you don’t stop doing what you are doing. Chronic pain just hurts! It has poorly defined mechanisms, it is not always clear why it gets better or worse, and its transmission within the nervous system, its central connections and pathways are unclear. Some pain researchers believe that chronic pain, if it persists long enough, gets “imprinted” upon the nervous system and can not be treated without extreme measures.

Once someone is put into the chronic pain category they are treated differently. Doctors stop looking for a cause, they try different types of medication in an attempt to suppress “persistent over-activity” in the nervous systems, they stop listening to the patient (if they ever listened at all), and they tell the patient that there is nothing more that can be done and that the patient should learn to live with it. Untreated pain can be a dangerous condition that can have ill effects on neurologic feedback processes that affect healthy brain function, psychological state-of-mind, and harm the immune system. There can be side effects or in some cases injury and even permanent impairment as a result of the medication or other treatments, including surgery, used to manage chronic pain.

I believe that there is a third category- persistent undiagnosed or inadequately treated acute pain. I have been treating pain patients for more than twenty-five years. My experience is that most patients with “chronic pain” actually have undiagnosed acute pain which can be treated and the pain greatly diminished or even eliminated once the correct diagnosis has been made. This requires more than just getting a blood test or a MRI. Many of the patients I have seen with long standing pain have never had detailed history and physical examination. Thus, a proper diagnosis has never been made. On more than a few occasions I have been told that I was the first doctor who ever did a thorough physical exam including palpation which addressed the area of concern. Many physicians because of various reasons including time restrictions or ignorance do just a “where does it hurt” examination and send the patient for a radiologic or blood test. These tests often show one or more findings which are not clinically relevant and do not explain the patient’s symptoms. However, those “objective” findings are what are treated, with predictably poor results. In other cases, it is the treatment which is not appropriate or adequate for the diagnosis. In many cases patients are told that there is nothing more that can be done and they are given prescriptions for anti-depressants, muscle relaxants or medication to “calm the nerves”. Given the limited choices of treatments known or available to most doctors, the statement that there is “nothing more that can be done” may seem to be true- BUT IT IS NOT!

I feel that Integrative Medicine, which is the combined use of both conventional and complementary diagnostic and healing techniques, offers the best approach to pain treatment. Multiple therapies can be blended in a way that is tailored to the individual and their specific health condition to cure both acute and chronic pain more quickly than is commonly thought possible. I have treated many patients with “chronic” or neuropathic pain for which conventional medicine has no treatment or where physicians have given up trying to treat them and have been able to resolve or greatly reduce their pain overnight or within a few days.

I have a first-hand understanding of the techniques used both in mainstream pain medicine and in Complementary and Alternative Medicine (CAM). My many years of hands-on experience in physical medicine, orthopedics, and multiple holistic health disciplines enable me to design a custom treatment plan for each of my patients.

Dr. Kochan and his clinical associate Mr. Ray Seipel, CMA specialize in the use of prolotherapy, *platelet rich plasma (PRP)* and apitherapy to treat acute and chronic pain including headaches, neck and back pain, joint pain and arthritis clinical and neuropathic pain including shingles pain and scar pain. In addition, when necessary, they may use other useful modalities including Botox injections, trigger point injections and oral and trans-dermal narcotic or non-narcotic medications, massage therapy and hormone or nutritional therapy. If warranted, patients may also be referred to outside specialists for adjunctive treatment with acupuncture, biofeedback, psychological counseling, and chiropractic, osteopathic or physical therapy.

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