Chronic Pain Division

William Caldwell, DO Assistant Professor Director: Center for Pain Management Chief of the Chronic Pain Division	Amit K. Kaushal, MD Assistant Professor Director: Stony Brook Pain Medicine Fellowship Program
Abhishek K. Gupta, DO Assistant Professor	Irina Lokshina, MD Assistant Professor
Amruta Desai, DO, MPH, MBA Assistant Professor

The Center for Pain Management utilizes a multi-disciplinary approach for the treatment of pain. Residents will be exposed to chronic, acute, and subacute pain including cancer, neuropathic, somatic, and visceral pain. Residents will learn to perform an initial assessment of the patient with chronic pain, decide on appropriate diagnostic testing, develop skills in performing diagnostic and therapeutic procedures, and learn the appropriate use of pharmacotherapy. In addition, the resident will develop communication skills that will help develop a professional and therapeutic relationship with chronic pain patients.

There is an in-office fluoroscopy suite for epidural, facet, major joint, peripheral nerve blocks, and sympathetic nerve block procedures. Ultrasound guided injections are also utilized. Residents will also be exposed to traditional spinal cord stimulation, as well as dorsal root ganglion stimulation and other treatment modalities such as Botox and IV infusion therapies.

Trainees will greatly expand their knowledge base, skills, and judgment so that they can recognize and manage complications associated with chronic pain. Residents receive hands on training to give them the skills necessary for their fellowship and future careers.
 

• The CA-2 rotation is a one month rotation. [Pain Rotation Primer]
• The three month elective in the CA-3 year is structured as a "mini-fellowship". Residents on the rotation will participate in journal club presentations and receive several core lectures. [CA-3 Mini-Fellowship]

• ▶ The life of a Resident on the Chronic Pain Rotation ...

  Your primary responsibility for this rotation is to learn the basics of chronic pain management in an outpatient setting. This not only includes the physiology of pain, but the pharmacological, interventional, rehabilitative, psychological, and complementary techniques to improve the quality of life of a patient suffering from chronic pain.
  
  The majority of your clinical services will be performed at The Center of Pain Management, located at the Cancer Center (3 Edmund D. Pellegrino Rd, Stony Brook, NY 11794). Arrive to the clinic at 8AM and familiarize yourself with the schedule. Introduce yourself to patients that you will be providing care to. Help facilitate the flow of patient care and get ready to help or do the procedures.
  
  The hospital clinic is located at the Urology Office on 24 Technology Drive, East Setauket. Office hours are Monday and Thursday afternoons, from 1PM till 6PM. Residents are offered more independence as patients are often regularly scheduled during shorter duration.
  
  At the first Wednesday of each month, there will be a journal discussion on a recent article related to chronic pain management. You will be expected to choose a relevant topic or short article to discuss using a 15-20 minute PowerPoint format presentation to the pain management staff.

The Pain Center was a sponsor at the CRPS Walk		Article in Newsday quoted Dr. William Caldwell about the diagnosis and treatment of CRPS.
The reception area of the newly opened Center for Pain Management.		A patient treatment room in the newly opened Center for Pain Management.

Resident authors denoted by bold type

• Tsui P, Gupta A, Cervoni C, Page C, Sonty N. Pain psychology and perioperative pain management. In: Svider PF, Pashkova AA, Johnson AP (eds) 2021. Perioperative Pain Control: Tools for Surgeons. Springer, Cham.
• Gupta AK, Mena S, Jin Z, Gan TJ, Bergese SD. Postoperative pain: a review of emerging therapeutic options. Expert Rev Neurother. 2021 Aug 31
• Desai A, Dahan A, Gan TJ. Perioperative Opioid Education Initiatives: Do They Add Value? Anesth Analg. 2022 May 1;134(5):938-939.
• Palaniappan D, Friedlander D, Desai A. Is it time to reconsider the routine blind insertion of double lumen endobronchial tubes? J Clin Anesth. 2022 Aug;79:110766.
• Ghaly L, Bargnes V, Rahman S, Tawfik GA, Bergese S, Caldwell W. Interventional Treatment of Complex Regional Pain Syndrome. Biomedicines. 2023 Aug 14;11(8):2263
• Rahman S, Kidwai A, Rakhamimova E, Elias M, Caldwell W, Bergese SD. Clinical Diagnosis and Treatment of Chronic Pain. Diagnostics (Basel). 2023 Dec 18;13(24):3689.
• Wang A, Murphy J, Shteynman L, Daksla N, Gupta A, Bergese S. Novel Opioids in the Setting of Acute Postoperative Pain: A Narrative Review. Pharmaceuticals (Basel). 2023 Dec 25;17(1):29.
• Burjek NE, Hafeman M, Guthrie D, Desai A, Jin Z, Brockel M, Moore R. Perioperative use of gabapentinoids in pediatric patients. APS 2023:1, 21.
• Wang A, Kerolus K, Garry E, Li D, Desai A, Bergese S. Novel Techniques and Local Anesthetics for Perioperative Pain Management. In: Advances in Regional Anesthesia. Rijeka: IntechOpen; 2023.
• Mena S, Raj A, Caldwell W, Kaushal A. The annoyance of singultus: a case report of a rare adverse effect after epidural steroid injection. BMC Anesthesiol. 2024 Aug 31;24(1):302.
• Desai A, Razak A, Ghaly L, Bennici L, Moore R. Opioid-Obviating Analgesia for Adolescent Multilevel Spinal Fusion Surgery: A Problem-Based Learning Discussion. A A Pract. 2024 Jul 11;18(7):e01823.
• Kirsch E, Rahman S, Kerolus K, Hasan R, Kowalska DB, Desai A, Bergese SD. Dysmenorrhea, a Narrative Review of Therapeutic Options. J Pain Res. 2024 Aug 15;17:2657-2666.

• Bracero LA, Gupta AK. Challenges in Clinical Management of Complex Regional Pain Syndrome Due to COVID-19 Outbreak in New York. North American Neuromodulation Society 2021
• Shah R, Mikell C, Gupta AK. Cingulotomy for Chronic Lower Extremity Pain After Failed Neuromodulation and DREZ. North American Neuromodulation Society 2021
• Kim BS, Kang RS, Shim H. Treatment of CPRS in the Setting of Newly Diagnosed Breast Cancer. North American Neuromodulation Society 2021
• Mena S, Ma S, Kaushal A. Persistent Hiccups after a Cervical Epidural Steroid Injection. ASA 2021
• Kim B, Xiao A, Jiang Y, Caldwell WM. Fluoroscopic Guided Aspiration And Caudal Epidural For Treatment Of Symptomatic Tarlov Cyst. ASA 2021
• Kang RS, Taft A, Wu D, Gupta AK. Airway Management Of A Patient With Zonisamide Induced Toxic Epidermal Necrolysis. ASA 2021
• Kozlowski P, Gupta AK. Superior Hypogastric Plexus Block For Chronic Bladder Pain: Two Case Studies. ASA 2021
• Kozlowski P, Gupta AK. Myofascial Pain After Covid-19 Vaccination And After Recovery From Covid-19: A Case Series. ASA 2021
• Zhu M, Jin Z, Gupta AK. Stellate Ganglion Block For Unstable Ventricular Tachycardia In Anticoagulated Patient. ASA 2021
• Kang R, Gupta AK. Treatment of Phantom Limb Pain: Two Case Studies and Literature Review. NYSIPP 2021
• Kozlowski P, Shafai A, Gupta AK. Successful Treatment of Bilateral Supraorbital Neuralgia Utilizing Both Pulsed and Thermal Radiofrequency Ablation. NYSIPP 2021
• Shafai A, Kozlowski P, Gupta AK. Series of Intra-articular Wrist Injections for Chronic Wrist Pain Due to Lack of Access to Care from the COVID-19 Pandemic. NYSIPP 2021
• Shafai A, Kozlowski P, Wu D, Caldwell W. Spinal Cord Stimulation for Treatment of Refractory Phantom Limb Pain. NYSIPP 2021
• Shafai A, Kozlowski P, Koh J, Gupta AK. Successful Treatment of Occipital Neuralgia Caused by VP Shunt Placement Using Cervical Radiofrequency Ablation. NYSIPP 2021
• Mena S, Parikh S, Desai A. Neuraxial Analgesia For A Sacral Decubitus Ulcer. PGA 2021
• Kang R, Shuaib K, Parikh S, Desai A. Epidural Analgesia For Chemical Pleurodesis. PGA 2021
• Mena S, Kang RS, Caldwell W. Spinal Cord Stimulation for Sciatic Pain in Seronegative Neuromyelitis Optica Spectrum Disorder. IARS 2022
• Mena S, Kang RS, Caldwell W. Spinal Cord Stimulation for Sciatic Pain in Seronegative Neuromyelitis Optica Spectrum Disorder. ASA 2022
• Elias M, Kang RS, Kaushal AK. Treatment of Umbilical Hernia Pain with Ultrasound-guided Abdominal Botox Injections. ASA 2022
• Hafeman M, Desai AG, Moore RP. High Thoracic Erector Spinae Plane (ESP) Block for Humeral Osteotomy. ASA 2022
• Kozlowski P, Turkiew E, Desai AG, Bennici LA, Moore RP. Opioid Free Thoracolumbar Fusion in a Pediatric Patient with a Polysubstance Abuse History. ASA 2022
• Ghaly L, Zimmerman A, Kaushal A. The use of stellate ganglion block for post- covid-19 pleuritic chest pain. ASRA 2023
• Rahman S, Desai A, Moore R. Erector spinae plane block for cancer related brachial plexus pain - A new role for regional anesthesia in NORA? ASRA 2023
• Rahman S, Desai A, Moore R. Erector spinae block for NORA to treat selective brachial plexus pain in patient with metastatic lung cancer. PGA 2023

faculty photos by Jeanne Neville