Dr Bruhnding with Dr Larry Part 1

OSMS Board Certified Physical Medicine & Rehabilitation (PM&R) and Pain Management Physician, Dr. Paul Bruhnding, joined Dr. Larry Loewen, chiropractor, and host of the Dr. Larry Radio Show, to discuss what PM&R and Pain Management is, the difference between an MD and DO, arthritis of the spine and sciatica, along with treatment options.

Dr. Bruhnding is a Doctor of Osteopathic Medicine (DO) with board certifications in PM&R and Pain Management. Being a DO allows Dr. Bruhnding to view his patients and their conditions through an osteopathic lens. This means that he takes a holistic approach and uses osteopathic techniques to understand the foundation or reasoning behind how or why pain is occurring.

Dr. Larry takes the time to explain what the differences are between a Doctor of Medicine (MD) and a Doctor of Osteopathic Medicine (DO), along with the history of how and why DO license’ were created.

The goal of Physical Medicine & Rehabilitation, otherwise known as PM&R, is to get one’s musculoskeletal functions back to normal, so that everyday things are done in the most functional way possible. PM&R is a type of residency, where Pain Management is a fellowship. Pain Management takes the musculoskeletal and spine conditions dealt with in PM&R and takes it a step further by putting them on steroid treatment. Training with invasive procedures becomes more in depth, as well as the literature, exposure of patients and pathology.

Arthritis is a standard aging process of a joint where inflammation can cause cartilage, joint capsules and articular surface damage that leads to limited ranges of motion, an increase in pain, and eventually can lead to chronic pain.

There are two different types of pain, somatic and visceral. Dr. Bruhnding takes the time to explain the difference between the two and explains how arthritis pain is a form of somatic pain. Arthritis will become more painful due to the loss of articular cartilage. This is when the cushion, or cartilage, between two joints starts to damage. This can downstream into cartilage loss, then, causing the small nerve endings to become sensitized.

Finally, the first two steps to treatment of neck or back arthritis that Dr. Bruhnding provides is getting the right diagnosis and manual or indirect soft tissue techniques. Dr. Bruhnding explains that getting the right diagnosis is where the physician takes the time to sit down with the patient, talks with them about their pain, provides a physical exam, and figures out what the specific problem or source of pain is.

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