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Best Kept Secret 2

The medical specialty of Physiatry, also known as Physical Medicine and Rehabilitation, is a comprehensive and multidisciplinary approach that improves function and relieves pain without surgical intervention.

Chronic Pain Stuart B. Krost, MD, P.A. Chronic pain is one of the most frequent causes of suffering and disability in the Western world, and one of its most pressing healthcare issues. The University of Utah Health Sciences Center reports that chronic pain affects about 80 million Americans and is the third leading cause of impairment in the United States, after cancer and heart disease. According to Washington University School of Medicine, chronic pain can lead to loss of employment and income; and to depression, fear, isolation and anxiety. Marital and family dysfunction can result. Persons suffering from chronic pain often describe their pain as unbearable.

It can interfere with their lives to the point that their sleep is disturbed, causing fatigue, depression, declining participation in work and leisure activities and disruption of family life. Yet, according to Stuart B. Krost, MD, who is board certified by the American Academy of Physical Medicine and Rehabilitation and the American Academy of Pain Management, many chronic pain sufferers can find the help they need. “The field of physiatry originated after the two World Wars, as returning soldiers came home with brain injuries, spinal cord injuries, amputation and other disabling traumas,” educates Dr. Krost. “This specialty developed to enable physicians to identify their patients’ physical impairments and functional disabilities and then rehabilitate them back to improved functional independence, restoring them to productive lifestyles.”

Today, Dr. Krost uses this little-known yet extremely powerful field of traditional medicine to treat patients in acute or chronic pain from auto accidents, sports injuries and physical injuries at work, and those who suffer spinal cord injuries, brain injuries, strokes or amputations. Comprehensive approach The field of physiatry not only addresses pain but also takes advantage of the pain relief provided to rehabilitate the patient and treat the pain generator that is causing the problems. “We do more than just block pain,” notes Dr. Krost. “We are focused on diagnosing where the pain is coming from, differentiating which pain generator is actually causing the problem and specifically addressing that pain generator to relieve pain and restore function.” For instance, for a patient with lower back pain, a physiatrist would determine whether the pain was caused from a muscular component, a ligament component, a joint component, a disc component or a nerve component. “In addition to diagnostic imaging such as x-rays, MRIs, or CT scans, we also use diagnostic injections or blocks to discover the specific pain generator. Diagnostic injections and blocks can sometimes act as both diagnostic and therapeutic tools.

“We offer many procedures, including epidural injections, facet blocks, BOTOX, percutaneous discectomy and electrodiagnostic testing,” says Dr. Krost. Percutaneous discectomy is a minimally invasive procedure for treatment of herniated discs. It is delivered through a needle rather than through open surgery with the ultimate goal of relieving pressure on the exiting nerve root as well as relieving pain. An electromyogram, or EMG, is a diagnostic study that provides information about the integrity of the muscles and nerves in the body. It is typically ordered by a physician to evaluate for muscle or nerve damage, can help diagnose whether or not the nerves are being pinched and can be helpful when correlating findings of an MRI. “Once we have determined the pain generator, we can outline a treatment plan for that specific problem,” points out Dr. Krost. “Each generator will have a different treatment approach. “What makes this field of medicine so effective is that we consider the patient as a whole. We not only determine the medical problem contributing to a patient’s complaints but we also consider how it affects their functional ability, vocation and quality of life. “Treatment is unique in that we combine medicinal and non-medicinal measures, offering treatment options to avoid medication when possible. We consider both the physical aspects of our patients’ conditions and how they affect them psychologically.”

Physical therapy Once the pain is relieved, a window of opportunity opens for rehabilitation. “Physical therapy can be a very important element in terms of rehabilitation when neurologic, muscular and skeletal problems are causing the pain or impaired function,” says Dr. Krost. “As a physiatrist, I can actually write a prescription for the therapist to follow, rather than merely writing an evaluation and treatment prescription, leaving it up to the therapist to design a program. By ensuring the program’s specificity based on the evaluation, we can offer our patients better results in fewer treatments. “And we not only treat our patients, but we also educate them in methods they can use to help themselves at home.” Dr. Krost believes that education can be key to a successful result. “Patients should leave their physicians’ offices with a full understanding of their conditions and treatment options,” insists Dr. Krost.

“It is critical that physicians listen to their patients and that there is full discourse.” In keeping with his philosophy, Dr. Krost offers a bilingual staff and encourages the public to further educate themselves on the field of physiatry. FHCN–Kris Kline If you have pain Dr. Krost invites your inquiries regarding the management of acute and chronic pain. For information or a consultation, please phone 561- 296-2220 for locations at 3618 Lantana Rd., Suite 201, in Lake Worth, 875 Military Trail, Suite 105, in Jupiter, or 7300 N.W. 5th St., Suite 1, in Plantation. Stuart B. Krost, MD, is board certified by the American Academy of Physical Medicine and Rehabilitation and the American Academy of Pain Management.

Dr. Krost earned his undergraduate degree graduating cum laude from State University of New York at Stony Brook, Long Island, NY, and his medical degree from State University of New York at Syracuse. He completed his general surgical internship at North Shore University Hospital, an affiliate of Cornell University Medical College, Manhasset, NY and his physical medicine and rehabilitation residency at State University of New York Health Science Center at Brooklyn in NY, where he served as chief resident. Dr. Krost is certified in thermography interpretation and is a certified independent medical examiner (CIME). He serves as a liaison of SUNY (State University of New York) Health Science Center at Brooklyn to the American Academy of Physical Medicine and Rehabilitation.