PM&R Musculoskeletal and Chronic Pain Programs

Program Lead: Dr. Noorshina Virani

Community PMR MSK practice has expanded with the opening of Dr. Arun Gupta’s Infini Health clinic.  Dr. Gupta completes all procedures for pain management including radiofrequency ablation and regenerative techniques. This clinic’s intent is to extend clinical learner and research opportunities in Musculoskeletal pain medicine.

Dr. Ranita Manocha is heavily involved in research and clinical initiatives. In addition to the Bracing and Mobility clinic, she has developed the Hypermobility Syndromes Rehabilitation Clinic and the Bracing Bunch,(quarterly bracing rounds for therapists, physicians, learners, orthotists, etc). Clinicians interested in participitating can contact Dr. Manocha.

Dr. Manocha and  Dr. Rebecca Iwaniki, from Kinesis, have created collaborative opportunities with other departments. Dr. Iwanicki has joined the Foot and Ankle orthopedics group at monthly Complex Case Rounds. They are looking forward to soon launching a central triage program for foot and ankle orthopedics, (similar to the Alberta Hip and Knee Clinic). Dr. Manocha has given formal outreach talks to both Orthopedics and Emergency Medicine.

Inpatient MSK Physiatry consults at Carewest Glenmore Park, Rockyview General Hospital, and Carewest Vernon Fanning Centre, unit 2W are fielded by Dr. Gentson Leung

Research

  • Merkobrada, S. Ultrasound analysis of cervical paraspinal muscles for needle EMG examination. Muscle & Nerve 2020; 61(6): 754-758.
  • Manocha RHK, Johnson JA, King GJW. The effectiveness of a hinged elbow orthosis in medial collateral ligament injuries: an in vitro biomechanical study. Am J Sport Med 2019;47(12):2827-2835.

Published abstracts

Russell M, Kuntze G, Jivan S, Ronsky JL, Manocha RHK. Differences in wrist and scapular kinematics when using axillary versus forearm crutches. Clin J Sport Med 2020;30(3):e100.

Grants

Upper extremity kinematics and muscle activity with crutch use

Funding Source: Cumming School of Medicine and Alberta Health Services
Program Name: Clinical Research Fund – Data Collection Grant
Principal Investigator: Dr. Ranita Harpreet Manocha
Role: Principal Investigator
Total Amount: $10,000.00
Support Period: 09/19 to 08/21
Co-Investigators: Drs. Gregor Kuntze, Janet L. Ronsky

Conference Podium Presentations

Jivan S, Kuntze G, Ronsky JL, Manocha RHK. Crutch length effects on scapular kinematics. McCaig Institute Summer Student Symposium, Calgary, Alberta, August 16, 2019.

Peer-reviewed conference poster presentations

  • Russell M, Kuntze G, Jivan S, Ronsky JL, Manocha RHK. The effect of axillary crutch length on wrist and scapular kinematics. Available at: https://drive.google.com/file/d/1WHq0p02oZ6-M1KMKV6C-GTqOrl0iyjyM/view. Hotchkiss Brain Institute Research Day, Calgary, Alberta, May 28, 2020.
  • Russell M, Kuntze G, Jivan S, Ronsky JL, Manocha RHK. Differences in wrist and scapular kinematics when using axillary versus forearm crutches. Canadian Academy of Sport & Exercise Medicine Conference, Banff, Alberta, April 29, 2020 [cancelled due to COVID-19].
  • Jivan S, Kuntze G, Ronsky JL, Manocha RHK. Crutch length effects on upper extremity kinematics. The Arthritis Society Calgary Walk for Arthritis, Calgary, Alberta, June 2, 2019.

Education

Dr. Vithya Gnanakumar has taken over as the Course 2 Chair for Musculoskeletal medicine in the undergraduate curriculum at the Cumming School of Medicine. Several Physiatrists participate in teaching undergraduate Course 2 lectures, including Drs. Ken Lam, Gentson Leung and Noorshina Virani.

Due to COVID-19 restrictions, Family Medicine residents can no longer attend the AHS Chronic Pain Centre (CPC) in person. As such, a virtual teaching program of pain related cases was developed by Drs. Ted Findlay and Yasmin Majeed at CPC. Dr. Noorshina Virani from the AHS Chronic Pain Centre (CPC), is one of three clinicians participating in this monthly teaching program.

Chronic Pain Program

There are three streams of patient delivery at the AHS Chronic Pain Centre (AHS CPC) in Calgary, including the neuromusculoskeletal (NMSK), pelvic and headache teams. Currently, 966 patients are on the NMSK wait list as of Sept. 30, 2019. An additional 135 patients are on the pelvic and 72 patients are on the headache team waitlists. NMSK physicians assessed 538 new patients in the reporting period, while pelvic and headache teams assessed 89 and 43 new patients respectively. Average wait time until the first patient-physician visit to the NMSK team, is reduced to approximately 9.7 months. Wait times for the headache team has increased to 11.3 months and to the pelvic team to 7.6 months.  This does not include visits to lectures, groups or other Allied Health providers, which may occur prior to the first physician visit.

The CPC is a mandatory rotation site for Family Medicine, Anesthesia and Physiatry residents. Unfortunately, due to COVID-19 restrictions, only Anesthesia residents, in addition to one Pain Medicine Resident, have rotated through since March 2020. For the reporting period, 29 clerks/students, 11 off service residents and one Pain Medicine resident have rotated through the CPC.

Members

AHS Chronic Pain Centre (AHS CPC): Dr. Nwamara Dike, Dr. Noorshina Virani

Community and Inpatient Practitioners:
Dr. Maryana Apel, Dr. Brian Benson, Dr. Darren Chiu, Dr. David Flaschner, Dr. George Francis, Dr. Tony Giantomaso, Dr. Arun Gupta, Dr. Chris Huang, Dr. Rebecca Iwanicki, Dr. Les LaPlante, Dr. Daniel LeBlond, Dr. Jennifer Litzenberger, Dr. Serge Mrkobrada, Dr. David Nabeta, Dr. Daniela Porter, Dr. Paul Reglin, Dr. Jordan Raugust, Dr. Vishal Tulsi, Dr. Andrew Malawski, Dr. Gentson Leung, Dr. Ranita Manocha