Dr. Chernish's Approach
"When treating patients with pain, I often, but not exclusively, use acupuncture and trigger point injections, dry needling or IMS within the context of a medical diagnosis. I frequently prescribe specific exercise when appropriate. I review all pain patients for psychological and physical comorbidities."
Dr. Chernish has found that these conditions are particularly amenable to acupuncture treatment, dry needling or trigger point injections:
Adhesive Capsulitis (Frozen Shoulder)
Trouble may start after a strain or fall or following surgery or injury to the arm. Pain and stiffness become increasingly severe, especially in the motion of placing your hand behind your back. Sleep is often interrupted by pain.
Western medicine has no effective way to treat this condition, although cortisone injections are often prescribed. The usual advice is to wait it out, as symptoms improve at the two-year mark.
Dr. Chernish finds that treatment requires an extremely light touch as it easy to aggravate adhesive capsulitis. Specific stretching exercises will be prescribed, and when necessary Dr. Chernish will prescribe medication in addition to acupuncture.
Diabetic amyotrophy is a painful nerve condition which most often affects the thigh and occurs usually in middle-aged men with type 2 diabetes. It is characterized by burning pain and muscle wasting and weakness. Dr. Chernish has found that very precise acupuncture offers quick and long-lasting relief.
Both rheumatoid arthritis and osteoarthritis respond well to acupuncture. The goal is not just reduced pain, but also reduced swelling, improved joint range of motion and improved function.
The easiest joints to treat are the smaller joints such as the thumb, fingers, toes, ankles and wrists.
Osteoarthritis of the Big Toe & Thumb, Hip, Knee, Shoulder and Spine
Osteoarthritis of the small joints are easiest to treat with acupuncture, and other affected joints also benefit.
Osteoarthritis of the big toe is painful and disabling, since pain interferes with each step. When the thumb is affected with “wear and tear” arthritis, daily tasks become very difficult.
Osteoarthritis of the knees, hips and shoulders produce pain and stiffness.
Using acupuncture, Dr. Chernish has helped many patients with arthritis to achieve long-term improvement in pain and stiffness, often with a short course of treatments, delaying or avoiding more invasive treatments.
Rheumatoid Arthritis & Psoriatic Arthritis
The goals of acupuncture in the treatment of rheumatoid arthritis and psoriatic arthritis are to improve joint motion and reduce pain, swelling and stiffness as well as frequency of flare-ups.
While results depend on the severity of the condition and the number of joints affected, Dr. Chernish has found that acupuncture is particularly successful for treating psoriatic arthritis.
Ankylosing Spondylitis & Other Spondyloarthopathies
Spinal pain has many causes, including wear and tear, trauma, occupational overload, and as part of the ageing process. Ankylosing spondylitis is an autoimmune condition which causes stiffness and pain of the spine and hips. Other spinal inflammatory conditions (spondyloarthropathies) cause similar symptoms. Dr. Chernish has found that acupuncture can have significant and prolonged effect on pain and stiffness regardless of whether you are also taking anti-inflammatory medications, immune suppressants or biologic therapies.
This is a condition usually occurring in the hip when blood supply to the femoral head is compromised by use of steroid drugs. Dr. Chernish has seen this condition occur even with short term use of cortisone for poison ivy treatment. Symptoms are severe pain in the groin and pain of the hip with motion and collapse of the head of the femur seen on x-ray or MRI. A total hip replacement is usually required at some point, but Dr. Chernish has found that acupuncture can help pain while waiting for hip replacement.
Back Pain and Neck Pain
Back and neck pain may originate in muscles, bones, joints or discs. Acute low back or neck strains, chronic back or neck aches and stiffness all respond well to acupuncture.
Herniated Disc/Degenerative Disc Disease, Lumbar Discopathy
Herniated or degenerative discs can occur in the neck, mid or low back, producing symptoms of aching or gnawing pain as well as shooting pain, tingling and numbness of the leg.
Dr. Chernish’s approach includes acupuncture to eliminate pain, stretching to restore range in affected spinal segments, and exercise programs to regain strength. Numbness usually improves slowly over time.
Spinal Stenosis occurs when the spinal cord is pinched in the neck or back by a herniated disc or osteophytes (bony growths related to wear and tear arthritis). Symptoms include back or neck pain and tingling of the arm or leg with activity or standing that is relieved with rest. Dr. Chernish has many long-term patients who experience long-term pain relief with acupuncture.
Occasional follow-up acupuncture treatments may be required. The best results occur when one adheres to a long term exercise program and weight loss program if required.
Sciatica is electrical pain shooting down the side or back of the leg, which results from a herniated disc in the lumbar spine. Dr. Chernish has treated this condition hundreds of times usually with quick and successful resolution of pain.
In acute sciatica acupuncture will improve pain significantly, setting the stage for a range of motion and strengthening program. Results are best when treatment begins during the first month.
Bell’s palsy is a complete one-sided facial paralysis that occurs following viral infections. It is common during pregnancy and occasionally produces facial pain.
Most cases of Bell’s palsy recover spontaneously, and current medical practice is to treat this condition early with steroids and antiviral medications.
The condition usually responds well to acupuncture with quick return of full facial function within 4 weeks in Dr. Chernish’s experience. In chronic situations where the paralysis has been present for more than six months, treatment may take a little linger.
Dr. Chernish finds that acupuncture can provide adjunctive pain relief in situations where cancer is causing bone or nerve pain. Treatment is most successful when narcotics are not being used or are used in low dose.
Complex Regional Pain Syndrome / Reflex Sympathetic Dystrophy
Complex Regional Pain Syndrome (CRPS, previously known as Reflex Sympathetic Dystrophy) occurs when an area is immobilised following a fracture, sprain or strain. In these cases, the following symptoms rage out of control:
- severe pain
- change in local skin texture
- excess hair growth
- excess sweating
- change in nail growth
The standard medical approach is treat this condition with medications and injections. Early mobilisation is important.
Dr. Chernish has found that, in situations where pain has been present for less than six months, acupuncture can be very effective. The expectation is that pain, swelling and any skin, hair and nail changes will improve or disappear. Here is an example from Dr. Chernish’s practice:
DISH (Diffuse Idiopathic Skeletal Hyperotosis)
Dr. Chernish has made this diagnosis many times and finds that acupuncture can play a very helpful role to reduce pain and stiffness particularly if there are signs of spinal stenosis. DISH is a condition in which, for reasons unknown, the spine stiffens and fuses together. Although stiffness will not disappear with treatment, acupuncture will definitely help pain significantly in most people in Dr. Chernish’s experience.
This is a painful vascular condition usually of the legs. Medical treatment is usually with vasodilating medications. Here is an example of a patient Dr. Chernish treated successfully with acupuncture:
Facial Pain, Hemifacial Spasm & Trigeminal Neuralgia
Trigeminal neuralgia is an episodic aching, shooting pain on one side of the face, often misdiagnosed as dental or sinus pain.
The treatment of trigeminal neuralgia has been revolutionised over the last decade with the use of the drug gabapentin and surgical decompression of the trigeminal nerve. When these treatments have not been successful, or for those who cannot tolerate or who wish to avoid medications and surgery, acupuncture has a traditional record of success and Dr. Chernish has treated this condition with success many times.
Dr. Chernish has found that fibromyalgia and other diffuse pain conditions require a multimodal treatment approach and has found that acupuncture does not provide sustained benefit for these conditions. Accordingly, Dr. Chernish does not treat fibromyalgia.
Dr. Chernish has found that acupuncture works well in treating acute, chronic and post-traumatic gout.
Migraine, Tension, Menstrual, Post-Concussion & Headaches
Dr. Chernish treats migraine headache and menstrual headache with acupuncture. For tension headaches, post-concussion headaches or whiplash-associated headaches, he will use either acupuncture or trigger point injections, depending on each individual’s requirements. When required, he may also employ relaxation training, medications, stretching exercises or medical investigations.
A suicide or cluster headache is an intense, one-sided throbbing headache associated with nasal stuffiness and eye tearing which occurs intermittently in cycles of days to weeks. The pain can be so intense as to provoke suicide.
Regular medical treatments may involve administration of oxygen or medications.
Injections or acupuncture are both effective in Dr. Chernish’s experience.
Phantom Limb Pain
Dr. Chernish has found acupuncture helpful in this sometimes difficult to treat condition.
Acupuncture treatment requires a very light touch for this condition in Dr. Chernish’s experience and sometimes medications are also required in addition to acupuncture.
Reflex Sympathetic Dystrophy (see Complex Regional Pain Syndrome, above)
Spinal Stenosis (see Back Pain, above)
Trigeminal Neuralgia (see Facial Pain, above)
Rotator Cuff Pain, Rotator Cuff Tear, Rotator Cuff Impingement, Impingement Syndrome
Dr. Chernish is very confident in diagnosing and treating shoulder pain syndromes.
Falls on the shoulder or injuries from work, exercise or motor vehicle accidents can result in a rotator cuff strain, rotator cuff impingement (“impingement syndrome”) or rotator cuff tear. Dr. Chernish has found that acupuncture is an effective treatment for pain associated with rotator cuff tears, rotator cuff impingement and impingement syndrome. Once pain is improved, a flexibility and strengthening program must be instituted in order to regain function and prevent recurrence.
Dr. Chernish can make the medical diagnosis, order an MRI or X-ray, refer to an orthopedic surgeon if necessary, and provide you with an individualised flexibility and strength program.
Whiplash/Motor Vehicle Accidents
Whiplash is a painful sprain of the neck typically following a car accident. This may be associated with headaches.
Dr. Chernish’s treatments for whiplash include acupuncture-type dry needling or trigger point injections of tender spots and trigger points in the neck and back. Dr. Chernish may recommend exercise to restore range of motion of the neck and spine, and strengthen the affected areas to prevent recurrence of pain or stiffness. No referral is required.
Veterans, DVA & Acupuncture
Acupuncture and trigger point injections are covered by the Department of Veterans Affairs (DVA) when performed by a medical doctor.
Worker’s Compensation Injuries & Acupuncture
Dr. Chernish has found trigger point injections and acupuncture to be valuable treatments for the injured worker. Acupuncture and trigger point injections can be directly billed to WCB after WCB approval.