Medical doctor Adnan K. Sammour had a personal experience with pain as a young man that has driven him to focus on pain in his Bradenton practice, Palma Sola Medical Associates.
"During my first year of residency in Scranton, Pa., I had a skiing injury that caused bilateral shoulder and hip pain that lasted several months," Sammour, an internist, said a few days ago.
Three years later, the pain turned from a constant nuisance to a severe pain in his right shoulder and his arm due to a herniated cervical disk, Sammour said.
"I was left with an achy feeling in my neck and shoulder for the next 11 years," Sammour said. "Then, the achy feeling transitioned to a stiffness and pain in my hands."
Sammour said he wanted to find a way to get rid of the pain without surgery as much out of his own medical education as personal relief.
The 57-year-old Sammour lives in Bradenton and is married to Lina and has two boys, Omar, 19, a premed student at the University of South Florida, and Ali, 17, a rising senior at Saint Stephen's Episcopal School.
He spent part of his medical education researching non-surgical and non-narcotic ways to treat pain.
"I tried physical and chiropractic therapy, osteopathic manipulation, acupuncture, Rolfing, structural integration, active isolated stretching, personal exercise training and even psychotherapy," said Sammour, who was born in Jordan in the Middle East and educated at Cairo University. "For me, dry needling and peripheral motor nerve block with a local anesthetic called lidocaine produced the best results with a 90 percent improvement in my hand."
By the time Sammour began practicing in Manatee County in 1998, he had become convinced he could treat patients in creative ways that do not use drugs or surgery, he said.
Apparently, Sammour is not alone among this new wave of pain treatment using alternative techniques.
"Pain is the number one reason people see their physician," Eugene Pereira, med
ical director for Sarasota Memorial Hospital's Pain Care Center, said Friday.
"More often than not, patients wander around from one specialist to another when they have chronic pain. Pain treatment is exploring new boundaries on a daily basis. We are using ultrasound and other procedures without having surgery."
Pereira notes that a few years ago, a patient with back pain was ordered to bed rest. Now, stretching exercises, physical therapy and even injections into the muscles are among early treatments.
"People are clearly becoming more aware in the medical community and patient population of the pros and cons of being on medications and surgical intervention," Pereira said.
At Sarasota Memorial Hospital's Pain Care Center, Pereira is seeing patients put on strong pain medication by their medical provider to treat chronic pain from trauma or injury. He says that often the medications do not work.
"There is no evidence that opioids are a benefit in the treatment of chronic pain," Pereira said. "They may alleviate acute pain. But if acute pain lingers beyond a 90-day period and becomes chronic pain, that is much harder to treat."
Known for pain treatments
Sammour is now known locally for his non-narcotic, non-surgical approaches, said Parrish's Sheri Fosser, who heard about Sammour from a physical therapist and now goes to him to treat her back pain resulting from a car crash on Interstate-4 seven years ago.
"I had seen so many doctors but he was different," Fosser said last Thursday. "I don't want to say he's old-fashioned. But the first time he saw me he said, 'If your body is in pain, something is wrong. We have to fix it.' Other doctors wanted to throw drugs at me. He listens and doesn't think you're crazy."
Sammour has attended roughly 90 conferences on using alternative methods to treat pain in the last decade, he said.
"They love to have me there," Sammour said.
To boil down what he has learned, he says much pain comes from myofascial pain. Myo refers to muscles. Fascia is a thin, tough, elastic type of connective tissue that wraps most structures in the body, including muscles.
"Muscles, tendons, ligaments and fascia are the biggest origins of pain," Sammour said.
Sometimes muscles spasm and contract, leading to muscle shortening, he said. "Muscle shortening is an important factor in pain," he said.
Sammour uses musculoskeletal ultrasound testing to see if there is muscle shortening, he said.
"When the muscle shortens, it pulls on tendons and stresses the joints they move," Sammour said.
Sammour treats these shortened muscles with injections of lidocaine.
Fosser came to Palma Sola Medical Associates, 2227 59th St. W., Bradenton, Thursday because she was experiencing foot pain which may have been a result of her accident. Sammour set up an ultrasound machine and went over her feet with an attachment coated in petroleum jelly. He showed Fosser thick lines on the ultrasound screen which he said were thickened tendons in the top of her foot. After determining exactly where the shortened muscles were, Sammour carefully injected Fosser with a thin needle containing lidocaine, a local anesthetic.
"I do a unique procedure that only a few doctors do," Sammour said. "I use a lidocaine injection in the muscles. If successful, the response is seen immediately in most of my patients and lasts from several weeks to several years. The majority of those who don't respond are having other issues, which may require other intervention like spinal injections. If they have advanced spinal pathology, they may need surgery."
Sammour says many of his patients' pain is from what he calls "nerve entrapment" which is when the nerve is compressed from pressure on it. Sammour tries to remove the pressure from these nerves.
"Oh, that's exactly the spot where it hurts," Fosser said, wincing a little, as the needle went in. "The needle hurts a little but I know the pain will be gone for months and sometimes a year."
"Most people don't mind the needles because they are small needles, but Sheri is sensitive," Sammour said.
Conditions like TMJ, headache, neck and shoulder pain and back pain all have been helped by this process, Sammour said.
"In most patients there are multiple muscles affected," Sammour said.
After her accident, Fosser had an assortment of pain from migraines to pain in the bottom of her feet.
"The only part of me not in pain was my hair," Fosser said.
Her back felt like it was being stabbed, she said.
"I was bubbly before the accident," Fosser said. "But I had become different. The accident had taken away my qualify of life."
Fosser said that Sammour has reduced her pain significantly with the injections and other treatments.
"We have tried the needles and also some other modalities including osteopathic techniques," Sammour said.
"We kid around with each other," Fosser said. "Dr. Sammour has gone all around the world getting these techniques. I say to him, 'Am I getting the German or Italian today?' I believe in him."
Richard Dymond, Herald reporter, can be reached at 941-745-7072. Follow him on Twitter @RichardDymond.