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dr tunkel's story

Non-pharmacuetical Multimodality Approach to Pain Management

There is substantial evidence in the medical literature that non-pharmacologic modalities are very helpful for patients suffering from chronic pain, especially when such treatments are provided in an integrated and well-coordinated fashion. To meet the needs of the ever-growing population of patients suffering from chronic pain, Richard Tunkel, MD, has developed over a period of two decades a coordinated, individualized non-pharmacologic multimodality approach to pain management. He sometimes works in concert with one or more health care providers, but personally provides all of the physical medicine and rehabilitation (PM&R) modalities required for each patient’s program. He has many years of experience treating those suffering from chronic pain. 


Dr. Tunkel began his professional career as a chiropractor, developing a successful practice treating primarily patients with chronic back and neck pain. However, he wanted to be more effective in helping his patients and thus decided to increase his capabilities, enrolling in medical school. He completed his medical training at SUNY Health Science Center in Brooklyn and subsequently became a board-certified specialist in PM&R in 1992. 


For more than a decade, Dr. Tunkel worked in academic medicine, the majority of that time as the Director of Rehabilitation Medicine at Memorial Sloan-Kettering Cancer Center in Manhattan. During that time, he found that many of those suffering from ongoing “non-malignant” pain complaints, especially those that were musculoskeletal in nature, were not improving using conventional medical approaches. Over time, they often reported worsening pain affecting increasing areas of their body and became withdrawn from the activities and the people they had known. They became more easily fatigued, anxious and despondent, and had difficulty sleeping.


Therefore, Dr. Tunkel decided to expand his repertoire of skills to include ‘complementary/alternative’ methods of healing, which proved to be of increasing benefit to his patients. Prominent among those he studied included osteopathic techniques, qigong (chi kung) and taijiquan (tai chi), Alexander method and Feldenkrais techniques, hatha yoga and pranayama (intentional breathing techniques), and breath awareness and other mindfulness and meditation practices. He also became certified in Medical Acupuncture in the state of New York.


In 2003, he relocated to California to become the director of pain management at a northern California hospital. Dr. Tunkel subsequently went into private practice, specializing in the treatment of chronic pain using individualized, coordinated non-pharmacologic modalities. Since that time, he has continued to refine his skills and to add additional methods to further improve the outcomes of his patients. 


Most of Dr. Tunkel’s patients have previously tried more than one ‘complementary/alternative’ method of healing with little or no short-term benefit. However, under Dr. Tunkel’s care, the treatments provided them in their individualized program have often led to significant, long-term improvements. The positive results not seen previously with the same modalities appear to be caused by two factors. First, the previous treatments were usually aimed at helping patients with pain, but were geared more toward pain of an acute nature. For example, although trained as a chiropractor, Dr. Tunkel uses specific osteopathic techniques that facilitate the nervous system self-correcting or rebalancing the problems which are maintaining the chronic pain.


The second reason is that the modalities used by Dr. Tunkel are specific to the patient’s needs and are coordinated to get the best outcome. For instance, it is well recognized that passive treatments, those received by patients without their active involvement, should be used to facilitate treatments requiring patients’ active participation, such as therapeutic exercises. There is a synergistic effect when the treatments are properly integrated as a complete program.


Over the years, many of Dr. Tunkel’s patients have been able to decrease or completely taper off the opioids and other medications which they had been taking, often for many years. Many have demonstrated increased mobility and function, empowering them to return to a better and more gratifying quality of life. Instead of focusing on their pain and suffering and the resulting limited life experience, they can now more fully participate in the world around them.