Thank you for being a patient at Pain Prevention. We hope to bring to your attention some cutting edge non-invasion (no needles) diagnostic tools to evaluate your risk for heart disease, circulation and neuropathy due to chronic illnesses, including covid, chronic pain and/or use of medications. More importantly we want to reduce your risk for future ER visits, hospitalization, other treatments, and maintain your independence of living. We hope this will benefit your health, but also reduce cost to the medical system and to society by keeping you healthy.
We now have the opportunity to take proactive steps to enhance your overall health and implement preventive steps to better health. These tests could also validate your current treatment strategy. Dr. Suthar believes that ANS testing can improve our ability to understand the effects of chronic pain, medications and other conditions on your health. From there, we can take steps to reverse and/or correct these risk factors. Dr. Suthar will need to make certain that these are appropriate for you and your future health.
97% of all vascular disease is reversible if caught early. The list* at the bottom of this page lists several risk factors to heart disease. Heart rate variability, blood vessel elasticity and your autonomic system each can determine your risk. We are now conducting these non-invasive, painless tests that can assess your vascular health, as well as help your care team to monitor the effects of treatment to your entire body.
What is ANS?: A Quick,Painless, & Insightful Vascular Assessments
ANS testing is a series of three very simple tests done in the office. None of them hurt (not invasive) and their results will help us understand how healthy your heart and nervous system are, and how your pain may be affecting your heart. The testing will take about 30 minutes and results will be reviewed separately by phone and/or video. Dr. Suthar and his office team will need to determine if you qualify for testing.
Heart Rate Variability (HRV):
Heart Rate Variablity is a sensitive quantitative measurement of the body’s experience of pain, stress, several co-morbidities, as well as potential imbalances in the Autonomic Nervous System (ANS). When used as a monitoring tool, i.e. before and after changes in medications or other treatments, HRV can act as a quantitative indicator of pain level change, improvement in overall health and measure compliance to treatment.
Measuring the 2 most heavily weighted biomarkers in the ANS testing Score:
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HEART RATE VARIABLITY: a very strong known predictor of a heart attack
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PHYSICAL STRESS INDEX: imbalance of the sympathetic and parasympathetic (ANS) and exaggerated by long-term chronic pain among other factors. Test includes the following:
- 3-LEAD ECG
- Chronic pain patients have very high probability of a high PSI
- 8:40 testing period with mild stressors and position changes
Sudomotor Function:
This is useful for monitoring patients BEFORE they are symptomatic of nervous system dysfunction, as the test will identify subtle abnormalities before the patient recognizes or reports physical symptoms. Early detection allows for early intervention and enables a significantly better outcome. Unlike, NCV/EMG testing sudomotor testing is not painful nor invasive.
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Critical in identifying early onset or advancing neuropathies, often before symptomatic
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Long used by endocrinology in monitoring diabetic neuropathy
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1 of 4 biomarkers used to assess and validate pain scores
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Physiological pain = REDUCED Sudomotor function
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12 minute test
Pulse Wave Velocity:
This has long been the gold standard for non-invasive test for arterial elasticity. The results will support system-wide inflammation due to an elevated PSI. Physicians in Pain Management, Obstetrics and Gynecology, Internal Medicine or Geriatrics may be the only physician that the patient sees regularly and therefore is their primary source for most diagnostic testing. Many patients may not have exposure or access to such life-saving testing if not for their specialty physician.
How does ANS testing benefit me?
Your doctor will need to deterimine if you qualify and if ANS testing could benefit your long-term health. Early detection and prevention to cardiovascular problems is why we conduct these tests. “An ounce of prevention is worth is weight in gold”. Ultimately we hope this reduces the need for hospitazlition, ER visits, and loss of independent living. The result of testing will also validate your current treatment success and the need to “tweak” your care. Just a few of the benefits of testing include:
- If there is early stiffening or atherosclerosis of the arteries.
- If your heart has any abnormalities in rhythm.
- Proper function of the autonomic and peripheral nervous systems.
- Neuropathies related to pain.
- Cardiac effects from chronic pain.
- Cardiac effects from pain medications.
- Need to consult with a cardiovascular expert or other specialist.
How to prepare for ANS?
ON THE DAY OF THE TEST:
- No Caffeine
- Try not to consume caffeine at least 2 hours before the test (coffee, tea, chocolate).
- No Smoking
- Try not to smoke for at least 2 hours before the test.
- Shoes & Socks
- You will need to take your shoes and socks off for the test.
- Comfortable Clothing
- A loose-fitting top or shirt will be most comfortable.
- Relaxed Environment
- Testing is done in a very relaxed setting and does not hurt.
Risk Factors for Cardiovascular Disease:
- Chronic Neck Pain (Kang et al., 2012)
- Chronic musculoskeletal neck-shoulder pain (Hallman DM, 2014) (Hallman DM and Lyskov E, 2012)
- Irritable Bowel Syndrome (Mazurak et al., 2012)
- Headache (Micieli et al., 1993) (Tubani, et al. 2003) (Koenig J et al 2016)
- Temporomandibular disorder (Maixner W, 2011) (Greenspan JD, 2013)
- Sciatica (Sodervall J, Karppinen J, 2013)
- Interstitial cystitis/bladder pain syndrome (Williams DP, et al, 2015)
- Chronic prostatitis (Cho DS, Choi JB, 2011)
- Chronic pelvic pain syndrome – in both men and women (Williams, 2015) (Cho, 2011) (Yilmaz, 2007)
- Complex Regional Pain Syndrome (Terkelson, er al., 2012)
- Fibromyalgia (Mork et al., 2013) (Meesus M, Goubert D, 2013)
- Rheumatoid Arthritis (Adlan AM, et al., 2017) (Provan SA, Olstad DS, et al., 2017)
- Spondyloarthritis (Provan SA, Olstad DS, et al., 2017)
- Chronic Low Back Pain (Storella RJ, 1998)
Contact Us
13710 Olive Boulevard (Primary Office)
Chesterfield, MO 63017
Telephone: 314-469-PAIN (7246)
Fax: 314-469-7251
Exchange: 314-441-6965 (for after-hour Emergencies Only)
Hours:
Monday thru Friday
8:30 AM – 4:30 PM