PainDoctor.com

Mission Statement
Kenneth Zahl, MD 23 North Fifth St. Stroudsburg PA 18360 Phone: 570-213-0292 Fax: 973-989-2645		I haveover twenty years experience in the evaluation, diagnosis, treatment and ultimate rehabilitation of chronic (and acute) pain. They may range from common spine problems such as neck (cervical) and back pain due to herniated discs, failed spine surgery and/or injured "facet" joints. I also treat patients with reflex sympathetic dystrophy RSD, occipital neuralgia, herpes zoster (shingles), cancer pain and other conditions such as fibromyalgia. I treat many patients with work-related or automobile accidents. I also have extensive experience with pulsed radiofrequency nerve modification to treat facet or reflex sympathetic pain. If necessary, Intradiscal Electrothermy, Nucleoplasty, epidural (spinal cord) stimulators, or narcotic pumps may be required for certain chronic conditions. I am a graduate of Columbia University, Medical School (College of Physicians & Surgeons) and had post graduate training in Anesthesiology at the University of Pennsylvania, where I also taught at the Medical School. I have held teaching positions at SUNY, Mt. Sinai, Columbia University and UMDNJ. I have given many national and international lectures. I have been in practice for over 21 years. In fact when I started Pain Medicine was only a small part of anesthesiology, now it is recognized as a separate field of specialization and as evidenced by the .com name, I saw that there would be the ability to broadcast this information on the world web web in 1995 which is how I reserved the paindoctor.com domain name. Technology is changing so quickly every day, that one has to sub-specialize, I have completely dedicated my practice to Pain Medicine, and have not done anesthesia since 1998. APPROACH: Treatment is done on an outpatient basis with the goal of reintegration into a normal life at home or work. I use a multi-disciplinary approach and coordinate the treatment with physical therapists, personal trainers at gyms, neurologists, orthopedic surgeons, neurosurgeons, physical medical and rehabilitation specialists, psychiatrists, psychologists and/or the family doctor. All treatment starts with a comprehensive detailed consultation that includes a detailed history and physical in addition to a review of X-rays, EMGs, CT or MRI scans. However, in many patients, with back or neck pain, it is often difficult to identify the exact source of pain. MRI scans frequently are not helpful, as they may show only the normal age related changes that occur in most people, whether painful or not. Diagnostic injections, may be useful both in cases of nerve root, back or neck pain. At the time of a diagnostic injection I selectively inject individual structures (i.e. nerve root, epidural space, disc or facet joint) of the vertebral area with contrast dye and/or local anesthetic, and observe the effect this has on the pain. If reproduction of typical symptoms occurs, this may indicate that the structure being injected is the source of pain. Alternatively, if the pain is relieved, even briefly, this could be another indication that the structure injected is the source of pain. Pain relief experienced immediately after a diagnostic injection is so important, that it leads to rational determination of future therapy. It removes the patient from psychogenic lock. Major injections are performed with stereotactic fluoroscopic control, to target an area, prevent errors and provide documentation. I see many patients who have been diagnosed with "fibromyalgia". In my opinion, true fibromyalgia is actually a rare condition, most of the time this diffuse muscular pain actually turns out to be pain related from facet joint syndrome (see better explanations on this website). This in turn, is a much more treatable condition, with a better prognosis. On occasion, if the patient qualifies, I prescribe chronic narcotic therapy with controlled release drugs in the form of long acting, slow release capsules, or patches worn on the skin. Customized drug combinations may be compounded. In some selected cases a narcotic infusion pump may have to be implanted (under the skin) to administer the medication directly to the spinal area. In other cases a spinal cord stimulator may be needed to modulate the painful nerve impulses. Finally, because of the overlap, I have many patients with chronic headaches from occipital neuralgia, to classic migraines or cluster headache in the practice. For a review of my curriculum vitae click here. "PAIN RELIEF DIGNIFIES LIFE"

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Mission Statement