Paul Christo, MD
Dr. Paul Christo is a board-certified, Harvard-trained anesthesiologist and Johns Hopkins–trained pain medicine specialist. He’s an associate professor and researcher at Hopkins in the division of pain medicine and department of anesthesiology and critical care medicine. You might think someone with such an impressive academic pedigree might talk a little over your head and overdo it on the medical jargon.
But for the past five years, Dr. Christo has also hosted a national radio show on overcoming pain and amassed 6,600 Twitter followers and 4,100 Facebook friends. He knows how to be concise and plainspoken.
So, it’s not surprising that the most compelling comment during our interview has nothing to do with research, science or numbers. “No one is immune to pain,” he says. “But together, we can overcome it.”
That simple notion is what motivates Dr. Christo—at Hopkins, doing clinical research and on the airwaves.
His weekly program, Aches and Gains®, is America’s national radio talk show dedicated to overcoming pain, reducing stress, and living healthfully. The show airs Saturdays from 5 to 6 pm Eastern on Sirius XM Radio, Family Talk 131. Aches and Gains offers listeners firsthand accounts from those who have conquered pain, and highlights emerging treatments, new technology, and coping strategies.
Celebrity personalities such as Naomi Judd, Joe Montana and Montel Williams are among the guests who have shared their pain stories. There are two 30-minute shows. Half of each show highlights a guest who has overcome pain, and the other half offers cutting-edge treatments from a contributing expert.
“I love being able to reach people around the country and even around the world,” Dr. Christo says. All episodes that air live on Sirius XM are then archived on his website and can be downloaded for free. His podcasts reach 164 countries and have been downloaded 93,000 times. His website has had 359,000 views and 93,000 visitors.
No matter the guest, Dr. Christo’s message—that together, we can overcome pain—is rooted in available research findings, his experience and the experience of both patients and experts.
Dr. Christo’s Calling
It was during his residency, at Massachusetts General Hospital rotating through a pain clinic, that Dr. Christo discovered his calling. He began to feel that pain medicine would be the most meaningful work he could pursue. He’s made it his life’s work to help others feel better through three main avenues— clinical care, education and research.
While Dr. Christo considers teaching future pain doctors, resident doctors and medical students at Hopkins his primary educational role, the radio show extends his reach nationally and internationally, far away from his home base of Baltimore. “The show has made a real impact on creating an awareness of the epidemic of chronic pain, and then goes a step further. It provides listeners with both conventional, integrative and up and coming treatment options as well as ways patients can cope with pain,” he says.
He’s not just innovating through the radio waves and social media to touch people’s lives. He’s a clinician and investigator too. In fact, he’s done breakthrough work in helping to treat neurogenic thoracic outlet syndrome (NTOS) less invasively using botulinum toxin (Botox). NTOS causes severe arm pain that often radiates from the neck, down the shoulder, arm and into the fingers following whiplash injury or repetitive overhead movements.
Women are more likely to have the condition than men, and it’s typically an overuse injury. The condition shows up in assembly line workers, athletes and even violinists. If you use your arm in an overhead motion repeatedly, you may have experienced symptoms of neurogenic thoracic outlet syndrome— or if you do a lot of typing and aren’t using good ergonomics.
Dr. Christo suggests simple physical therapy as an initial treatment of the condition, but if that doesn’t work, and patients want to wait on having surgery, inserting a small, thin needle into a scalene muscle in the neck and injecting a small dose of Botox under CT guidance (a needle guided while being viewed by the physician on a computed tomography [CT] scan), can help ease the symptoms. “It’s safe, quick and can be quite effective,” according to Dr. Christo.
Putting Opioids in Their Place
You can’t talk to a leading pain physician and not talk about opioids. And Dr. Christo believes they have their place … but not in the top of the toolbox. “I have a lot of options,” he says about prescribing a treatment plan. Opioids aren’t the first tool he reaches for. In most cases, he says, he can offer injection therapies, non-opioid medications, sometimes implantable devices and even integrative treatments before prescribing an opioid.
Specific, pain-reducing anti-depression and anti-epileptic medications are often part of a treatment plan before opioids would enter into the picture. Dr. Christo believes it’s important for physicians to be open-minded when talking about treatment options. “There is a lot we can try,” he says.
He still asks patients to rate their pain on a scale of zero to ten, but he also understands zero pain isn’t often possible, even with a combination of pain therapies. Improving quality of life and helping patients reach functional goals is the key.
“It’s not always possible to do what you did before the pain began, but it’s often possible to find something different and to enjoy it,” he says. “It’s important for us to discuss expectations,” he says.
“Together, doctors and patients should be able to come up with some course of treatment that’s going to make the patient feel better. Even a 20–30 percent improvement may be very significant.”
Advocate for Simplicity
Of all the interventions available to Dr. Christo and his team at Hopkins, you might think the latest breakthrough or surgical gizmo would be the first thing he’d recommend. But he loves the idea of integrative medicine and often suggests yoga, meditation and acupuncture as methods of pain relief.
And he marvels over the effectiveness of proper nutrition as a way to combat pain. “Nutrition can alter pain,” he says. Anti-inflammatory foods, like salmon, tuna and halibut; dark cherries, blueberries, kale, green beans; cinnamon, ginger and rosemary; walnuts; green tea and avocado oil can provide real benefit, he says. And avoiding fried foods is also important in an anti-inflammatory diet (or any diet).
Exercise is incredibly important, advises Dr. Christo—especially when it comes to low back pain. Exercise is a top priority in his own life, too. The married father of two goes to the gym regularly and plays tennis with his kids, who are 8 and 7. He also enjoys music, reading and playing the piano.
Dr. Christo says he’s even had a (gasp!) energy healer on his radio show and was surprised by how effective the healer’s treatments had been for the guest on his show. “There’s a lot of skepticism in the scientific community about these alternative methods,” he says. “But when you talk to patients who’ve tried them, you realize they may have real potential.”
He’s willing to try whatever might get the job done safely. “There’s a lot we could be doing better,” he says of the field of pain medicine. For instance, pelvic and abdominal pain aren’t very well understood mechanistically. “This type of pain is visceral, and can be more grueling than a migraine headache or constant low back pain,” he says. That’s one area where less traditional methods of treatment may come into play.
If it has potential and it’s safe, Dr. Christo believes there’s value in trying.
PainPathways is the first, only and ultimate pain magazine. First published in spring 2008, PainPathways is the culmination of the vision of Richard L. Rauck, MD, to provide a shared resource for people living with and caring for others in pain. This quarterly resource not only provides in-depth information on current treatments, therapies and research studies but also connects people who live with pain, both personally and professionally.
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