St. Augustine doctor sheds light on alternative pain treatment

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In 2015, Dr. Mitchell Yass first introduced his medical breakthrough, dubbed the “Yass Method,” in his debut book, “The Pain Cure Rx: The Yass Method for Diagnosing and Resolving Chronic Pain.”

With its release, the New York native who now practices in St. Augustine revealed the findings of his life’s work. Developed over 20 years with more than 14,000 patients, the Yass Method (www.mitchellyass.com) addressed an issue plaguing an estimated 1 billion adults around the world: chronic pain and the often ineffectual treatments meant to alleviate it.

The theoretical basis for his method, Yass said, is that almost everyone has pain. Performing any activity causes muscles to create a force equal to the force of gravity. When one muscle isn’t strong enough, it can cause any number of issues, such as pinched nerves, straining or forcing another muscle to compensate. Ultimately, there’s a symptom, and the Yass Method is responsible for interpreting the symptoms presented by the muscle in question and targeting it with a progressive resistance program. This gradually strengthens muscles associated with the ones causing symptoms until they are strong enough to perform activities without breaking down. By encouraging patients to consider his method, Yass said he’d like to break the cultural mold of the fallacy that often leads them to other ineffectual treatment.

For the decades spent developing his method, however, Yass’ breakthrough came rather early in his career.

Early breakthrough

The young graduate had just earned his degree from Brooklyn’s Downstate Medical Center in 1993 when he began treating his first crop of patients for chronic pain. Typically, the diagnosis begins with imaging to scan the problem area once the pain is in full swing. Yass quickly determined, however, that it was possible medical professionals, educators and patients had been trying to remedy chronic pain the wrong way all along.

“Between my educational background and my own experience, there was a gap between what I saw taught and what I was seeing,” Yass recalled. “In medical school, you’re taught principles in areas of pain like arthritis and herniated discs. You’re told that’s what you’re supposed to treat. Simultaneously, you’re told that discs are made of fibrocartilage, which have no pain receptors. So, from the very beginning (of my career) I questioned … the accuracy of the current model of diagnosis.”

That model often involves a patient who has experienced chronic pain for an extended period of time. With most chronic pain attributed to structural problems such as herniated discs, meniscal tears and arthritis. the patient is only referred to get an MRI after experiencing pain. The image is then used to determine a diagnosis.

But there, Yass said, is where the fault lies: Because MRIs often showed structural variations in pain patients, but were only taken after the patient noticed the pain, it wasn’t entirely possible to attribute the pain to the variation found in the images.

“Structural variation is always found when patient has pain – but what if the MRI was taken before the pain was experienced?” Yass said. “The same things would be found before the pain was felt because variations can take years or even decades to develop.”

It wasn’t long before Yass was able to confirm what he’d long suspected: Studies showed that 70 percent of patients given an MRI had structural variations such as herniated or bulging discs, but felt no pain. Likewise, 90 percent of people over the age of 60 experienced no back pain but did have bulging or degenerative discs. As more medical studies showed that there were as many people with structural variations who experienced pain as there were who did not, Yass determined that it was possible the pain wasn’t structural, but muscular.

“If perhaps 2 percent of the pain patients felt could be attributed to structural variations, I believe 95 to 98 percent of the cases could be muscular,” he said. “That’s the realization that I came to, which has allowed me to come out with one of the most broad statements I’ve ever made. But I believe the MRI is completely baseless because it’s finding variations that existed before pain was felt.”

With those findings in mind, Yass developed the Yass Method, an alternative model of treatment that could save patients the pain and expense of unnecessary surgery or medication. His method involves a three-step process of observing common areas of pain, implementing tests to examine things such as range of motion, walking patterns and posture, and teaching patients to use their findings to determine if the pain is structural or muscular – and, most importantly, whether surgery is the right option for them.

Saving patients trouble

Yass hastens to assure what he and other medical professionals now know to be true – MRIs were developed with the best of intentions, but the diagnosis produced by them can sometimes lead to unnecessary surgery that doesn’t alleviate pain or makes it worse. Faced with the massive failure rate of surgeries and joint replacements, Yass said he understands the frustration pain patients feel.

“I’ve seen patients who are living with chronic pain who just want their lives back,” he said. “And it’s my responsibility to inform them of this possibility and why I feel so compelled. Nothing matches the breadth of this issue and everyone’s searching for an answer that I think I’ve come up with.”

For that reason, Yass would like to see his method widely embraced in the medical world.

“I hope that (the Yass Method) becomes the gold standard and that the medical establishment embraces it as the primary mechanism to diagnosis and pain treatment,” he said. “I’ve stopped several unnecessary surgeries and treated people who’ve experienced surgeries that haven’t worked for them. There are people who are still in chronic pain and I just want them to be open to an alternative, to know that it’s not their problem but a systemic problem. And once the method is applied properly, pain becomes easier to treat.”