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Standing Up to Pain

Pain took center stage during season 11 of ABC’s “Dancing with the Stars,” when Jennifer Grey almost didn’t perform during the finale due to a severe back injury.

The actress, who shot to fame in the 1987 flick “Dirty Dancing,” ruptured a disc during her final freestyles and turned to her longtime physician, Dr. Robert Bray, the first California neurosurgeon to devote his practice to minimally invasive spine surgery. Following an outpatient procedure, the then 50-year-old actress returned to the prime time show to beat out competitors a fraction of her age and take home the coveted mirror-ball trophy. “She went from disabled to winning the mirror ball,” Bray said.

Diagnosis

As many as eight out of 10 people will be affected by debilitating pain in their lifetime. “It’s the leading cause of disability for work in the United States, other than the common cold,” Bray said.

Fortunately, most of these cases are temporary inflammation, which the body uses to jump start the immune system, and can be managed with rest or over-the-counter drugs. “A heating pad, ice packs, physical therapy can help,” said Dr. Rostam Khoshsar, a pain management specialist at the Presbyterian Intercommunity Hospital in Whittier.

But about 3% of people affected by pain end up with chronic pain syndrome, which is pain that lasts longer than six months and interferes with lifestyle.

Grey is one of the thousands of patients treated at the L.A.-based DISC Sports and Spine Center, founded by Bray in 2006. The center, which is the official medical provider of the U.S. Olympic Teamand Los Angeles Kings, takes a multidisciplinary approach to pain with a team of providers — acupuncturists, chiropractors, pain management specialists, rehab therapists and surgeons — functioning as an integrated group.

“When a patient is truly affected by chronic disabling pain, they need to seek a level of expertise where they will be fully evaluated,” Bray said.

At DISC, which has offices in Marina del Rey, Beverly Hills and Orange County, specialists use different techniques, including a scans and X-rays, to hunt down the cause of a patient’s pain.

“The most important thing, in my opinion, is getting an accurate idea of the cause,” Bray said. “Too many people are just treated with narcotics without a diagnosis.”

Treatment

When it comes to treatments, Bray’s philosophy is to try the most conservative options first, including prescribed exercise and rehabilitation programs, counseling with a psychologist to help with stress and pain management, as well as injections and anti-inflammatory drugs.

Khoshsar turns to new technology to treat patients, including radio frequency treatments, epidural injections and a spinal cord stimulator. Acting like a pacemaker for the spine, the stimulator releases electrical impulses to block pain. “I’ve done over 150 cases with a very high success rate,” he said, adding that the procedure can be used to treat abdominal pain, endometriosis and migraines.

Even the most minimally invasive surgeries are often last on the treatment list. “We created this entire structure to try to avoid surgery,” Bray said of D.I.S.C.

If a patient is still in severe pain post-surgery, Khoshsar said a spinal pump is another option. “It’s implanted in the body and delivers medication to the spinal cord where it needs to go without side effects of oral narcotics.”

Despite the variety of potential treatments, patients often need a dose of reality.

“Chronic pain patients have to live with a certain degree of realism — they’re going to live with some pain,” Bray said. “We shoot for an improvement in their lifestyle, not necessarily pain-free perfect.”

Jamie Wetherbe, Brand Publishing Writer

Copyright © 2014, Los Angeles Times
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