History of Pain and Rehabilitation Medicine
Pain and Rehabilitation Medicine (PRM) was founded in 1994 by Robert Gerwin, MD. He was soon joined by physical therapist Jan Dommerholt PT, MPS. Together, they built PRM into the leading neuro-musculo-skeletal multidisciplinary pain management program in the region.
Dr. Gerwin had founded Neurological Medicine in 1973, and built it up into an eight-person neurological practice in Prince George’s and Montgomery Counties, Maryland. During this time, he became acquainted with Janet G. Travell, MD, President John F. Kennedy’s White House Physician. He found that Dr. Travell’s assessment and management principles of musculoskeletal pain syndromes addressed many of the difficult neurological pain problems that were not readily identified or treated by classical neurological medicine approaches. He began to study with Dr. Travell, an association that lasted almost 15 years. His interest in myofascial pain developed during this period.
Dr. Gerwin initiated training workshops and national seminars, such as the Focus on Pain Seminar (now held every 23 years), that focused on myofascial pain problems. The growth in understanding the underlying neurologic basis of pain grew simultaneously during these years, providing the physiologic basis for the concepts of myofascial pain syndromes. The teaching programs that Dr. Gerwin started began to be given internationally in the early 1990s. He left Neurologic Medicine in 1994 to found PRM, a medical practice devoted more to the pain problems in which he had become interested, than the general neurological practice that he had originally founded.
Jan Dommerholt, PT, MPS, was also looking for a similar practice at that time. He had just left his position of Director of Clinical Operations at the National Rehabilitation Hospital Outpatient Centers in Bethesda, MD, which he had developed together with Richard Materson, MD. Mr. Dommerholt joined Dr. Gerwin within one month of the opening of PRM in Bethesda, Maryland.
Together, Dr. Gerwin and Jan Dommerholt have created a unique program devoted to the diagnosis and management of persons with complex neuromusculoskeletal pain and dysfunction syndromes. The distinctive diagnostic and treatment programs that they developed have extended Dr. Travell’s work, and incorporated the thinking of other clinicians and investigators like David Simons, MD, of the United States, Beat Dejung MD, PhD, of Switzerland, Peter Baldry, B.Ch of England, Mariano Rocabado, DPT of Chile, Chan Gunn, MD of Canada, Karel Lewit, MD of the Czech Republic, and Andrew Fischer, MD of the United States.
Over the years the program expanded its interests and focus to include osteopathic and orthopedic concepts of diagnosis and treatment, acupuncture, and temporomandibular physical therapy treatment techniques, in addition to maintaining its existing interest in myofascial pain syndromes:
- We evaluate and treat persons with headaches, including migraine, tension and cluster headaches. We place a great deal of emphasis on disorders of posture and of physical stress caused by work.
- A major emphasis is placed on pelvic disorders such as incontinence and interstitial cystitis and irritable bowel syndrome, pain on sitting, tail bone and prostate region pain issues.
- We have also been interested in the musculoskeletal pain problems associated with excessive flexibility, most commonly seen in women.
- In addition, we continue to see routine neurological problems such as peripheral neuropathy, shingles pain, and Parkinson’s disease.
- Our clinical program has included attention directed to the emotional issues associated with pain. We have had a social worker and a psychologist on staff since our inception.
Dr. Robert Gerwin and Jan Dommerholt have developed a world-renowned professional continuing education programMyopain Seminarsfeaturing the Focus on Pain conferences and the Janet G. Travell, MD Seminar Series, named in honor of our teacher. The most recent Focus on Pain conference was conducted in September 2005 in conjunction with Jefferson Medical School in Philadelphia. The Janet G. Travell, MD Seminar Series includes a full complement of workshops covering all parts of the musculoskeletal system. The program takes students systematically through diagnosis, manual therapy and needling treatment of trigger points. This program has been taught around the world by Dr. Gerwin and Jan Dommerholt.
Pain and Rehabilitation Medicine conducts ongoing clinical research studies directed towards various aspects of pain diagnosis and treatment. For example, our clinicians were the first to demonstrate the effectiveness of physical diagnosis in myofascial pain. Current studies evaluate the effectiveness of various interventions for low back pain and the role of myofascial trigger points in the lumbar multifidi muscles.
In summary, today, clinicians at Pain and Rehabilitation Medicine offer a balanced program of evaluation and medical management of acute and chronic pain problems. We address the physical and psychological aspects of pain with our staff of physicians, nurse practitioner, social worker and psychologist. Our practices have grown, in the decade since it was founded, from a two person clinical practice to a multidisciplinary program consisting of several companies with a renowned, world-wide teaching program and a respected clinical research program.