All Posts tagged pain management

Response to the Surgeon General’s Letter

Response to the Surgeon General’s Letter

The Surgeon General, Vivek H. Murthy, M.D., M.B.A. recently sent out a letter to all American physicians urging us to do everything in our power to address the opioid epidemic.

The opioid epidemic is a very real and serious situation, so too is the need to treat pain responsibly.

Newbridge Spine & Pain Center is one of the Greater Washington area’s premier interventional pain management facilities dedicated to treating pain. Our physicians are Anesthesiologists with sub-specialty training in pain management.

There are many misconceptions about the ‘pain management’ specialty resulting from the mismanagement and over-prescribing of addictive painkillers. However, our specialization, interventional pain management, addresses both the rising opioid epidemic and the need to treat pain.

Treating pain in a conservative, responsible manner is our daily commitment.

We do this by:

  • Utilizing non-surgical, interventional pain procedures to quickly and effectively reduce pain levels.
  • In cases where medication management is unavoidable, we aim to reduce reliance on pharmacologic substances, opioids & narcotics by maintaining low doses and outlining treatment plans that take a multidisciplinary approach to include; weight-loss, physical therapy and/or counseling for example.

The Newbridge team spends a significant amount of energy encouraging our fellow healthcare providers to refer to interventional pain management before prescribing or laying out a treatment plan. This is because our therapeutic procedures work at the onset of pain as well as for chronic pain conditions.

Dr. Jay GonchigarWe firmly believe that the sooner a patient can be treated by a pain specialist using interventional methods the less likely that patient is to be prescribed a long-term medication schedule.

Most pain complaints relate to pain originating throughout the spine, however, an interventional pain doctor can treat acute and chronic pain all throughout the body to include the limbs and joints in the peripheral body.


Treating Pain Responsibly

Treating Pain Responsibly

Statistics show that chronic pain affects more Americans than diabetes, heart disease and cancer combined (Source:

These statistics indicate that treating pain responsibly is a major health concern and demonstrate the need for ethical, qualified and specialized practitioners in the field.

The term “pain management” is likely to conjure thoughts of dangerous medications and drug addiction. The mismanagement and over prescribing of addictive pain killers has certainly become a major problem in today’s society making it no longer appropriate or appealing for your family practitioner to treat pain.

A relatively misunderstood and underutilized specialty called interventional pain management has emerged from the well-publicized opioid epidemic and the genuine need to responsibly and effectively treat pain.

The role of a good interventional pain management physician is to provide improved quality of life and enable patients to participate in activities such as; pick up their child, walk the dog and participate in physical therapy sessions for example.

An interventional pain management specialist could be a physical medicine and rehabilitation (PM&R) physician or, as is the case at Newbridge Spine & Pain Center, a highly skilled, board certified anesthesiologist sub-specialized in pain management procedures and techniques.

There are many misconceptions about what an interventional pain management physician actually does and few people know the full scope of procedures available to responsibly and effectively treat pain.

interventional pain management, treating pain responsiblyFirstly, an interventional pain specialist does not just write prescriptions, in fact, this is at the bottom of their toolkit. The interventional pain doctor performs procedures either in an office or ambulatory surgical center (ASC) setting.

These procedures range from a simple trigger point injection, epidural steroid injection, or a nerve block to radiofrequency ablation or spinal cord stimulation for example. Many of these procedures can help patients avoid an opioid or narcotic medication schedule altogether.

Learn more about interventional pain management at

View Doctor bios at


Leesburg Pain Physician receives thumbs up!

Leesburg Pain Physician receives thumbs up!

Chirag Sanghvi M.D. now seeing patients in Leesburg, Virginia

Leesburg, Virginia – July 26, 2016 – Newbridge Spine & Pain Center, Loudoun County’s specialist pain management facility added physician Chirag Sanghvi, M.D. to head their Virginia team.

Dr. Chirag Sanghvi is board certified in both Anesthesiology and Pain Management and completed his fellowship in Pain Management at the Cleveland Clinic in Cleveland, Ohio.

Dr. Sanghvi was the lead physician at the Prince Frederick, MD branch of Newbridge Spine & Pain for over 4 years until his recent move to Northern Virginia. After several months in Loudoun County patient feedback for this physician has been outstanding;

“[He is] very knowledgeable and professional. He listens and explains the causation and treatment plan for my condition thoroughly. I have the utmost trust in his decision making.” states current patient Kevin K.

The complexity of treating pain has never been more evident than it is today.

Due to this Dr. Chirag Sanghvi urges patients to come to pain management as early as possible, “to prevent pain from progressing into a debilitating hindrance it needs to be treated appropriately. Patients come to me after years of improperly dealing with pain and perhaps having seen many physicians. I cannot emphasize enough that the earlier I can treat a patient with interventional procedures the less likely they are to have long-term pain and the need for long-term treatment”

Pain is one of America’s largest health challenges and can have a devastating impact on a person’s ability to do every-day-things. As a firm believer in the multidisciplinary approach most of Dr. Sanghvi’s treatment plans incorporate other modalities such as physical therapy.

This fact makes Dr. Sanghvi’s goal all the more promising as he takes the Leesburg practice under his wing, “my goal is not only to help reduce pain but to optimize my patient’s ability to perform their daily tasks, pursue their hobbies and live a happy, active lifestyle.”

Newbridge Spine & Pain Center is open 5 days a week and is located at 161 Fort Evans Rd NE, Suite 340, Leesburg VA 20176. View Dr. Sanghvi’s bio at



Prince Frederick Pain Clinic Builds Local Facility

Prince Frederick Pain Clinic Builds Local Facility

Prince Frederick, Maryland – March 3rd, 2015 – Newbridge Spine & Pain Center, Prince Frederick’s premier specialist pain management facility has moved.

After 5 years at 70 Sherry Lane, Newbridge Spine & Pain Center founder Jay Gonchigar M.D., decided it was time to plant permanent roots in the community where he and fellow physicians, Chirag Sanghvi M.D. and Greesh John M.D. have successfully treated over 2,500 local pain patients.

The business has constructed a brand new facility at 80 Sherry Lane boasting modern décor with 6 exam rooms, 2 procedure rooms and a state-of-the-art recovery area.

The building will be home to both the pain management office, where patients are seen for consults, and the Procedure suite, where patients are treated with interventional, out-patient, procedures for a full range of pain conditions.

With an administrative and clinical team comprised of over 15 local residents, the new premises is open 5 days a week and marks a serious commitment to providing specialist pain relief to the Prince Frederick community.

“Over the past 5 years we have been honored to provide Prince Frederick and the surrounding community with the highest-quality interventional pain treatments available anywhere. Our new premises demonstrate our commitment to do so for many years to come” states founder Jay Gonchigar, M.D.

The new facility opened 1 March 2016 and is now accepting new patients.


Post Traumatic Stress and Pain

Post Traumatic Stress and Pain

Post traumatic stress disorder (PTSD) is often known to occur in military veterans and those who have suffered traumatic events involving either physical harm or the threat of physical harm [ Source:]. PTSD is defined as having at least 1 month of re-experiencing trauma symptoms, 3 avoidance symptoms and/or two or more hyperarousal symptoms.

Symptoms of PTSD make it difficult for patients to function throughout their regular daily lives and is often found to co-occur with chronic pain. A recent study published in the Journal of Pain [Vol. 16, No. 10, Oct 2015) found that the two conditions exacerbate each other. Chronic pain intensity was associated with anxiety and anxiety sensitivity, a symptom of PTSD.

We have long known that depression and chronic pain have a similar co-occurrence. However, the study showed that PTSD had a unique profile for hyper-responsiveness and hypersensitivity to pain.

Chronic pain was reported to be 2-5 times more likely to affect PTSD patients than the general population. Conversely chronic pain patients were 2-4 times more likely to exhibit PTSD symptoms than the general population.

PTSD is not the only type of stress that has been linked with pain. Psychological factors of stress have been long known to impact the central nervous system feeding into the stress cycle and exacerbating chronic pain.

The journal of pain article indicates that a reduction in stressful episodes may lead to a reduction in pain over time.

The US Department of Veteran’s affairs suggests that patients experiencing PTSD may benefit from therapy sessions and provide several resources, including the Veteran Combat Center 1-877-WAR-VETS for 24/7 support and the Vet Center for military vets transitioning into civilian life.

There are many other stress reduction techniques including; meditation, yoga, and exercise. For those in severe immediate pain interventional pain management can help improve mobility and the ability to participate in some of the above stress reduction techniques.



Vacationing with Pain

Vacationing with Pain

As much as we would love to take a vacation from our pain the reality is that our chronic pain will vacation with us.

Here are are few suggestions for those suffering from severe, persistent or chronic pain while preparing for your summer vacation.

  1. Check out the digs before you go. Sleeping on a hotel or guest bed is trying for anyone; however, for those dealing with chronic pain this could mean the difference between sleeping at all and being able to walk the next day. Prepare yourself by calling ahead find out about the size, age and quality of the mattress you’ll be sleeping on. If need be bring your own mattress topper (you can buy a Tempur-Pedic mattress topper online for the price of one nights stay in a hotel) and remember your own pillow if you suffer from neck pain.
  2. Find out where the local urgent care, internal medicine, PT and/or massage therapist is at your destination. You may need to make a visit to one of these providers so having their contact details on-hand will avoid wasted time in the event you may need their services. You may wish to call each of these places to check their office hours and keep in mind that booking a mid-vacation visit to the local massage therapist before you get on the road might be necessary if they are popular.
  3. If you’re travelling long distances be sure to prepare your vehicle for optimum comfort. There is nothing worse than feeling the onset of that pinched nerve or nagging sciatica when you’re only 1 hour in to a 5 hr drive.
  • If you are travelling by car bring a cooler with an ice-pack ready to go and any topical pain relievers you may wish to use. Plan out your route and take time at rest stops to stretch and move around,
  • If you are travelling by air be sure to pack light / use a rolling bag to avoid any unnecessary lifting and request an aisle seat so you can get up when and if you need to move around.

Either way you travel taking a warm bath right before you leave the house can help relax your muscles and prepare you for a long trip too.


Interventional Pain Management. What is it?

Interventional Pain Management. What is it?

What is interventional pain management?

Interventional pain management or interventional pain medicine is a sub-specialty of pain management. Interventional pain specialists are devoted to the use of minimally-invasive techniques such as facet joint injections, nerve blocks, radiofrequency ablation, vertebral augmentation, and neuromodulation (implantable drug delivery) therapies.

Finding long lasting relief can be difficult for many suffering from chronic pain. Interventional pain procedures offer new hope for patients presenting with any variety of persistent and severe pain conditions. In addition these procedures can help prevent patients from being tied to a long-term medication schedule.

Interventional pain specialists are highly trained in a myriad of pain procedures that treat the underlying source of pain, these procedures play a pivotal part of a multi-disciplinary approach to relieving pain.

These treatments offer pain relief for a wide range of conditions from headaches, pain in the neck, back or spine, to stomach, shoulder, pelvic, hip, knee or foot pain.

Patients often comment that seeking interventional pain management at the early stages of their diagnosis and treatment speeds up their recovery time and ability to pursue daily activities.interventional pain specialist

Is interventional pain management right for me?

These techniques, performed by qualified anesthesiologists, provide relief and improve the quality of life of many patients. To determine if a particular procedure or combination of procedures is right for you talk to your doctor, or make a new patient appointment. Our anesthesiologists will review your MRIs, Xrays, medical history and any records from your referring physician to determine a) the root cause of your pain and b) if you are a candidate for a procedure and c) what procedure you may benefit most from.

Interventional procedures are out-patient procedures performed in our office or ASC (ambulatory surgical centers) most of these procedures take less than 45 minutes from the time you enter the procedure room and require minimal recovery time. For patients who are anxious or in severe pain our office is equipped to offer monitored anesthesia care (sedation) to help you relax during your procedure.


Pain due to Scoliosis

Pain due to Scoliosis

We’ve been getting a number of questions regarding pain treatment for scoliosis lately. We thought we’d elaborate a little on what scoliosis is and what we can do to help manage pain associated with this condition.

What is Scoliosis?

Scoliosis is an abnormal (usually sideways) curving of the spine. The spine might look like the letter “C” or “S.” An inward curving of the spine is called lordosis.

What causes pain in Scoliosis patients?

As the spine twists it effects the supporting musculature and can affect heart and lung function if severe enough. The imbalance of the spine causes trouble with posture and puts stress on joints that wouldn’t otherwise see so much weight.

How can a pain management specialist help scoliosis patients?

In the setting of scoliosis our pain specialists would make sure the scoliosis is not severe enough to require surgery. If the scoliosis is not severe we can deal with the stress of the curved spine on the joints of the spine and the pain due to pinch nerves where the spine bends and puts strain on the supporting muscles on each side.

Treatment includes facet blocks, epidurals, trigger points for myofascial pain, muscle relaxants, nerve pain medications, gait supporting accents such as canes and foot insoles.

In cases where surgery is required our pain management physicians will refer the patient to an Orthopedic spine surgeon. Following surgery and orthopedic treatment a pain specialist can continue to help manage pain associated with scoliosis and would do so in coordination with a patient’s Orthopedic specialist.


Dr. Sana Shaikh shares her philosophy on Pain Management

Dr. Sana Shaikh shares her philosophy on Pain Management
Pain Management Frederick Sana Shaikh MD

Dr. Sana Shaikh is a Pain Management Specialist in Frederick MD

Sana Shaikh, MD is one of the newest additions to the Newbridge pain management and anesthesia teams. Dr. Sana Shaikh is an experienced pain management provider and ABA board-certified Anesthesiologist, read Dr. Sana Shaikh’s bio.  We asked Dr. Sana Shaikh about the practice of pain management, her philosophy and the treatment of chronic pain. Here is her response:

What can a pain management specialist do for pain?

A common misconception about pain management is that it is primarily pain medication management. As pain specialists we are actually are able to treat many kinds of chronic pain by doing x-ray, fluoroscopic and ultrasound guided procedures in hopes of minimizing the need for pain medications and injections. These minimally-invasive procedures allow people to return to their daily activities without being tied to a medication schedule.

Why is it important for patients to see a pain specialist at the earliest opportunity?Musculoskeletal Pain

As a pain management physician, I find patients come to me after years of dealing with their pain and having seen many physicians but having minimal improvement in their symptom. As the source of pain becomes a chronic problem, it starts to affects other aspects of a your health. The social, emotional and psychological impacts of chronic pain start to play a role in the perception of your pain and thus start adding to the impact of pain in a persons daily life.

Limiting activity, restricting social engagements and the stress and barriers that severe pain imposes starts to change a patients outlook on improvement and hope for a pain free future. There are actually documented physical and chemical changes that occur in a patient with chronic pain. Changes are seen in circulating cortisol levels, along with other normal transmitters involved with sleep cycles and mood.

I am a great believer in treating pain as early as it starts as I find we can prevent pain from progressing into a debilitating hindrance for many patients. Once a patient’s pain has already become chronic, I always make sure the treatment is a multimodal plan, involving interventional techniques that treat the initial source of the pain along with the incorporation of physical rehabilitation and psychosocial therapies to help get the patient back to the quality of life they strive for.

Healthy sleep behaviors are also significantly impacted by chronic pain. Typically patients experience frequent awakening at night and unrestful sleep. Patients with fibromyalgia, a pain reliefdisorder which causes chronic pain have documented changes seen in their sleep EMG studies. The lack of deep sleep in these patients has been linked to decreased levels of healthy neurotransmitters which affect the way a patient’s body copes with and perceives pain.

The chronic pain patient starts to experience a hindrance to their daily life, work, financial ability as well as their interpersonal relationships due to the many ways chronic pain affects the human body. As healthcare develops and our patient population ages, it is important to effectively treat acute pain as soon as possible before it takes such a great toll on people’s lives.

What happens when pain becomes chronic?

Treating chronic back painOnce pain becomes chronic, the treatment changes as well. Although we start by focusing on the main source of the pain, it becomes important to also address the other aspects of a patient’s health that have been affected. Chronic pain patients typically avoid behaviors and movements that trigger their pain, however, these adjustments in a patient’s behavior & movement often leads to further muscle wasting and usually leads to additional myofascial pain.

Because of this,  a multimodal / multidisciplinary care plan for treating pain, such as we provide at Newbridge Spine & Pain, is often crucial in long term pain management. Developing a care plan that includes physical therapy and rehabilitation are crucial to changing learned behaviors that may have contributed to a patient’s pain.

As part of my pain management care plans I also assess how pain has affected my patient’s coping skills and objectivity. Typically there is also a level of depression that accompanies the changes seen with chronic pain. Many times, incorporating behavioral and psychological therapy can help patients change their perspective and outlook on their pain allowing them to be more positive and proactive towards improvement.

Chronic pain is defined as a pain lasting more than 3-6 months. It happens to be a great source of healthcare cost per year and affects 100 million adult Americans as reported in 2011 by the Institute of Medicine. On February 2014, it even got the attention of USA Today News which highlighted the prevalence, impact and missed treatment options throughout the nation.