Pain and Rehabilitation

Dr. Chernish's Approach

Dr. Chernish has practiced both western medicine and traditional Chinese medicine for more than 30 years. His unique approach combines western medical science with traditional non-drug treatments including acupuncture and trigger point injections. Dr. Chernish develops rehabilitation, exercise and relaxation programs individualized to each patient. He also makes referrals to other medical specialists and prescribes medications when necessary. Dr. Chernish has extensive experience within the insurance industry, and can help guide you past any difficulties with your insurer if necessary.

Dr. Chernish’s approach to pain is:

  • Treat pain with acupuncture or trigger point injections and prescribe stretching exercises to improve range of motion in the spine and extremities.
  • Develop an individualized strength-training regime aimed at improving overall function and prevent pain from recurring.
  • Prescribe physiotherapy or athletic therapy for soft tissue mobilizations and improve strength and flexibility.

The goal is for pain to disappear and sleep and function to improve.

Dr. Chernish treats localized pain only; he does not treat generalized pain syndromes.

Acute Injury

Most strains, sprains, fractures and post-surgical issues are best treated as soon as possible, minimizing the risk of developing chronic conditions.

Acupuncture, dry needling and trigger point injections can reduce pain and swelling and improve range of motion and function when done as soon as possible after an injury or surgery.

Once pain is treated, range of motion exercises, soft tissue mobilizations and then strengthening exercises are added to regain function as soon as possible. Dr. Chernish relies on his team of therapists to expand his reach in this area.

Most acute conditions can be treated within two to four weeks, the goal being return to pre-injury/pre-surgery function.

Soft Tissue Pain

Dr. Chernish’s experience and training in treating pain is extensive and he relies on two main techniques: acupuncture and trigger point injections. Dr. Chernish also uses dry needling as a component of his acupuncture treatments.

In all cases of soft tissue pain lasting more than three months, there must be an element of stretching, soft tissue mobilization and strengthening to prevent chronicity and to regain full function.

Arthritis

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.

Hallux Rigidus & Osteoarthritis of the Great Toe & Thumb

Osteoarthritis of the big toe is painful and disabling, since pain interferes with each step. When the toe also becomes stiff, the condition is called Hallux Rigidus. Similarly, when the thumb is affected with “wear and tear” arthritis, daily tasks become very difficult.

The standard western medical approach is to prescribe anti-inflammatory medication and to perform surgery.

Using acupuncture, Dr. Chernish has helped many patients with arthritis of the big toe and thumb to achieve long-term freedom from pain and stiffness, often with a short course of  treatments, avoiding surgery and medication.

Rheumatoid Arthritis & Psoriatic Arthritis

Although there are a number of western medical treatments for rheumatoid arthritis, psoriatic arthritis and other inflammatory arthritic conditions, only acupuncture has been used to treat these conditions for thousands of years.

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 finds that acupuncture to treat psoriatic arthritis is particularly successful.

Spinal Pain

Spinal pain has many causes, including wear and tear, trauma, occupational overload, and as part of the aging process.

Dr. Chernish has found acupuncture to be very helpful in treating symptoms of spinal stenosis, acute and chronic sciatica, and cervical radiculopathies.

Herniated Disc/Degenerative Disc Disease, Cervical or Lumbar Discopathy

Herniated discs occur in the neck and mid-back, producing symptoms of aching or gnawing pain as well as shooting pain, tingling and numbness of the arm or other affected areas.

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

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 that is relieved with rest.

From a western medical perspective, the only treatment is surgery or an aggressive lumbar stabilization exercise program.

Dr. Chernish favours acupuncture to reduce pain and increase the capacity to move, exercise and enjoy life.

Occasional follow-up acupuncture treatments may be required. Best results occur when one adheres to a long term exercise program.

Nerve Pain

Sciatica

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 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.

“Slipped discs” in the neck and back, degenerative disc disease and disc herniations or protrusions all respond very well to this technique, with long-term improvement.

Nerve Palsies

Bell’s Palsy

Bell’s palsy is a complete one-sided facial paralysis that occurs following viral infections. It is common during pregnancy.

Most cases of Bell’s palsy recover spontaneously, but the current medical practice is to treat this condition early with steroids and antiviral medications. There are risks to even short- term courses of Prednisone for one to two weeks, including hypertension, elevated blood sugar and a very serious degenerative condition of the hip called avascular necrosis.

Acupuncture has been used as a stand-alone treatment for Bell’s palsy for thousands of years in China.

The condition usually responds well within one to three weeks, with improved pain and return of full facial function. In chronic situations where the paralysis has been present for more than six months, good results are still possible with a short course of treatment.

Drop-foot/Peroneal Nerve Palsy

Traditionally, acupuncture has been used to treat drop-foot or peroneal nerve palsy. This can be caused by injuries to the nerve itself, from sciatica or a disc problem in the lumbar spine and other situations. The goal is to restore function of the nerve within a short course of treatments.

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 revolutionized 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.

Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS, previously known as Reflex Sympathetic Dystrophy) occurs when an area is immobilized following a fracture, sprain or strain. In these cases, the following symptoms rage out of control:

  • severe pain
  • swelling
  • redness
  • 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, although the evidence suggests they may not be effective. Early mobilization is important however.

Dr. Chernish has found that, in situations where pain has been present for less than six months, acupuncture can be effective. The expectation is that pain, swelling and any skin, hair and nail changes will improve or disappear.

Headaches

Dr. Chernish’s goal in the treatment of all headaches is to eliminate pain and prevent headaches from recurring. Most patients achieve a remission of headache pain for months or years – or even permanently.

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 the individual’s needs. When required, he may also employ relaxation training, medications, stretching exercises or medical investigations.

“Suicide”/Cluster Headache

Dr. Chernish uses acupuncture to break the pain cycle of cluster headaches and prevent the “suicide headache” from returning. Long-term or permanent remission can be possible with a course of acupuncture.

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.

Medical treatments for these severe headaches are not regularly effective, and involve administration of oxygen or medications.

Other Pain Conditions

Frozen Shoulder (Adhesive Capsulitis)

In China, this is called the “50-year-old shoulder,” as it occurs in middle age. 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, though cortisone injections are often prescribed. The usual advice is to wait it out, as symptoms improve at the two-year mark.

Acupuncture has been used for centuries to successfully treat frozen shoulder.

Dr. Chernish is expert in administering this type of treatment, which 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.

Whiplash (Neck Strain Following a Motor Vehicle Accident)

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 therapy programs to restore range of motion of the neck and spine, and strengthen the affected areas to prevent recurrence of pain or stiffness.

Dr. Chernish’s treatments for whiplash, and athletic therapy and physiotherapy at HealthPoint Clinic, are usually covered by Manitoba Public Insurance. No referral is required.

Rotator Cuff Pain or Tear/Rotator Cuff Impingement/Impingement Syndrome

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. Acupuncture is an effective treatment for all of the 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 individualized flexibility and strength program.

Shoulder pain following flu shots is common and is usually amenable to acupuncture treatment.

Motor Vehicle Accidents & Work Injuries

Dr. Chernish has found trigger point injections and acupuncture to be invaluable in the treatment of whiplash and other car accident and work injuries. Acupuncture and trigger point injections can be directly billed to MPI and with pre-approval, WCB.

 Veterans

Acupuncture, trigger point injections and the management of pain and post traumatic stress disorder (PTSD) are covered by the Department of Veterans Affairs (DVA) with private approval.