tell me where it hurts

Dr. David A. Spinner is intimately acquainted with pain.

During his medical training on rotation with an intensive care unit, he contracted a common but virulent virus that left him with post neuropathic neuralgia, a debilitating and intensely painful condition that lasted for weeks. It was, he says, “humbling and life-altering.” It toughened his resolve to discover and employ pain relief methods that rely less on pharmacology and act more in harmony with the body.

Spinner, an osteopathic physician who was recently appointed director of Pain Management at White Plains Hospital, is a specialist in the treatment of all forms of pain. He’s also an active baseball enthusiast and family man. Most winter weekends, you’ll find him skiing with his family—wife Jessica and their children Shirley, 9, and Charlie, 7. The rest of the year he plays baseball with an amateur team of doctors, first responders and teachers. The “weekend warrior” injuries he sees, both in his practice and his busy personal life, explain in part why he chose a career devoted to relieving pain and restoring people to their active lives.

Spinner’s patients are evenly divided between adults under and over the age of 65. The most common complaint is back pain, followed in frequency by shoulders, knees and hips. Patients come in with a diagnosis—anything from diabetic neuropathy to arthritis to a pulled hamstring—and are evaluated by Spinner and his team of rehabilitation practitioners.

After assessing the cause and severity of a patient’s pain, he develops a comprehensive program of physical therapy, injections or medication, with a preference for minimally invasive techniques without the use of opiates. Aside from the well-documented risks of addiction and rising death toll from opioids, he believes side effects such as drowsiness, confusion and impaired balance demand a conservative approach. And lest we forget drug interactions, Spinner says, “The average person over age 55 is on multiple prescribed medications,” a situation he would rather not exacerbate.

Spinner’s therapeutic approach includes an arsenal of injections that can relieve pain, sometimes instantly, thus allowing patients to resume their active lives. Modern pain-relieving injections have “moved up in the treatment algorithm,” Spinner says. “A quick aspiration or injection can relieve your knee pain and send you on your way, without the need for surgery or a prescription.” Besides cortisone, injections include hyaluronic acid, which can ease the pain of osteoarthritis by lubricating and cushioning the joints. For the athlete, he often administers platelet-rich plasma (PRP), to heal and replenish cartilage—good for tennis elbow, post-surgical pain, and chronic pain in the joints and tendons.

Spinner knows his injections. Not only is he an expert in musculoskeletal (MSK) sonography, a non-invasive technique that uses sound waves to guide the needle. He is also one of the nation’s first physicians to become certified in MSK ultrasound, and has authored and edited the first textbook on the subject, Atlas of Ultrasound Guided Musculoskeletal Injections. “With ultrasound, we can literally see our intended target,” giving him pinpoint accuracy, he says.

Whatever a patient’s age or situation, the conversation usually turns to lifestyle solutions, starting with exercise. “Everyone could benefit from a stronger core,” Spinner emphasizes. Daily activity can trim excess weight that may be adding stress to painful joints. A stretching regimen can improve range of motion and blood flow. Of physical therapy, which some love and some detest, he says, “It doesn’t heal everything or take away the condition, but the correction and strengthening can reduce pain over time, restoring functionality.”

Spinner often refers patients to other specialists—sports medicine practitioners, trainers, acupuncturists—who tailor each program to the individual. “I’ve had patients who practiced yoga every day without realizing certain poses were making their pain worse,” he says. “Sometimes switching from yoga to Pilates can make all the difference.”

In his new position at White Plains Hospital, Spinner sees both a partner and a community. “White Plains offers many of the same advantages of a mega teaching hospital, minus the politics and red tape,” he says. “The physician group here is fully supportive of what we’re trying to do. It’s an exciting opportunity for me and for the hospital. We’re building something great from the ground up.”

Photo: Dr. David A. Spinner, Director of Pain Management at White Plains Hospital, standing next to the hospital’s fluoroscopy machine, which provides live x-ray guidance to assist with safe interventions. 

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