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Hunger activates a neural pathway that inhibits chronic pain signals

Research using mice showed that being hungry activates a neural pathway that inhibits the perception of and response to chronic pain. The findings offer up new targets for treating pain.

Pain can be valuable. Without it, we might let our hand linger on a hot stove, for example. But longer-lasting pain, such as the inflammatory pain that can arise after injury, can be debilitating and costly, preventing us from completing important tasks. In natural settings, the lethargy triggered by such pain could even hinder survival.

According to research by University of Pennsylvania neuroscientists, the brain has a way to suppress chronic pain when an animal is hungry, allowing it to go look for food while leaving intact the response to acute pain. Their work pinpointed a tiny population of 300 brain cells responsible for the ability to prioritize hunger over chronic pain, a group of neurons that may offer targets for novel pain therapies.

“In neuroscience we’re very good about studying one behavior at a time,” says J. Nicholas Betley, an assistant professor of biology in Penn’s School of Arts and Sciences. “My lab studies hunger, and we can find neurons that make you hungry and manipulate those neurons and monitor their activity. But in the real world, things aren’t that simple. You’re not in an isolated situation where you’re only hungry. This research was to try to understand how an animal integrates multiple needs to come to a behavioral conclusion that is optimal.”

“We didn’t set out having this expectation that hunger would influence pain sensation so significantly,” says Alhadeff, “but when we saw these behaviors unfold before us, it made sense. If you’re an animal, it doesn’t matter if you have an injury, you need to be able to overcome that in order to go find the nutrients you need to survive.”

The work will be published in the journal Cell. Betley and Alhadeff collaborated with Zhenwei Su, Elen Hernandez, Michelle L. Klima, and Sophie Z. Phillips of Penn Arts and Sciences; Ruby A. Holland and Bart C. De Jonghe of Penn’s School of Nursing; and Caiying Guo and Adam W. Hantman of the Howard Hughes Medical Institute.

Betley’s lab has focused on studying hunger, in particular how hunger can alter perception. Curious about how hunger may interact with the sensation of pain, the researchers observed how mice that hadn’t eaten for 24 hours responded to either acute pain or longer-term inflammatory pain, which is thought to involve sensitization of neural circuits in the brain.

The Penn team found that hungry mice still responded to sources of acute pain but seemed less responsive to inflammatory pain than their well-fed counterparts. Their behavior was similar to that of mice that had been given an anti-inflammatory painkiller.

In a conditioning experiment, the researchers found that hungry mice did not avoid a place where they had been exposed to inflammatory pain, while mice that were not hungry avoided the place.

That left the question of what part of the brain was processing this intersection between hunger and pain. To find out, the researchers experimentally turned on a group of neurons known to be activated by hunger, agouti-related protein (AgRP) neurons, and found that chronic pain responses subsided, while acute pain responses stayed intact.

To get more specific about the brain region involved, the team next looked at which subpopulation of AgRP neurons appeared to integrate the signals of hunger with inflammatory pain. Activating each AgRP neuron subpopulation one at a time, Betley, Alhadeff, and colleagues found that stimulation of only a few hundred AgRP neurons that project to the parabrachial nucleus significantly suppressed inflammatory pain.

“It was really striking,” Alhadeff says. “We showed that acute response to pain was perfectly intact, but inflammatory pain was suppressed to a very significant extent.”

“The really interesting thing to my mind is that out of a brain of billions of neurons, this specific behavior is mediated by 300 or so neurons,” Betley says.

Further experiments pinpointed the neurotransmitter, a molecule called NPY, responsible for selectively blocking inflammatory pain responses. Blocking receptors for NPY reversed the effects of hunger, and pain returned.

The researchers are excited by the potential clinical relevance of their findings. If they hold up in humans, this neural circuit offers a target for ameliorating the chronic pain that can linger after injuries, a type of pain that is currently often addressed by opioid medications, drugs that also inhibit acute pain.

“We don’t want to shut off pain altogether,” Alhadeff says, “there are adaptive reasons for pain, but it would be great to be able to target just the inflammatory pain.”

Taking the next steps in this line of work, the researchers would like to map out in greater depth how the brain processes inflammatory pain, ideally identifying more targets for suppressing it. And they will continue considering how different survival behaviors integrate in the brain and how the brain processes and prioritizes them.

“We’ve initiated a new way of thinking about how behavior is prioritized,” Betley says. “It’s not that all the information is funneled up to your higher thinking centers in the brain but that there’s a hierarchy, a competition that occurs between different drives, that occurs before something like pain is even perceived.”

The study was supported by Penn’s School of Arts and Sciences, the American Heart Association, the Whitehall Foundation, and the National Institutes of Health (grants DG33400158, DK114104, DK731436, DK112561, and DK112812.)


Story Source:

Materials provided by University of Pennsylvania. Note: Content may be edited for style and length. Read this article on Science Daily: University of Pennsylvania. “Being hungry shuts off perception of chronic pain.” ScienceDaily. ScienceDaily, 22 March 2018. www.sciencedaily.com/releases/2018/03/180322125024.htm.

Holding hands can sync brainwaves, ease pain, study shows

A new study by a pain researcher shows that when a romantic partner holds hands with a partner in pain, their brain waves sync and her pain subsides.

Reach for the hand of a loved one in pain and not only will your breathing and heart rate synchronize with theirs, your brain wave patterns will couple up too, according to a study published this week in the Proceedings of the National Academy of Sciences (PNAS).

The study, by researchers with the University of Colorado Boulder and University of Haifa, also found that the more empathy a comforting partner feels for a partner in pain, the more their brainwaves fall into sync. And the more those brain waves sync, the more the pain goes away.

“We have developed a lot of ways to communicate in the modern world and we have fewer physical interactions,” said lead author Pavel Goldstein, a postdoctoral pain researcher in the Cognitive and Affective Neuroscience Lab at CU Boulder. “This paper illustrates the power and importance of human touch.”

The study is the latest in a growing body of research exploring a phenomenon known as “interpersonal synchronization,” in which people physiologically mirror the people they are with. It is the first to look at brain wave synchronization in the context of pain, and offers new insight into the role brain-to-brain coupling may play in touch-induced analgesia, or healing touch.

Goldstein came up with the experiment after, during the delivery of his daughter, he discovered that when he held his wife’s hand, it eased her pain.

“I wanted to test it out in the lab: Can one really decrease pain with touch, and if so, how?”

He and his colleagues at University of Haifa recruited 22 heterosexual couples, age 23 to 32 who had been together for at least one year and put them through several two-minute scenarios as electroencephalography (EEG) caps measured their brainwave activity. The scenarios included sitting together not touching; sitting together holding hands; and sitting in separate rooms. Then they repeated the scenarios as the woman was subjected to mild heat pain on her arm.

Merely being in each other’s presence, with or without touch, was associated with some brain wave synchronicity in the alpha mu band, a wavelength associated with focused attention. If they held hands while she was in pain, the coupling increased the most.

Researchers also found that when she was in pain and he couldn’t touch her, the coupling of their brain waves diminished. This matched the findings from a previously published paper from the same experiment which found that heart rate and respiratory synchronization disappeared when the male study participant couldn’t hold her hand to ease her pain.

“It appears that pain totally interrupts this interpersonal synchronization between couples and touch brings it back,” says Goldstein.

Subsequent tests of the male partner’s level of empathy revealed that the more empathetic he was to her pain the more their brain activity synced. The more synchronized their brains, the more her pain subsided.

How exactly could coupling of brain activity with an empathetic partner kill pain?

More studies are needed to find out, stressed Goldstein. But he and his co-authors offer a few possible explanations. Empathetic touch can make a person feel understood, which in turn — according to previous studies — could activate pain-killing reward mechanisms in the brain.

“Interpersonal touch may blur the borders between self and other,” the researchers wrote.

The study did not explore whether the same effect would occur with same-sex couples, or what happens in other kinds of relationships. The takeaway for now, Pavel said: Don’t underestimate the power of a hand-hold.

“You may express empathy for a partner’s pain, but without touch it may not be fully communicated,” he said.

Story Source: Read this article on Science Daily: University of Colorado at Boulder. “Holding hands can sync brainwaves, ease pain, study shows.” ScienceDaily. ScienceDaily, 1 March 2018. www.sciencedaily.com/releases/2018/03/180301094822.htm.

 

Last Patient Implanted for the Evoke Study

On Friday, February 23rd, Summit Pain Alliance’s last patient enrolled for the Evoke Study with Saluda Medical was implanted at Sonoma Valley Hospital by Dr. Eric Lee. This implant closes the door to new enrollments since enrollment has now been reached.

Congratulations to our Providers, Managers, Surgery Schedulers, Psychologists, Research staff and everybody involved for your hard work in making this possible. It has been an incredible journey and the Saluda team has become part of our family. We are thankful for being given the opportunity to participate in the development of such groundbreaking technology. This will be a revolutionary advance in neuromodulation. We have come a long way since February 2017 when we consented the first patient.

Study Facts as of March 1, 2018:
Patients Screened: 27
Patients Enrolled: 6
Revisions: 1

The study is now closed for new patients. There is still a lot of work ahead of us, collecting the data from our study subjects and getting the best results possible from them. We are excited for the next milestone: the 3 month primary endpoint which is around the corner. We have to thank Saluda Medical for all the help and support we have received up to this point in the study, it has been a pleasure to work with them so far and they have definitely made our work easier.

About the Evoke™ Spinal Cord Stimulation System

Millions of people struggle with chronic pain in their back and legs. Oftentimes, the pain is caused by an underlying condition that puts pressure on spinal nerves – such as a herniated disc, bone spurs, or spinal stenosis. Many people have surgery to correct these issues but continue to have nerve pain even after the surgery is fully healed.

People experience nerve pain very differently. For some, the pain causes tingling or numbness, or travels along a path (shooting pain). For others, the pain is burning or stabbing, or overly sensitive to touch. Due to these complexities, many people struggle through months or years of treatments without finding a suitable option.

The Evoke SCS System is an investigational device for the treatment of chronic pain, currently being offered at select U.S. centers through the Evoke Clinical Study. The Evoke System is designed to continuously measure the body’s response to stimulation, and can be programmed to automatically adjust stimulation levels to the patient’s preferred level.

 

The challenge of determining the origin of radiating back pain

Many patients live with low back pain that radiates to the buttock, groin, thigh, and even knees. The challenge for patients, and often their doctors, is determining the origin of the pain — the hip, the spine, or both. A new article published in the February Journal of the American Academy of Orthopaedic Surgeons (JAAOS) outlines the identical symptoms associated with hip and spine pain and discusses the diagnostic steps and tests required to treat them appropriately.

Typically, groin pain, and/or difficulty putting on shoes or getting in and out of a car, are associated with a hip condition. Buttock or back pain, with or without a tingling sensation, most likely originates in the spine. However, patients with complex “hip-spine syndrome” have lower back and hip pain with no clear source of the discomfort. Hip arthritis, for example, can increase pressure on the lower back.

“In these instances, similar or overlapping symptoms may delay a correct diagnosis and appropriate treatment,” said article author Afshin Razi, MD, an orthopaedic surgeon and clinical assistant professor at NYU Langone Hospital for Joint Diseases.

The article recommends that patients provide a detailed health history and undergo a comprehensive physical examination that includes an assessment of gait (how the patient walks); hip and back range of motion; posture; pelvic, lower limb, and spinal alignment; loss of muscle (atrophy); previous surgical scars; and limb-length discrepancy.

“Plain and advanced imaging studies and diagnostic injections also can be used to further delineate the primary problem and guide the appropriate sequence of treatment,” said Dr. Razi.

Diagnoses for hip and spine pain can include hip osteoarthritis, a stress fracture, osteonecrosis of the hip (a blockage in blood flow to the hip), a labral tear (damage to the cartilage that surrounds the hip), disc herniation and possible pinched nerves, stenosis (narrowed spinal canal causing nerve pain), sacroiliac joint dysfunction, and other less common sources of pain.

“Focusing on both the spine and the hip as potential causes of pain and disability may reduce the likelihood of misdiagnosis, and the management of conditions affecting the spine and/or hip may help reduce the likelihood of persistent symptoms,” said Dr. Razi.

 


Read this article on Science Daily: American Academy of Orthopaedic Surgeons. “Is the pain coming from your hip, spine or both? New article looks at the overlapping symptoms and challenges in correctly diagnosing ‘hip-spine syndrome’.” ScienceDaily. ScienceDaily, 6 February 2017. www.sciencedaily.com/releases/2017/02/170206130408.htm.

At Summit Pain Alliance we provide individualized pain management for a pain-free life. To schedule an appointment call (707) 623-9803.

Better back pain management may help older adults remain active

At Summit Pain Alliance we provide individualized pain management for a pain-free life. To schedule an appointment call (707) 623-9803.
 In a Journal of the American Geriatrics Society study, many well-functioning and highly active older adults experienced back pain, which was linked with poorer perceived and observed walking endurance.
“Older adults are living longer and healthier active lives, so paying attention to conditions that may threaten independent function is increasingly important,” said lead author Dr. Eleanor Simonsick, of the National Institute on Aging. “In this study, we found that back pain affected nearly half of well-functioning, highly active older adults. We also found that back pain was linked to less energy efficient walking and poorer endurance, which can lead to walking difficulties. These findings suggest that better back pain management may help older adults remain active and free of mobility limitation.”

The authors noted that it will be important to study whether back pain may serve as a catalyst for future loss of mobility in active older individuals.


Journal Reference:

  1. Eleanor M. Simonsick, Benjamin Aronson, Jennifer A. Schrack, Gregory E. Hicks, Gerald J. Jerome, Kushang V. Patel, Stephanie A. Studenski, Luigi Ferrucci. Lumbopelvic Pain and Threats to Walking Ability in Well-Functioning Older Adults: Findings from the Baltimore Longitudinal Study of AgingJournal of the American Geriatrics Society, 2018; DOI: 10.1111/jgs.15280

Read this article on Science Daily: “Back pain is common in highly active older adults.” ScienceDaily. ScienceDaily, 7 February 2018. www.sciencedaily.com/releases/2018/02/180207085734.htm.


At Summit Pain Alliance we provide individualized pain management for a pain-free life. To schedule an appointment call (707) 623-9803.

 

 

New research reports that hyperreactive brain networks could spark fibromyalgia

New research reports that hyperreactive brain networks could play a part in the hypersensitivity of fibromyalgia.

A new study finds that patients with fibromyalgia have brain networks primed for rapid, global responses to minor changes. This abnormal hypersensitivity, called explosive synchronization (ES), can be seen in other network phenomena across nature.

Researchers from the University of Michigan and Pohang University of Science and Technology in South Korea report evidence of ES in the brains of people with fibromyalgia, a condition characterized by widespread, chronic pain. The paper, published in Scientific Reports, details only the second study of ES in human brain data.

“For the first time, this research shows that the hypersensitivity experienced by chronic pain patients may result from hypersensitive brain networks,” says co-senior author Richard Harris, Ph.D., associate professor of anesthesiology at Michigan Medicine with the Chronic Pain and Fatigue Research Center. “The subjects had conditions similar to other networks that undergo explosive synchronization.”

In ES, a small stimulus can lead to a dramatic synchronized reaction in the network, as can happen with a power grid failure (that rapidly turns things off) or a seizure (that rapidly turns things on). This phenomenon was, until recently, studied in physics rather than medicine. Researchers say it’s a promising avenue to explore in the continued quest to determine how a person develops fibromyalgia.

“As opposed to the normal process of gradually linking up different centers in the brain after a stimulus, chronic pain patients have conditions that predispose them to linking up in an abrupt, explosive manner,” says first author UnCheol Lee, Ph.D., a physicist and assistant professor of anesthesiology at Michigan Medicine. These conditions are similar to other networks that undergo ES, including power grids, Lee says.

‘Electrically unstable’ findings

The researchers recorded electrical activity in the brains of 10 female participants with fibromyalgia. Baseline EEG results showed hypersensitive and unstable brain networks, Harris says. Importantly, there was a strong correlation between the degree of ES conditions and the self-reported intensity of chronic pain reported by the patients at the time of EEG testing.

Lee’s research team and collaborators in South Korea then used computer models of brain activity to compare stimulus responses of fibromyalgia patients to the normal condition. As expected, the fibromyalgia model was more sensitive to electrical stimulation than the model without ES characteristics, Harris says.

“We again see the chronic pain brain is electrically unstable and sensitive,” Harris says.

He says this type of modeling could help guide future treatments for fibromyalgia. Since ES can be modeled essentially outside of the brain or in a computer, researchers can exhaustively test for influential regions that transform a hypersensitive network into a more stable one. These regions could then be targeted in living humans using noninvasive brain modulation therapies.

George Mashour, M.D., Ph.D., co-senior author and professor of anesthesiology at Michigan Medicine, says, “This study represents an exciting collaboration of physicists, neuroscientists and anesthesiologists. The network-based approach, which can combine individual patient brain data and computer simulation, heralds the possibility of a personalized approach to chronic pain treatment.”


Journal Reference: UnCheol Lee, Minkyung Kim, KyoungEun Lee, Chelsea M. Kaplan, Daniel J. Clauw, Seunghwan Kim, George A. Mashour, Richard E. Harris. Functional Brain Network Mechanism of Hypersensitivity in Chronic Pain. Scientific Reports, 2018; 8 (1) DOI: 10.1038/s41598-017-18657-4

Read this article on Science Daily:  “Does an exploding brain network cause chronic pain?.” ScienceDaily. ScienceDaily, 12 January 2018. www.sciencedaily.com/releases/2018/01/180112132916.htm.


About Summit Pain Alliance

Thank you for choosing Summit Pain Alliance for your care. Our goal is to provide you with the highest quality medical service.At Summit Pain Alliance, we believe in improving your quality of life by getting you back to doing the things that you enjoy. Our double board-certified physicians use state-of-the-art diagnostic and therapeutic techniques that exceed standards in safety and efficacy. We will be your partner on this journey. To schedule an appointment call (707) 623-9803.

Tai Chi can help relieve chronic neck pain, study shows

Tai Chi, a low-impact mind-body exercise, can be as effective as neck exercises in relieving persistent neck pain, according to results of randomized controlled trial.

Tai Chi, a low-impact mind-body exercise, can be as effective as neck exercises in relieving persistent neck pain, according to results of randomized controlled trial. 

Tai Chi, a low-impact mind-body exercise, can be as effective as neck exercises in relieving persistent neck pain, according to results of randomized controlled trial reported in The Journal of Pain, the peer-reviewed publication of the American Pain Society.

An international team of researchers investigated the efficacy of group Tai Chi compared with group neck exercises and no treatment to improve neck pain, disability and quality of life in groups of people with nonspecific chronic neck pain. They hypothesized that 12 weeks of Tai Chi would prove superior to no treatment for chronic neck pain. The study also explored whether Tai Chi was more and less effective than conventional neck exercises.

One hundred fourteen subjects were enrolled in the trial. Eligibility requirements were age18 years or older and having chronic neck pain for three consecutives months.

“The study results showed that 12 weeks of Tai Chi was more effective than no treatment to improve pain, disability, quality of life and postural control in persons with chronic neck pain,” said Peter M. Wayne, Ph.D., a co-author, founder of the Tree of Life Tai Chi Center and assistant professor of medicine at Harvard Medical School. He added that Tai Chi was neither superior nor inferior to 12 weeks of neck exercises.

Tai Chi originated in China and involves integrated dynamic musculoskeletal breathing and meditation training. It often is used for health care purposes and evidence supports its potential to help people with back pain, rheumatologic disease and psychological disorders. No studies had been performed previously to determine Tai Chi’s benefits in relieving chronic neck pain.

Story Source:

Materials provided by American Pain SocietyNote: Content may be edited for style and length.


Journal Reference:

  1. Romy Lauche, Christoph Stumpe, Johannes Fehr, Holger Cramer, Ying Wu Cheng, Peter M. Wayne, Thomas Rampp, Jost Langhorst, Gustav Dobos. The Effects of Tai Chi and Neck Exercises in the Treatment of Chronic Nonspecific Neck Pain: A Randomized Controlled TrialThe Journal of Pain, 2016; 17 (9): 1013 DOI: 10.1016/j.jpain.2016.06.004

Read this article on Science Daily: “Tai Chi can help relieve chronic neck pain, study shows.” ScienceDaily. ScienceDaily, 13 October 2016. www.sciencedaily.com/releases/2016/10/161013130106.htm.

Free Seminar: Find Pain Relief

Join us for a free educational seminar to learn about a new pain management option called neurostimulation. Upcoming events include;

Wednesday, January 17 – 5:30 p.m. – 6:30 p.m.
–Eric Lee, M.D.

 

 

 

Dr. John Y. Hau Top Doctor 2017Saturday, January 27 – 10:00 a.m. – 11:00 a.m.
–John Hau, M.D.

 

 

 

Sessions are held at Summit Pain Alliance, 392 Tesconi Ct., Santa Rosa 95401.

RSVP: Keith Silva, 707-326-7666, keith.silva@abbott.com

See flyer for more details.

 

High-frequency spinal cord stimulation provides better results in chronic back, leg pain

For patients with severe, chronic back and leg pain, a new high-frequency spinal cord stimulation (SCS) technique provides superior clinical outcomes, compared to conventional low-frequency SCS, reports a clinical trial.

For patients with severe, chronic back and leg pain, a new high-frequency spinal cord stimulation (SCS) technique provides superior clinical outcomes, compared to conventional low-frequency SCS, reports a clinical trial in the November issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Wolters Kluwer.

The new ‘HF10′ technique offers lasting reductions in back and leg pain after other treatments have failed, according to the report by Dr. Leonardo Kapural of the Center for Clinical Research and Carolinas Pain Institute, Winston-Salem, N.C., and colleagues. They believe that HF10 therapy could have a major impact on the treatment of chronic back and leg pain, and possibly other conditions as well.

With HF10, Lasting Reduction in Pain Scores at Two Years’ Follow-up

The study included 171 patients with moderate to severe back and leg pain that persisted despite other treatments. Treated at 11 US comprehensive pain centers, the patients had chronic pain that had been present for an average of 14 years. Nearly 90 percent had had previous back surgery; a similar proportion were taking opioid pain medications.

After a trial period, patients were randomly assigned to one of two SCS techniques, with mild electrical stimulation applied to targeted spinal nerves. One group was treated using HF10, with high-frequency stimulation (10 kilohertz) applied for very short periods. The other group received traditional SCS, with lower-frequency stimulation applied for relatively longer periods.

As previously reported, HF10 provided superior pain relief. At three months, scores for back and leg pain decreased by at least half in more than 80 percent of patients receiving HF10. By comparison, conventional SCS achieved similar responses in back pain for 44 percent of patients and in leg pain for 55 percent.

At two years’ follow-up, the HF10 group still had higher response rates: 76 versus 49 percent for back pain and 73 versus 49 percent for leg pain. On a 0-to-10 rating scale, average back pain score decreased by 5 points with HF10 versus about 3 points for traditional SCS. About 60 percent of patients receiving HF10 were “very satisfied” with their treatment, compared to 40 percent with conventional SCS.

Although SCS is not a new treatment, it provides more consistent results for leg pain than back pain, and relies on producing overlapping areas of numbness (paresthesia) to mask pain. By comparison, HF10 seems to provide greater relief of back pain without inducing areas of numbness. The new study is among the few to directly compare different approaches to SCS in patients with back and leg pain.

Within its limitations, the pragmatic clinical trial supports the superiority of HF10 over conventional SCS for patients with chronic, severe back and leg pain. Extending follow-up to two years “provides physicians, patients, and payers with rigorous evidence demonstrating the durability of SCS in treating chronic pain,” Dr. Kapural and coauthors write. They note that the results are “particularly impressive” given the patients’ long history of pain and lack of response to other treatments, including back surgery.

Further research will determine whether HF-10 is useful for other chronic pain problems as well, such as arm and neck pain. Dr. Kapural and colleagues conclude: “The superior and durable results demonstrated in this study are anticipated to lead to improved long-term cost effectiveness and payer acceptance, making this therapy broadly available to patients suffering from chronic pain.”


Story Source:

Materials provided by Wolters Kluwer Health: Lippincott Williams and Wilkins. Note: Content may be edited for style and length.


Journal Reference:

  1. Leonardo Kapural, Cong Yu, Matthew W. Doust, Bradford E. Gliner, Ricardo Vallejo, B. Todd Sitzman, Kasra Amirdelfan, Donna M. Morgan, Thomas L. Yearwood, Richard Bundschu, Thomas Yang, Ramsin Benyamin, Abram H. Burgher. Comparison of 10-kHz High-Frequency and Traditional Low-Frequency Spinal Cord Stimulation for the Treatment of Chronic Back and Leg Pain. Neurosurgery, 2016; 79 (5): 667 DOI: 10.1227/NEU.0000000000001418

Read this article on Science Daily: Wolters Kluwer Health: Lippincott Williams and Wilkins. “High-frequency spinal cord stimulation provides better results in chronic back, leg pain.” ScienceDaily. ScienceDaily, 28 October 2016. www.sciencedaily.com/releases/2016/10/161028125354.htm.

Summit Pain Alliance’s Dr. John Y. Hau and Michael Yang M.D. Selected as  ‘Top Doctors’ of 2017 by Sonoma Magazine.

Sonoma Magazine’s Top Doctor survey was submitted to Sonoma County doctors who were then asked which medical specialist they would most often recommend to a loved one, and more than 300 professionals emerged as top docs in 50 categories of medicine. The research organization tasked with this survey deems that medical professionals are the best judges of other medical professional’s clinical excellence, so the survey was sent to all licensed doctors in Sonoma (including Napa and Marin, as well), asking doctors to nominate three physicians in each category. They were instructed to take into account such factors as education, hospital appointment, board certifications and bedside manner and they could not nominate themselves. Dr. Hau and Dr. Yang rose to the top of the survey and were highlighted for their work in Pain Medicine.

About Dr. John Hau, M.D.

Dr. John Y. Hau Top Doctor 2017Dr. John Hau is a Board Certified Anesthesiologist and Board Certified Pain Management Physician. Dr. John Hau completed his undergraduate studies in Molecular and Cell Biology at the University of California, Berkeley, after which he went on to complete his medical school training at Temple University School of Medicine in Philadelphia.

Following medical school, Pain Doctor John Hau completed residency training in anesthesiology at Rush University Medical Center in Chicago, where he was elected chief resident by his peers and faculty during his final year of residency. Dr. John Hau then went on to complete fellowship training in interventional pain management at the University of California, Los Angeles, which is ranked as one of the best hospitals in California and the nation. During his training at UCLA, he learned advanced and cutting edge interventional pain management techniques used in the treatment of many painful conditions. Dr. Hau is proud to join the Petaluma and Santa Rosa community. He currently serves as the Medical Director of Summit Pain Alliance, Petaluma.

About Dr. Michael Yang, M.D.

Dr. Michael Yang M.D. Top Doctor 2017Dr. Michael Yang grew up in Southern California and completed his undergraduate degree with Phi Beta Kappa and Psy Chi honors from Johns Hopkins University with dual majors in Biology and Psychology. He then returned to the west coast where he conducted neurosurgery research at UCLA. Pain Doctor Yang attended UCSF, one of the top five medical schools in the nation, to complete his medical degree. Throughout his medical education, he continued to be interested in the connection between the physical body and the mind. This led him to graduate with honors in psychology and anesthesiology rotations.

After medical school, Dr. Yang moved to New York City where he completed his residency in anesthesiology at Cornell University. After residency, Dr. Yang completed ACGME-accredited fellowship training in the field of pain management from a multidisciplinary approach, working in three of the top hospitals in the nation: Memorial Sloan-Kettering Cancer Center, Hospital for Special Surgery and New York Presbyterian Hospital. From his fellowship and his experience in private practice in Santa Rosa, Dr. Yang treats patients with cancer pain, acute and chronic orthopedic injuries, and various chronic back and nerve pains.

In his free time, Dr. Yang enjoys fishing, tennis, hiking, travel and snowboarding. He looks forward to becoming an integral part of the medical community in Santa Rosa, providing the latest of techniques and innovations to treating his patients.

At Summit Pain Alliance, we believe in improving your quality of life by getting you back to doing the things that you enjoy. Our double board-certified physicians use state-of-the-art diagnostic and therapeutic techniques that exceed standards in safety and efficacy. We will be your partner on this journey. To schedule an appointment call (707) 623-9803.

 

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