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Best doctors for repetitive strain injuries in Boston

• I realize that this probably is not a typical question, so let me start by saying that any comments on how to make it better would certainly be appreciated. I am looking for a survey of the best doctors in Boston for someone with a collection of repetitive strain injuries (RSI). My case is a complex one, and it doesn't fit easily into the common diagnoses. I have received diagnoses of tendinitis, tendinosis, tenosynovitis, thoracic outlet syndrome, and myofascial pain syndrome for pain that has primarily been in my neck, back, thumbs, fingers, and hands (I do NOT have carpal tunnel syndrome). However, beyond these diagnoses, I seem to be very susceptible to repetitive strain injuries (in other areas of my body as well), and seem to heal from them very very slowly. I would tend to see this extreme susceptibility to repetitive strain injuries as being connected to a bunch of other symptoms I have, and suspect that my connective tissue might just heal more slowly than most people's. This makes it very important for me to find an especially smart, open-minded, and compassionate doctor who will be able to provide the documentation that I need in order to work without further injuring myself--even though such accommodations might not seen immediately necessary based only on the classic diagnoses and even though my RSI can't be verified using lab tests or other "objective" measures. I'm looking to form a relationship with a physician who will really get to know my case, who will work as closely with me as is necessary in order to provide the best care. A search like this will of course rely on many intangible factors that may be hard to track down on the Internet. In the end, there will probably be a lot of work that I will have to do on my own in terms of calling possible providers and asking questions, etc. To be honest, I'm not quite sure what can be done to gather information about these intangible factors, so I'm looking for an answer that will include research and recommendations about this very question (i.e. what can be done on my side). Unfortunately, I am insanely busy right now, and won't be able to do very much of the research myself. However, I have lined up a bunch of people who would be willing to help me out with things like interviewing possible providers, etc. Thus, I'm looking for an answer that would include a plan for what these people could do to follow up on the answer that you provide. In other words, please research what can be done to find a very good match for a doctor for someone in a situation like mine, and do as much of it as you feel is appropriate (see below for further guidance regarding how much to do). However, if there are things that can only be done in Boston, or that would require an excessive amount of calling, please include a "next steps" plan for what people on my end would be able to do to finish the project. The people who would be doing this for me won't necessarily have any relevant experience doing things like this, (they would be college students) so I am sure that they would appreciate very clear and explicit directions for what they should do. I won't be able to work with them very much, so clear explicit instructions would be very important. For example, RSI Action (http://www.rsiaction.org/ and http://www.masscosh.org/index.htm) has a binder (or binders) of evaluations of RSI doctors in the Boston area. Unfortunately, those binders do not exist in an electronic format. Certainly, doctor evaluations would be very very helpful in this search, so I could have someone go there and make copies of the relevant pages. In fact, they could possibly even send scans of those pages back to you for you to incorporate into your answer, though it may be more efficient for you to provide (in the "next steps" plan) instructions for how they can incorporate the information into the materials you provide. For example, you could gather all of the information that you have collected into a file, somehow transmit that file to us, and then they could integrate information from the RSI action database into the file. If Google won't allow us to exchange files in that manner, perhaps you could paste comma delimited text into your answer that we could import into a spreadsheet program or possibly you could include raw XML/html that we could paste into a file and open either in Microsoft Word or OpenOffice.org 2.0. I like computers a lot (too much!), so technical workarounds like this are definitely possible. In deciding whether to do something yourself or whether to have someone else do it by including it in the "next steps" plan, use the following guideline: I really don't care who does it as long as it is done well in the end and as long as I don't have to get too involved, given how busy I am. Of course, if you are going to include something in the "next steps" plan, it seems sensible that you try it out once or twice yourself, so that you are better able to instruct someone else to do it. Other than that, I don't want to micromanage, so will trust your judgment. I have learned to think of my RSI as something that I will be dealing with for the rest of my life. I hope to find a doctor who will stick with me for thirty years. If you have atypical disabling RSI like I do, finding the right doctor can be crucial for your quality of life, which is why I'm taking this search so seriously (aside from medical aspects, because my case is atypical and because there are no medical tests that can back up my claims, a doctor has to really be willing to stick his neck out in order to provide documentation so that I can get a job that won't worsen my disability. It is much easier for them to just tell me to just not worry about it so much-- perhaps also prescribing high-dose ibuprofen and some OT-- and then to look surprised when my symptoms have worsened two years later. This has happened to me several times before with fairly devastating consequences). When I look back on this in twenty years, I want to know that I got the best medical care that I possibly could have. One approach would be to go the "Mass General" route, going to the best teaching hospital that I can find and trying to get an appointment with the most accomplished physician. The advantages of such an approach are clear: someone who works on the cutting edge, who sees many other people with repetitive strain injuries is more likely to have seen a case similar to my own and to know what to do about it. On the other hand, as the first paragraph suggests, I need someone who will really take the time to get to know my case. Reading my symptoms to figure out "how much is too much" can be difficult, because underuse can be almost as dangerous as overuse, and I'd like a physician who will get to know me well enough to help me with this. I'm not sure what the best strategy is to handle this. Perhaps I could work with multiple doctors. Another possible route is to hook up with someone who does research on RSI. Certainly having research articles on RSI to one's name is a very impressive credential. Also, if I could find someone who might be interested in publishing a case history on me and how I seem to be very susceptible to RSIs, I'm sure that the level of care that I would receive would change my life very much for the better. Certainly, Boston would seem to be a good city to be in if one is looking for medical researcher! In terms of specialties, though it seems like almost no one has heard of them, I think that a physiatrist would be an excellent match ( http://www.aapmr.org/condtreat/what.htm ). The reason for this is that my issues seem to focus on connective tissues such as tendons (tendinitis and tendinosis), synovial sheaths (tenosynovitis; synovial shades are tubes through which tendons slide), fascia (myofascial pain syndrome; fascia are sheets of connective tissue around muscles). There is nothing really to operate on, and rehabilitation generally consists of avoiding the offending activities, exercising, anti-inflammatory agents, and applying modalities such as heat and cold. As far as I can tell, these seem to be the domain of the physiatrist. In comparison, orthopedists seem to be much more surgery oriented, and, as I mentioned, surgury probably wouldn't be helpful. Of course, I am much more interested in general expertise than in what is listed as their official specialty, so I wouldn't completely rule anyone out based on official specialty. Based on the above paragraph, Spaulding Rehab seems like it might be a good place to look. Other resources worth checking out for referrals might include MIT's ATIC: http://web.mit.edu/atic/www/index.html or a similar institution at a different university. I haven't looked at it for a while, but a web site, www.tendinosis.org, seems to describe pretty much what I have (mine would be a very bad case), and you could mine its bibliography for names of physicians who also do research. I am looking for an answer that not only provides a lot of raw information, but which also provides a lot of analysis, synthesis, and organization. It should include a summary that can be read (including recommended links) in less than two hours and which includes information on, say, the top ten or fifteen candidates, but should also include a more detailed reference section, that I can return to over the next several years as needed. I will probably provide a version of the answer that doesn't include unnecessary personal details to a couple of the web sites I've mentioned in hopes that it may help other people, so it wouldn't hurt to include some extra details that may be of use to a wider audience. Finally, it should include a very clear and explicit "next steps" plan, describing what both I and people helping me should do next to move the project along. (We won't necessarily follow exactly those instructions, but having something written down will save me a bunch of time. For this reason, it would probably be good to include alternative approaches to the "next step" plan if appropriate). One place to get great info would be at the FINDADOC web site: http://eeshop.unl.edu/findadoc.html in particular, http://eeshop.unl.edu/providers/massachusetts.html , where it has patient recommendations for Massachusetts RSI doctors. Another great resource is the SOREHAND e-mail list: http://sorehand.org/ I also just came across: http://www.ctdrn.org/rsi-support/selecting_a_treating_physician-joan_lichterman.htm but haven't had a chance to read it. In the past, the thoracic outlet syndrome braintalk community originally hosted by the Mass General Hospital neurology department would have been a great source for referrals, but both it and its successor, braintalk.org, seem to be down. Obviously, the ideal physician would devote a large proportion of their practice to repetitive strain injuries. Ideally, the doctor would work in a clinic or center that focuses on repetitive strain injuries. I figure that this would increase the likelihood of them having good specialists whom they had good relationships with and whom they could refer me to if something was outside of their area of expertise. My nature is to be very skeptical of alternative medicine. However, I do recognize that alternative medicine practitioners may be more open-minded, and may be better at listening. As I say, I am firmly skeptical, but I am interested in learning more. Please make sure to include: 1.) a list of clinics focusing on repetitive strain injuries in the area 2.) A list of questions that it would be good to ask a provider I am considering. 3.) Any suggestions that you might have about how to better use Google answers in this project.

• Answer:

  Hello Robbins, I have found physicians for you, from RSI specialists to rheumatologists. I found them using numerous web searches; seeking complaints and reviews, and even forum recommendations. I have not posted many sources as the info was extraneous, and I have posted names and contact numbers, and found additional information. (Who wants to wade through all that?) You are fortunate to live in Boston, where you are surrounded by some of the top hospitals in the country! I have worked in hospitals for over 25 years as a health care professional, and I have seen patients adore physicians that we, those who worked along with them, thought were lousy doctors. On the other hand, we have seen patients think the most brilliant physicians were twits. It?s all subjective and depends on what you think makes a great doctor. I?m not a doctor, but it seems to me that you should not rule out problems that lead to RSI, and not focus expressly on RSI. For this reason, I am including several rheumatologists in the list. Because of copyright restrictions, I am able to post only a small amount of a web site here. Please see each site for complete information. At the end of the answer, I have complied a list of names, addresses, and phone numbers. The Google interface does not provide for very good formatting, so you may need to copy and paste into an Excel Spreadsheet or a Word Table. Perhaps just printing out the answer and marking it up with different colored markers and highlighters can help those who will be making calls for you. Remember, building a relationship with a doctor may take time. You may need to try out several doctors before you find one that ?fits? you. Even with ratings, rankings and recommendations, it?s hard to gauge a doctor?s philosophy, compassion and attitude without talking to her/him in person. I?d like to start this answer with some quotes from Joan Lichterman, East Bay RSI Support Group, Oakland, CA - ?An accurate diagnosis is essential, but diagnosing repetitive strain injuries (RSIs) is extremely difficult. As Dr. Emil Pascarelli and Deborah Quilter note in Repetitive Strain Injury: A Computer User's Guide (John Wiley & Sons, 1994), "RSI can be a baffling disease, affecting neck, shoulder, forearm, and hand, as well as bone, nerve, and muscle. Ailments in these areas can be treated by orthopedists, hand surgeons, neurologists, occupational medicine doctors, physiatrists, rheumatologists, internists, and family practitioners" (p. 42). Dr. Pascarelli claims that most of his patients "saw at least six different specialists before they were properly diagnosed, and they often describe an exasperating odyssey. Typically, people try both traditional medicine and alternative treatments. First, they see their chiropractor or acupuncturist. When that doesn't solve the problem, they try their general practitioner. Then they see a rheumatologist, or orthopedist, then a hand surgeon, then an occupational health physician. Because there is an uneven awareness in the medical community about RSI, any one of these doctors could be the right one for you ? but any one of them could also be the wrong one. For instance, people go to orthopedists because they have musculoskeletal problems, but if that orthopedist is not knowledgeable about soft tissue injury, the problem may be underestimated, ignored, or misunderstood" ?As important as it is to do your homework, don't defer your treatment until you've learned everything you can about repetitive strain injury, and don't kick yourself because you have it, and don't expect to learn everything at once. In between learning that you have RSI and learning how to manage it you are likely to go through a bleak period of having to give up a lot of things you do and love, and then a period of learning anew how to do everything. But if you are patient with yourself, take responsibility for your care, and develop the assertiveness to get what you need, you will get better.? Here, she took the words right out of my mouth! ?By the way, it is critical to have your family practitioner run a number of tests to check whether you have a systemic problem that may be causing your RSI symptoms, such as diabetes, thyroid problems, lyme disease, degenerative disk disease, etc.? Also, chondritis, myopathies and myositis could be involved. http://www.ctdrn.org/rsi-support/selecting_a_treating_physician-joan_lichterman.htm ?Actually, Repetitive Strain Disorders (RSI) is really a misnomer. They should be called Cumulative Trauma Disorders or CTD, reflecting the true nature of the disease. YES, CTD is a disease. It is a disease of the musculoskeletal system, produced by a gradual build up of tiny amounts of damage. This damage occurs on a daily basis as a result of repetitive motions and/or sustained postures, focused to only a few parts of the musculoskeletal system. All suffered by a working body that cannot tolerate the damage because of various contributing medical circumstances.? ?It is the lack of blood supply that is the primary mechanism of injury. When you watch people at work, you quickly realize that it is very difficult to eliminate repetitive motion from most jobs. A good strategy instead, is to decrease sustained posture and to increase blood supply to the working tissues. You may not be able to reduce repetitive motions, but you can usually improve the blood supply to the working tissues by reducing posture stress and stretching exercises. That is one extremely effective and efficient strategy for preventing cumulative trauma disorders? http://www.impaccusa.com/rsifaq.html Then, starting with your second question first: 2) A list of questions that it would be good to ask a provider I am considering. ================================================================================ Questions to ask a potential doctor?s staff/doctor: --------------------------------------------------- ?First phone the doctor's office to find out if s/he accepts workers' compensation cases, and if you could make a telephone appointment to ask the doctor a few questions. If the doctor or a well-informed aide won't take the time to talk to you, perhaps you should look elsewhere. The questions to which I would want answers are: What percentage of the doctor's cases are RSIs, and what percentage of those get better? How long is the initial diagnostic appointment, and how does the doctor diagnose the injuries (for example, does s/he take a thorough case history, including work history, job conditions and duties)? Does the doctor check for myofascial stress and neurovascular compression (two major sources of hand problems)? What kind of treatment does the doctor prescribe? For example, does s/he support "alternative" therapies (acupuncture, chiropractic, myofascial release work ? and any others in which you're interested)? If the doctor's customary treatment regimen doesn't help your condition, will s/he be willing to send you to another treatment professional for evaluation and/or treatment? http://www.ctdrn.org/rsi-support/selecting_a_treating_physician-joan_lichterman.htm ?Most of us find our doctors through the recommendations of others, and that can be a blessing -- or a curse. One physician's type-A-personality bedside manner may be perfectly suited to your hypochondriac best friend's needs but not to your laissez-faire approach to survival. Whether you're in an HMO or have the means to go to any doctor you desire, nothing is more important than getting comfortable with your primary-care physician, typically an internist with a specialty in some field of particular relevance to you. If you're not comfortable with the gatekeeper, you won't be comfortable with his or her referrals, which are often sought during times of crisis, and you'll end up shortchanging your health in ways you wouldn't dream of doing to, say, your appearance. If you're fortunate enough to have a friend who's a doctor, ask for referrals, for scuttlebutt, and for guidance. But Mack Lipkin, a professor of clinical medicine and director of the primary-care division at NYU Medical Center, who frequently finds himself serving as a medical clearinghouse, says his recommendations are only as good as the information prospective patients provide at the outset.? http://newyorkmetro.com/bestdoctors/articles/02/bestdoctors/index.htm ?Once you feel like you've found a good match, you should provide accurate, thorough information about yourself so your new doctor can care for you in the best way possible, Frank and Rudnick said. Start by covering four topics during your first visit: your medical history, your family history, your lifestyle, and the medications you take. Knowing which health problems you've had in the past can help your new doctor assess your current health status and be on the lookout for potential problems, Rudnick said. And learning about your family's medical history can also help your new doctor help you, Rudnick and Frank said. Certain diseases and conditions -- cancer, diabetes, heart disease, mental illness, high blood pressure and high cholesterol, for instance -- often run in families, Rudnick said.? http://www.medicinenet.com/script/main/art.asp?articlekey=53609 ?Step 3: Ask around for advice Talk to friends and family about doctors they recommend. Perhaps your current doctor can even make some recommendations. Nurses in your doctor's office or at your local hospital might be able to offer recommendations, since they often work with several doctors. You might also consult: ? A local hospital you respect. If you've heard that a particular clinic or hospital in your town is good, you might want to call that hospital's referral service and ask for more information about the doctors available to see you. ? Local, county or state medical societies. Networks of doctors in your area might have referral services to assist you with your search. Check your local telephone directory. ? Medical organizations. The American Medical Association (AMA) is a national organization that allows you to search listings by name or specialty. Some organizations have local chapters that can supply you with the names of specialists in your area. Medicare operates an online directory of doctors on its Web site. You can search by location and the doctor's specialty.? http://www.mayoclinic.com/health/senior-health/HA00058 ?At your first appointment you'll probably be able to tell if you've found a doctor you're comfortable with. Did she review your past medical history, find out about diseases that run in your family, inquire about your current health habits, and perform a thorough physical examination? Did she listen well to your questions? Did she talk to you about prevention, such as diet, exercise, monitoring for breast cancer, osteoporosis, etc? Was she approachable? Did she explain things in ways you could understand? If the answer to all of the above is yes, and you felt a good "chemistry," then your search was successful. Good luck!? http://healthlink.mcw.edu/article/901217376.html ?? Audition the doc. Once you've found a potential candidate, set up an office visit to meet the doctor so you can find out whether or not your interests mesh. "I like to interview my doctors," says Lifetime Online community member Selene. "Many people don't realize that they are allowed to have expectations of their doctors beyond their simply showing up and writing a prescription." Dr. Krupat agrees. "The first meeting is like a first date," he says. "You can size each other up and find out whether or not you work well together." During the meeting, tell the doctor what you're looking for in terms of the relationship and ask him to tell you the same. For instance, Dr. Krupat has found that some patients get frustrated when physicians offer a number of treatment options, rather than just telling them what to do. Others prefer docs with a more give-and-take style. ? Be alert to these warning signs. If any of the following occurs, find another physician: 1. She gives you orders, rather than discussing options. 2. She doesn't give you an opportunity to ask questions. 3. She rushes you, without an apology. 4. She interrupts you while you're voicing a concern. http://www.lifetimetv.com/reallife/health/features/doc_right2.html ?? After the exam, did the doctor talk to you about your concerns and ask you if you have questions? Did he seem knowledgeable about your illness, tests, current treatment options and medications? Did he discuss all of your treatment options with you? Did he immediately discredit any treatment options? Did he ask you if you were currently taking any medications? ? When discussing testing and treatment options, was the doctor condescending when you asked for clarification of the information he was giving you? Did he seem cocky or egotistical or try to sound more knowledgeable than other doctors? Did he discuss any of his philosophies about treatment? Are they unusual or against the norm? Did he ask for your opinions about treatment and treat you like a partner? If he disagreed with you, how did he address your disagreement? ? When discussing pain management, what were his philosophies? How does that correspond with your philosophies? Are you confident that the doctor will manage your pain to your expectations? Are you confident that he will be available in an emergency? Who fills in for him when he's on vacation or unavailable? Do you feel that you can trust his judgement enough to comply with his treatment?? http://lungdiseases.about.com/od/generalinformation1/qt/findgooddoctor.htm ?Decide what qualities are most important to you - experience, reputation, good bedside manner, office hours/location, or insurance coverage, for example. While the doctor with the highest grade point average may be the best choice for some, a physician?s manner is more important to others.? http://www.aanma.org/medicalcenter/mc_finddoctor.htm Phone Questions: ================ 1) Is the doctor board certified? 2) Does this doctor see other patients similar with similar problems as yours? (RSI, soft tissue injuries) 3) What is the doctor?s attitude about your role in your health care? Is he or she willing to receive input from you? 4) Is your doctor willing to take time for an interview before you make your choice? 5) Is your doctor willing to work with other health care providers in partnership with you? 6) How much time does the doctor spend on an initial visit? 7) How long is the wait in the waiting room, generally speaking. 8) Which hospital affiliations does the doctor have? Ten signs you have the wrong doctor: http://thyroid.about.com/cs/doctors/a/neednewdoctor.htm 1)A list of clinics focusing on repetitive strain injuries in the area ====================================================================== Massachusetts General Hospital 15 Parkman Street Boston, Massachusetts 02114 Phone: 617-726-5750 Fax: 617-726-8543 Director of Neuromuscular Clinic: Robert H. Brown, Jr., D.Phil., M.D. Medical Co-Director of ALS Clinic and Director of Clinical Trials Unit: Merit E. Cudkowciz, M.D. Specialties: Neuromuscular Other medical specialties: Rehabilitation Other information: The Neuromuscular Clinic was opened at the Massachusetts General Hospital in 1983 to serve the population of neuromuscular patients. We are a designated MDA clinic. It encompasses the full range of neuromuscular disorders, primarily of adults, including muscular dystrophies and myopathies, neuropathies, neuromuscular junction diseases and ALS. Its research focus is ALS and selected muscular dystrophies. The clinic offers full diagnostic and therapeutic services for our neuromuscular clients. We are affiliated with a full complement of physicians, nurses and therapists from all of the relevant disciplines. In addition, we interdigitate closely with a laboratory that studies the basic pathogenesis of these diseases and with the Clinical Trials Unit at our hospital. That Trials Unit is now conducting several clinical trials in ALS. Other diseases treated: Muscular dystrophies, post-polio syndrome, myasthenia gravis. http://www.wfnals.org/clinics/usma.htm ======================================= ?RSI Action is a student group providing preventative education about RSI to the general public and to students at Harvard. It also provides advocacy and support for Harvard students with RSI. Harvard staff should see the section on staff. Our purpose is three-fold: ? Education of students, to prevent RSI. ? Advocacy for students with RSI. ? Support for students with RSI. Harvard staff Harvard clerical and technical staff with problems are encouraged to contact the union (HUCTW), at 617-661-8289. The contacts are Donene Williams and Gloria Buffonge. They are willing to talk to non-HUCTW staff members as well, but are unable to work with those staff members in their worksite.? http://www.rsi.deas.harvard.edu/about_us.html ?When you first go to UHS , you will see your primary care physician. UHS primary care physicians have received some training in RSIs, but certainly aren't specialists. (Elsewhere, most clinicians have likely received no training.) Try to get referrals to more knowledgeable people, depending on your symptoms. Several people in our group received incomplete or faulty diagnoses from their primary care physicians (though this may not be representative of people's experience at UHS in general). Since getting the proper diagnosis and treatment is very important, we strongly recommend getting a referral. If your symptoms are not very severe (e.g. minor pain only while typing -- goes away quickly), then you may not be able to get referrals. Instead, your physician will (or should) probably suggest rest, ergonomic changes, stretching, and exercise, as well as possibly splints, anti-inflammatories, ice, or heat. In a classic case of tendonitis, with these changes, your symptoms should go away in about two weeks. In any event, schedule a follow up appointment so that if your symptoms do not go away, you can get more referrals.? http://www.rsi.deas.harvard.edu/tips.html#uhs ======================================= RCHI 311 Service Road East Sandwich, MA 02537 General Information (508) 833-4000 Inpatient Referrals (508) 833-4200 Outpatient Appointments (508) 833-4141 Physician Appointments (508) 833-4160 Community Programs (508) 833-4008 Employment Opportunities (508) 833-4041 Development Office (508) 833-4004 Patient Accounts (508) 833-4023 General Fax (508) 833-4195 Directions on this page http://www.rhci.org/html/quicklink_contact.htm (Affiiated with Spaulding Rehab) Because of copyright restrictions, I am only posting information on two of their physiatrists. Susan Ehrenthal, M.D., Staff Physiatrist Medical School: Tulane University School of Medicine, New Orleans Internship: Tulane University School of Medicine Residency: Rusk Institute of Rehabilitation Medicine, New York University Medical Center ? Physical Medicine and Rehabilitation; Chief Resident Diplomate: American Board of Physical Medicine and Rehabilitation Interests: General rehabilitation. Acupuncture. Musculoskeletal injuries, chronic pain (including fibromyalgia and myofascial pain), arthritis, osteoporosis, sports medicine, trigger point injections, electrodiagnostics. Other: Medical acupuncturist Offices: RHCI in Sandwich; RHCI-Yarmouth Appointments: Sandwich ? (508) 833?4160; Yarmouth ? (508) 771?1300 Scott Abramson, M.D., Staff Physiatrist Medical School: Northwestern University Medical School, Chicago Internship: UCLA San Fernando Valley ? Internal Medicine Residency: Harvard Medical School ? Physical Medicine and Rehabilitation; Chief Resident Diplomate: American Board of Physical Medicine and Rehabilitation Memberships: Fellow, American Academy of Physical Medicine and Rehabilitation Interests: General rehabilitation. Neurological, orthopedic, cardiac and pulmonary rehabilitation, treatment of musculoskeletal and neurologic injuries, electrodiagnostic studies, spine injections, trigger point injections, sports medicine, Botox injections for spasticity and pain management. Office: RHCI in Sandwich, RHCI-Bourne Appointments: (508) 833?4160 RHCI?s medical staff includes six full-time physicians: a neurologist and five physiatrists (physicians specializing in physical medicine and rehabilitation). Information, appointments: (508) 833?4160 http://www.rhci.org/html/physicians_docs.htm Spaulding Rehabilitation Hospital (617) 573-7000 125 Nashua Street, Boston, MA 02114 Outpatient Services: Downtown Crossing (617) 728-6050 294 Washington Street, Boston, MA 02108 http://www.spauldingrehab.org/ Alec L. Meleger, MD Physiatrist Director, Spaulding/Harvard Pain Medicine Fellowship Board Certification: Physical Medicine and Rehabilitation Pain Medicine Research Interests: Interventional Spine Care Musculoskeletal Medicine Comprehensive Pain Management Dr. Meleger?s numerous publications are posted on this page: http://www.spauldingrehab.org/staffprofile,uid=136 James Sarni, MD Staff Physiatrist Instructor, Department of Physical Medicine and Rehabilitation, Harvard Medical School Education: MD, Mt. Sinai School of Medicine, 1986 Residency: Albert Einstein College of Medicine, Physical Medicine & Rehabilitation,1989 Fellowship: Hospital for Joint Diseases, 1990 Board Certification: Physical Medicine & Rehabilitation, 1991 http://www.spauldingrehab.org/staffprofile,uid=151 When I worked for a major teaching hospital, patients with RSI injuries found our sports medicine program was helpful. I suggest you investigate the UMass Sports Medicine program. They may or may not see non-student athletes. http://www.athletics.umb.edu/sports_medicine/index.html CNOT CNOT, the Coalition on New Office Technology, 650 Beacon St., 5th Floor, Boston in Kenmore Square, 617-247-6827 is a great resource. You can check out the CNOT home page, http://www.rsiaction.org/. While most of their members are in Massachusetts, they are a national resource. They run various seminars and maintain a referral book with reviews of various doctors related to RSI. If you need to find a good doctor, or you want to check on a referral, or you have a good or bad experience with a doctor, give CNOT a call. Out of the same office is the Office Technology Education Project, with the same phone number. Finally, in this one space, there is RSI Action, (an unaffiliated inspiration for Harvard RSI Action), which works on issues of RSI in the UniveRSIty, across universities in the Boston area, and in general on RSI prevention and advocacy for workplace and legislative changes.? http://www.rsi.deas.harvard.edu/resources.html ======================================= Physicians: ---------- Some of these physicians are not likely to be practicing in 30 years, but once you have a definite diagnosis and a treatment plan, other doctors should be able to manage your care. At the very least, an older doctor can refer you to one of her/his younger partners. These physicians were recommended by Dr. John Sarno (See below) Boston area--Physicians & Psychologists Eugenio Martinez, MD The Spine Center- New England Baptist Hospital Bone and Joint Institute 125 Parker Hill Avenue Boston, MA 02120 [email protected] (617) 754-5246 or Eugenio Martinez, MD Pro Sports Orthopedics 200 Providence Highway Dedham, MA 02026 [email protected] (781) 326-7108 (781) 326-5839 Fax http://profiles.massmedboard.org/Profiles/MA-Physician-Profile-View-Doctor.asp?Brn=76293 ======================================= Ronald D. Siegel, Psy.D. 20 Long Meadow Road Lincoln, MA 01773 www.backsense.org (781) 259-3434 ======================================= Harvard Resources: ? Edgar S. Miller, DO. 49 Red Pine Dr Carlisle, MA (978)369-6030 (Not sure if this is a business or home phone!?) Very highly recommended. (He has been licensed since 1952, so he will not be able to follow you for 30 years!) I did not include him on the ?Call list?, but you may reconsider him. ? James H. Gronemeyer, DO. 290 Massachusetts Ave, Arlington MA 02174. (781) 646-7790. Massachusetts Board of Registration in Medicine http://profiles.massmedboard.org/Profiles/MA-Physician-Profile-View-Doctor.asp?Brn=60288 ? B. Jayne Alexander, DO. (508) 697-3185 ======================================= Mark C. Gebhardt, MD, among Boston?s 100 Top Docs Specialty Bone and Soft Tissue Tumors Children's Hospital Boston Orthopedic Surgery 300 Longwood Avenue Fegan 2 Boston, MA 02115 Phone: 617-355-6021 Fax: 617-730-0456 http://www.childrenshospital.org/chnews/03-10-06/topdoctors.html And Mark C. Gebhardt, M.D. Beth Israel Deaconess Medical Center, Department of Othopaedic Surgery 330 Brookline Ave - Chief, Ortho. Boston, MA 02215 office phone: 617-667-2181 patient phone: 617-667-2140 fax: 617-667-2155 http://children.photobooks.com/directory/profile.asp?dbase=main&setsize=5&last=Gebhardt&searchButton.x=0&searchButton.y=0&pict_id=9903870 A Mass. Board of Registration in Medicine profile http://profiles.massmedboard.org/Profiles/MA-Physician-Profile-View-Doctor.asp?Brn=47866 ======================================= ?Dr. Robert A. Sands is Board-Certified in Internal Medicine and Rheumatology. He earned a M.D. from Baylor College of Medicine and completed an Internship at Georgetown University Hospital. Dr. Sands also completed his Residency at New England Medical Center and a Fellowship at Beth Israel Hospital/Brigham and Women?s Hospital. He sees patients at Winchester Hospital and at his office at Baldwin Park II in Woburn.? http://www.winchesterhospital.org/webpage.cfm?site_id=8&org_id=1&morg_id=0&gsec_id=0&item_id=3966 Arthritis and Rheumatology Center Treatment of arthritis, joint and muscular diseases Choate Medical Center, 23 Warren Avenue, S-150, Woburn, Tel. 781-938-3985 Robert Sands, M.D. Khalid Syed, M.D. http://www.cummings.com/woburn_medical_center.htm 133 Brookline Ave Boston, MA 02215-3904 (617) 541-6300 http://boston.citysearch.com/profile/4731165 A Mass. Board of Registration in Medicine profile on Dr. Sands http://profiles.massmedboard.org/Profiles/MA-Physician-Profile-View-Doctor.asp?Brn=47776 ======================================= Peter A. Merkel, M.D., M.P.H. MED Arthritis Center Office address 715 Albany St, E Office phone 617-414-2501 ?Newton resident Peter A. Merkel, M.D., M.P.H., a rheumatologist at Boston Medical Center (BMC) was recently named one of America?s Top Doctors by Castle Connolly Medical Ltd. The America?s Top Doctors guide, recognized by consumers seeking high-quality medical care, is a trusted and authoritative resource for identifying top doctors in the United States. The selected top doctors are nominated by hospital presidents; vice presidents of medical affairs; and chiefs of service in anesthesiology, obstetrics and gynecology, medicine, emergency medicine, pediatrics, psychiatry, radiology and surgery; as well as randomly selected board-certified physicians.? http://www.bu.edu/phpbin/webph/index.php Merkel, an associate professor of medicine at Boston University School of Medicine, joined Boston University Medical Center in 1998. He was previously a faculty member at Harvard Medical School.? http://www.bu.edu/phpbin/news/releases/display.php?id=970 ?Massachusetts - Boston University School of Medicine Arthritis Center, Boston, Massachusetts, 02118, United States; Recruiting Ashley Leavitt 617-414-2509 [email protected] Peter A. Merkel, MD, MPH, Principal Investigator http://www.clinicaltrials.gov/ct/show/NCT00315393 ======================================= David E. Trentham, M.D. BIDMC-Division of Rheumatology 110 Francis Street, W/LM-4B Boston, MA 02215 Phone: 617-632-8658 Fax: 617-632-9681 http://bidmc.harvard.edu/?node_id=6 ?One of the leading researchers in the field of arthritis and rheumatology is David E. Trentham, M.D. Dr. Trentham holds a medical degree from the University of Tennessee College of Medicine, and has spent almost 30 years working in the field of rheumatology. He is a member of several associations in the field, including the American Society of Clinical Rheumatologists, and is on the board of directors for the International Society for Rheumatic Therapy. Dr. Trentham is an associate professor of medicine at Harvard Medical School; his primary research interests are the immunologic properties of collagen, animal models of arthritis, cellular autoimmunity in rheumatic diseases and therapeutic evaluations in rheumatoid arthritis. HSR talked with Dr. Trentham about the research on Type II collagen. Associate Professor of Medicine, Harvard Medical School http://www.zoominfo.com/people/Trentham_David_3506385.aspx ======================================= Fitzgerald, Lisa M., MD 300 Mount Auburn Street Suite 410 Cambridge, MA 02138 Phone: 617-868-2650 Fax: 617-868-2641 830 Boylston Street Chestnut Hill, MA 02167 Phone: 617-754-6840 BIDMC-Division of Rheumatology 110 Francis Street, Suite 4B Boston, MA 02215 Phone: 617-632-8658 Fax: 617-632-9681 http://bidmc.harvard.edu/?node_id=6 ======================================= Stuart Rosenberg,MD 375 Longwood Avenue 3rd floor Boston, MA 02215 Phone: 617-632-7441 Fax: 617-632-7442 BIDMC Division of Rheumatology 110 Francis Street, Suite 4B Boston, MA 02215 Phone: 617-632-9674 Fax: 617-632-9681 http://bidmc.harvard.edu/?node_id=6 ?Previously, Rosenberg was associate medical director for practice management at the Ochsner Clinic, a 420-pysician-multispecialty group practice in New Orleans. He was a staff rheumatologist and regional medical director for Ochsner Health Plan. Prior to this, Rosenberg was director of ambulatory services and a member of the executive management team at the University of Virginia Medical Center (UVMC). He had also been assistant professor of medicine, and later, director of internal medicine/subspecialty clinics at UVMC. Rosenberg received an AB degree from Duke University and an MD from the University of Virginia.? http://www.zoominfo.com/people/Rosenberg_Stuart_25817967.aspx ======================================= Dr. Robert Yood Phone: (508) 595-2855 ?In working with his patients, Dr. Yood strives to make them feel as comfortable as possible in dealing with their disease. ?I try to understand the patient?s fears, anxieties and concerns and respond accordingly. I also work hard to educate my patients so they can understand their disease and the risks and benefits of each treatment option I present?that?s very important.? In addition to being Chief of Rheumatology at Fallon Clinic, Dr. Yood is also Medical Director of the Research Department, which is currently conducting more than 30 different drug studies and dozens of epidemiologic studies. ?This research eventually impacts patients in terms of the medications they take and type of care they receive. That?s why it?s so important to build our knowledge base in treating different diseases.? Dr. Yood is also very involved in teaching and is Chief of the Division of Rheumatic Diseases and Musculoskeletal Medicine at Saint Vincent Hospital and Clinical Professor of Medicine at the University of Massachusetts Medical School. ?I work a lot with medical residents, both at St. Vincent Hospital and in the office diagnosing patients. For me it?s very satisfying to help train the next generation of physicians.? http://www.fallon-clinic.com/internet/physician/index.aspx?PAGE=mtd/mtdYood&LEVEL1=physician&LEVEL2=meetthedoctor1 ?I've had excellent treatment from (and rapport with) Dr. Robert Yood, who's affiliated with the Fallon Clinic in Worcester (no 'H'), MA where I live.? http://eeshop.unl.edu/providers/massachusetts.html ?Dr. Robert Yood - Chief of Rheumatology receives prestigous Paulding Phelps Award for outstanding service.? http://www.fallon-clinic.com/internet/physician/index.aspx?PAGE=awardsPublications&LEVEL1=physician&LEVEL2=awardspublications ======================================= From the site you posted, I found these practicioners: Fornier, Thea H., CN, 247 Main St., North Andover MA 01845, Ph 978-686-7103 Nutrition, kinesiology, muscle testing. ======================================= Simms, Robert, MD, Rheumatologist Boston University School of Medicine, Arthritis Center, K5, 71 East Concord St., Boston, MA 02118, Ph 617-638-4310. FMS. ===================================================== Have you ever had scintigraphy testing for lesions from RSI? It appears to be useful in advanced cases. ?Repetitive strain injuries (RSI) are characterized by lesions to the soft tissue after strainful work. RSI require rapid diagnosis and treatment since it may lead to temporary or permanent functional impairment. Diagnosis is based mainly on clinical complaints, physical examination and radiographs.? http://www.alasbimnjournal.cl/revistas/2/aborthopheadics.htm ======================================= Mass General/Boston Children?s Hospital have a neuromuscular research center: ?Neuromuscular diseases are a group of diseases that can be relatively mild, moderate, or severe, and can present early or later in life. The severe cases of neuromuscular disease may lead to death in early infancy while milder cases may cause significant muscle weakness that persists for life. These disorders can be inherited in different ways, including both X-linked and autosomally. As summarized by (1) O'Brien and Kunkel (2001), neuromuscular disease research has significantly progressed since dystrophin was cloned. The functions of dystrophin and its associated protein complex (DAPC) are being elucidated. (Please refer to our Researcher Informaiton section for a diagram of the DAPC.) However, a delay in developing treatment has taken longer than expected. New advances have created the potential for several therapies which will be explored further, in hope that we will be better able to manage muscular dystrophies. Our research is dedicated to this goal.? http://www.chb-genomics.org/hndp/pat_fam-index.php Elizabeth Taylor, MS, CGC Research Study Coordinator, Board Certified Genetic Counselor Children's Hospital Boston Division of Genetics 300 Longwood Avenue Enders 6 Boston, MA 02115 Telephone: 617-919-2169 Fax: 617-730-0253 E-mail: [email protected] http://www.chb-genomics.org/hndp/contact-index.php ======================================= Alternative Therapy that many on RSI forums recommend: ?Most patients have cramping or twisting postures that are not completely resolved by all of the best attempts of using medications. Especially for these patients, it is important to maintain as much flexibility and as complete a range of motion of the affected body part as possible. Gentle stretching and range-of-motion exercises suggested by your physician can help. Your physician may also suggest evaluation by a physical therapist or occupational therapist. The intent is to preserve range of motion and flexibility, not necessarily to lessen the amount of spasm. However, after gentle stretching, the affected body part may feel better temporarily.? http://www.dystonia-foundation.org/treatment/comp.asp ======================================= Feldenkrais Method From Cathy Wong, N.D., Your Guide to Alternative Medicine. FREE Newsletter. Sign Up Now! What is Feldenkrais? ?Feldenkrais is a form of movement re-education developed by nuclear physicist and engineer Moshe Feldenkrais after suffering a sports-related injury. Rather than undergo surgery, he explored alternatives and created his own form of rehab integrating physiology, anatomy, martial arts, psychology, and neurology. A key principle of Feldenkrais is that the way that a person speaks, moves, and thinks is based on the self-image that person has developed over the years. In order to change the way we move and carry ourselves, we have to change how we see ourselves. Feldenkrais recognized the importance of proper breathing to movement. He also believed that postures and movements reflected the state of the mind and body. For example, a depressed person may have hunched shoulders? http://altmedicine.about.com/od/therapiesfrometol/a/Feldenkrais.htm ?yes, I understand. Most people can't stop working. But I do worry about you overusing your left hand. My doc was top notch but it's the OTs who can help you. I urge you check out the Feldenkrais practitioner site and call up any OTs or PTs in your area.? http://www.mediabistro.com/bbs/cache/t25763_1.asp 32 practicioners in Boston http://www.feldenkrais.com/guild/find/list.lasso?country=&state=ma ======================================= 3) Any suggestions that you might have about how to better use Google answers in this project. It?s always good to post site you have already found, and you did that! Nothing bothers researcher more than getting told, after the fact, that the researcher already found those sites! (Yet failed to tell us). I actually researched without using your sites, to see what I could find, and later found I came across your sites anyway! As you noted, this question was locked and left several times. It is quite a daunting project, and it took considerable time. I felt confused, and am not even sure I was able to provide you with sufficient information. I hesitated taking this question after reading it thoroughly for fear of not being able to meet all your criteria. Perhaps by breaking a large project into two (or more) questions, it would be less of an overwhelming task to researchers. Subjective answers are always difficult. We can?t be sure you will like the doctors we find, and we can?t be sure the doctors are still at the posted locations. We can?t be sure the doctors are accepting new patients, and we can?t always find the doctor?s age. Sometimes the customer ?punishes? a researcher with a low rating when they find that a doctor has retired or moved. Do remember, that Google Answers has the Clarification process, which encourages a dialogue between customer and researcher. You can utilize this if I have failed to include something. ======================================= Additional: Dr. John Sarno is at NYU Medical Center, and not Boston, but he seems to enjoy a great reputation. http://www.med.nyu.edu/people/J.Sarno.html ?He calls the painful syndrome which results Tension Myositis Syndrome (TMS). In essence, he argues that the pain exists not because there is a structural injury at the site of the pain, but because your brain has somewhere deep inside chosen to latch onto the pain as a mechanism to divert you from painful feelings that have been pushed deeper than your conscious level. He boasts a high rate of treatment success, and there are many Harvard students in the RSI Action Group who have been healed by his program (and they are available to talk to you). The following several pages have been adapted from a handout which the RSI group has produced about Dr. Sarno, and are a summary of Dr. Sarno's research on TMS.? Dr. Sarno?s writings on TMS: http://www.tarpityoga.com/tms.html Dr. Sarno?s book: http://www.amazon.com/gp/product/0060851783/ref=nosim/102-4921246-8552959?n=283155 If you have MS Word installed (And you said you did) You can read a 7 page handout from Dr. Sarno. Click on the blue word ?Handout? near the bottom of the page. I am unable to post it here due to copyright restrictions. http://www.rsi.deas.harvard.edu/mb_what_is.html ======================================= ?ARMS has received national coverage from such publications as Time Magazine and the Congressional Quarterly Researcher and is the only international RSI resource listed in Dr. Koop's Self-Help Advisor, written by the former Surgeon General of the United States? http://www.certifiedpst.com/arms/ Newsletter Archives http://www.certifiedpst.com/arms/newsletters.html Order additional Information and newsletter http://www.certifiedpst.com/arms/contact.html ======================================= Success Stories http://www.geocities.com/la_rsi/healing.html?200630 ======================================= Musculoskeletal Disorders http://www.mic.ki.se/Diseases/C05.html Polymyositis http://healthgate.partners.org/browsing/browseContent.asp?fileName=100268.xml&title= ======================================= List of rheumatology clinics in the Boston Area http://local.infospace.com/insp.bylocation/local/byloc/MA/Boston/Health-and-Fitness/Doctors/Rheumatology The BrainTalk site has relocated to http://brain.hastypastry.net/ I found nothing of use on the cached site. This is the chat forum http://brain.hastypastry.net/forums/chat/flashchat.php Monthly support group in your area: 650 Beacon Street, Kenmore Square, Boston, 4th Floor, in the room to your left as you exit the elevator. There is a physician evaluation book there as well. ?RSI Action?s book of user evaluations of health-care and other providers may be viewed by appointment at the MassCOSH office in Dorchester; call 617-825-7233 extension 10. You may also view it during the monthly drop-in meeting. If you have RSI we invite you to contribute evaluations of providers you have used? Clicking on the link under RSI ACTION FLYER takes you to a downloadable Word document that states ?RSI Action?s book of user evaluations of health-care and other providers may be viewed by appointment at the MassCOSH office in Dorchester; call 617-825-7233 extension 10. You can also view it during our monthly drop-in meeting. We invite you to contribute evaluations of providers you have used; the forms are on our web site.? http://www.rsiaction.org/ You may also contact: The Association of Occupational and Environmental Clinics 1010 Vermont Avenue NW Suite 513 Washington DC 20005 (202) 347-4976 AOEC will refer you to an occupational and environmental clinic near you. The clinic may direct you to doctors knowledgeable about RSI or support groups in your area.? http://www.rsihelp.com/physician.shtml ======================================= For your eventual appointment: Request copies of your records from past doctors you have seen, particularly any imaging studies, such as X-rays, MRIs, etc., and blood tests. Take them with you, or request that they be faxed in advance of your appointment. Wear easy to remove clothing, for comfort and ease in undressing. Take or wear any supportive devices you may use, such as a brace or splint. Compile a list of medications you have tried, and a separate list of all medications you currently take and their dosages. Include any supplements and vitamins. Ask if you should be fasting in case fasting labs may be drawn. Compile a list of all therapies you have tried. ========= Call List ========= Massachusetts General Hospital 15 Parkman Street Boston, Massachusetts 02114 Phone: 617-726-5750 Fax: 617-726-8543 RSI Action at Harvard 617-661-8289 RCHI 311 Service Road East Sandwich, MA 02537 General Information (508) 833-4000 Inpatient Referrals (508) 833-4200 Outpatient Appointments (508) 833-4141 Susan Ehrenthal, M.D., Staff Physiatrist Scott Abramson, M.D., Staff Physiatrist Spaulding Rehabilitation Hospital (617) 573-7000 125 Nashua Street, Boston, MA 02114 Outpatient Services: Downtown Crossing (617) 728-6050 294 Washington Street, Boston, MA 02108 Alec L. Meleger, MD, Physiatrist James Sarni, MD, Staff Physiatrist CNOT, the Coalition on New Office Technology 650 Beacon St., 5th Floor, Boston (Kenmore Square) 617-247-6827 Eugenio Martinez, MD The Spine Center- New England Baptist Hospital Bone and Joint Institute 125 Parker Hill Avenue Boston, MA 02120 (617) 754-5246 or Pro Sports Orthopedics 200 Providence Highway Dedham, MA 02026 (781) 326-7108 (781) 326-5839 Fax Ronald D. Siegel, Psy.D. 20 Long Meadow Road Lincoln, MA 01773 (781) 259-3434 James H. Gronemeyer, DO (781) 646-7790 Mark C. Gebhardt, M.D. Beth Israel Deaconess Medical Center, Department of Othopaedic Surgery 330 Brookline Ave - Chief, Ortho. Boston, MA 02215 office phone: 617-667-2181 patient phone: 617-667-2140 fax: 617-667-2155 http://www.dfci.harvard.edu/abo/danafarber/detail.asp?personID=326 Robert Sands, MD 133 Brookline Ave Boston, MA 02215-3904 (617) 541-6300 David E. Trentham, M.D. BIDMC-Division of Rheumatology 110 Francis Street, W/LM-4B Boston, MA 02215 Phone: 617-632-8658 Fax: 617-632-9681 Fitzgerald, Lisa M., MD 300 Mount Auburn Street Suite 410 Cambridge, MA 02138 Phone: 617-868-2650 Fax: 617-868-2641 830 Boylston Street Chestnut Hill, MA 02167 Phone: 617-754-6840 Stuart Rosenberg,MD 375 Longwood Avenue 3rd floor Boston, MA 02215 Phone: 617-632-7441 Fax: 617-632-7442 Dr. Robert Yood Phone: (508) 595-2855 Peter A. Merkel, M.D., M.P.H. MED Arthritis Center Office address 715 Albany St, E Office phone 617-414-2501 Simms, Robert, MD, Rheumatologist Boston University School of Medicine, Arthritis Center, K5, 71 East Concord St., Boston, MA 02118, Ph 617-638-4310 Fornier, Thea H., CN, 247 Main St., North Andover MA 01845, Ph 978-686-7103 ======================================= I hope you have found this information useful. If anything is unclear, please request an Answer Clarification, and allow me to respond, before you rate. I will be happy to assist you further on this question, before you rate my answer. Sincerely, Crabcakes Search Terms ============= RSI + differential diagnosis Best Sports medicine physicians + Boston Best RSI Physicians + Boston Best soft tissue physicians + Boston Musculoskeletal disorders + Best physicians + Boston Myositis + physicians + Boston Best rated physicians + Boston + rheumatologists repetitive stress injuries specialists + Boston CTD + MSD + physicians + Boston Top rated physicians + Boston