Neil Kirschen, M.D., chief of pain management at South Nassau Communities Hospital in Oceanside, N.Y., isn’t your typical anesthesiologist. Kirschen opened one of the first pain management clinics on Long Island in the mid-1980s, giving nerve blocks to people in chronic pain. “I realized very quickly that some people get better, but some people don’t,” he says. “I wanted to improve my skills and help more people.”
So Kirschen dove into the world of alternative treatment modalities, studying first acupuncture and then osteopathy and other hands-on techniques including craniosacral therapy, myofascial release and high-velocity, low amplitude manipulation. “I basically created my own fellowship,” he says. “I went from class to class, going back to work on patients with the skills I learned. I saw I was getting much better results.”
Kirschen’s practice at the Pain Center of Long Island now incorporates all those modalities and more. “I’m always listening, always looking at other ways to heal patients. We spend a lot of time on nutrition, smoking cessation, exercise and eating habits,” he says. “I loathe prescribing medications. That’s not what I do.”
One of the therapies in which he’s found great success is proliferation therapy, or prolotherapy, where a dextrose solution is injected into ligaments, tendons and joints to strengthen attachments and promote a healing response in the body. “It goes well with manipulation and massage and can help many chronic pain issues, from tendonitis to torn rotator cuffs to low back pain,” he explains.
Kirschen serves on the board of directors of the American Association of Orthopaedic Medicine, an educational association for physicians that uses largely nonsurgical treatments for chronic pain conditions and overuse injuries. He was president for about a decade.
As part of his work with the AAOM, Kirschen developed educational workshops, teaching physicians hands-on treatment techniques that can be taken to impoverished areas in other countries to help people in chronic pain.“We have done probably 20 or so trips since 2006," says Maelu Fleck, AAOM’s administrative director. "We take a teaching team of five or six physicians and two dozen students and spend a week in the country, treating about 1,000 people in five days.”
The team’s main destination has been Guadalajara, Mexico, and the surrounding rural towns. “We started providing musculoskeletal care to laborers, farm workers — people who work very hard physically over the years,” Kirschen says. “Their knees hurt; their shoulders hurt. We just try to provide care. It’s very cost-effective, and there are no drugs involved.” They also teach the physicians and residents in the hospitals to administer the same treatment protocols they do. “This way, when we leave, they are empowered to continue the good work we’re doing,” he says. AAOM conducts four workshops a year outside the United States, including China, Romania and Greece.
Before going to medical school, Kirschen was an emergency medical technician, volunteering with a local ambulance corps in Queens. Once he became an anesthesiologist, he wanted to get involved again with first responders, and signed up as a volunteer firefighter, recertifying as an emergency medical technician along the way.
“Over the years, I’ve seen a lot of police officers and firefighters in my practice who are in pain,” he says. “So, I introduced myself to the local police departments and have become the police surgeon for several of them. I evaluate officers who’ve been injured, and help them get the proper care they need, so they can get back on the job.”
That involvement led to an initiative to train first responders to treat themselves and their partners. “We teach self-aid and buddy-aid,” explains Kirschen. “If a police officer has been injured, shot or stabbed, they learn to apply their own tourniquet, use topical clotting agents, and so on. They can treat themselves right away.” Kirschen also has taught first responders to administer intranasal Narcan, so they can immediately treat individuals who are suffering from a narcotics overdose.
Kirschen serves on the Nassau Regional Emergency Medical Advisory Committee, helping to write protocols, policies and procedures for what EMTs and paramedics can do for patients on ambulances, — so-called “pre-hospital emergency care.” And he helps to advise emergency preparedness officials on course curricula offered at the New York State Preparedness Training Center, a hub for emergency response training.
Asked how he balances so many causes and a thriving practice, Kirschen demurs. “It’s necessary, you know? It’s just fun. I have my medical job, but I have second and third jobs, too.”