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Pain Medicine Interview with Dr. Kalter

March 30, 2018 | By | In: Dr. Kalter, Neuropathic pain, Nociceptive pain, Pain Medicine

Dr Matthew Kalter talks about pain medicine, pain treatments for different types of pain and how he helps patients deal with pain in this interview with Larry Mikorenda of Excelsior Forum.

Dr. Mathew Kalter one of the top pain medicine doctors in New York, physical medicine rehabilitation doctors, discusses the different aspects of musculoskeletal medicine, rehabilitation medicine. Dr. Kalter is triple board certified in pain management and disability analysis in Smithtown New York.

In this interview Dr. Kalter discuses answers Larry Mikorenda’s question to “What is pain management?“.

“I like to call it pain medicine” Says Dr. Kalter. “It’s more than just managing the pain. First we want to come up with what’s causing the pain. Diagnostics is very important. There’s numerous test that we can do. Once we have established the cause of the pain, we can determine the best treatment for the patient. Treatment is usually multi motto meaning there is many different types of treatment that usually work together that give the best results.” continues Dr. Kalter.

Larry Mikorenda asks Dr. Kalter to define the certain types of pain and degree of pain.

“There are many categories of pain. There’s Neuropathic pain is basically damage to a nerve (Spinal cord injury, peripheral nerves, compression of the nerve i.e. herniated disc or bone bullet from arthritis). Nociceptive pain (Visceral pain: pain from a diseased organ or Somatic pain: basic tendons, joints, bones, and muscles pain).” explains Dr. Kalter.

Larry Mikorenda asks Dr. Kalters to explain disk deterioration in the back, “bone on bone” pain.

“Yes it’s something that everyone gets eventually, some earlier than others. Certain factors that come into play that causes this type of pain the back. For example weight gain, or just wear and tear. A person that’s a construction workers that has heavier work will have more problems with that. What happens over time, this plump disc that keeps the space between the two bones,wears away with time, and those two bones meet and start causing pain and inflammation.” Explains Dr. kalter.

“Is that what they mean by the expression “pinched nerve?” asks Mikorenda.

“Yes that’s the layman’s term for nerve compression. When people call and say I have a pain in the leg it’s means that there is some kind of compression of the nerve from a bone or from a disc pushing on that nerve.” Says Dr. Kalter.

“The Neuropathic pain, how do you do test to find out how you can actually help these people that have Neuropathic pain?” asks Mikorenda.

“The best initial diagnoses is speaking to the patient. Basically asking them to describe the pain, followed by a physical examination. A physical examination can determine a lot of things. There’s certain special testing, for example, for leg pain a sciatic type of pain, you can do what’s called a straight leg raise test, which will test if there is neuropathic compression in the leg. There’s strength testing, pain sensation testing, and then after that you get into the bigger diagnostics which is nerve testing (Electromyography (EMG)), MRI’s (shows what is compressing that nerve), and basic blood work that shows neuropathic injuries as well.” explains Dr. Kalter.

Mikorenda asks Dr, kalter about his expertise relating to treating injured workers and occupational therapies.

“Yes, I see all types of patients from different occupations. Again the more heavier lifting positions, (construction workers, mechanics, moving around or bending a lot. Those are the fields I tend to see more of because ther’s more wear and tear on the spine.” responds Dr, Kalter.

Mikorenda elaborates for confirmation. “I guess that would include people on computers, the writes, with carpal tunnel, everything like that?”.

“Absolutly, that type of injury.’ confirms, Dr. Kalter.

Dr. Kalter goes on to explain how some of theses pains are treated. Dr. Kalter explaining there isn’t one treatment that cures everything. That the treatments available do effectively give a good amount of pain relief. Dr. Kalter goes on to emphasize the importance of educating the patient on life style changes. For example weight loss can take a lot of pressure off the back. There’s recreational drugs, alcohol use, smoking that can contribute to the pain. Smoking can cut the blood supply to certain joints, which can make arthritis worse, increasing the pain level. Then there’s exercise, educating the patient on physical health and how that can reduce pain.

Dr. Kalter offers physical therapy in his office, which is vital to a patients overall health, utilizing certain modalities like Electrodes, TENS Units, Stimulators, etc. to stimulate muscles and reduce spasms. there is of course the whole slew of medications, different drug groups, inflammatory’s which are very good for arthritis pain, decreasing inflammation. There’s muscle relaxants for spasms. There are neuropathic drugs/medications that specifically are used for nerve pain.

Dr. kalter Discusses in the interview injection therapy for pain. For instance there are gel injections for the knees that are like a filler cushion effect that separates the bones taking pressure off the nerve. there are a number of injections that include epidural injections, set joint injections. Then there’s the bigger pain relieving procedures which include spinal cord stimulators. etc…

Take a moment to watch this very informative interview between Larry Mikorenda and Dr. Matthew Kalter about the specialty pain medicine and how it relates to relieving pain. Learn more about Dr. kalter, his practice (Kalter PMR), and and his approach to treating pain at his practice located in Smithtown, New York.

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