All our Physicians are Board Certified Anesthesiologists with Fellowship Training in Pain Management.

Dr. Ravi Venkataraman has recently celebrated his 24th anniversary of graduation from Medical School in New Delhi, India. He has also studied and obtained Board Certification in Ireland and England before coming to the US. He has had extensive training at SUNY Health Science Center in Brooklyn. Although he originally trained in Anesthesiology, his focus for the last fifteen years has been on Interventional Spinal Diagnostics and Spinal Pain Management.

His most recent work history includes:
Medical Director-Pain Centers of America, Clifton
Director of Anesthesiology at St. Mary’s Hospital in Passaic, at Bergen Regional Medical Center in Paramus, and at Barnert Hospital in Paterson.

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Dr. Shanti Eppanapally has recently celebrated her 15th anniversary of graduation from Medical School in AP, India. She has had extensive training at SUNY Health Science Center in Brooklyn and has provided Anesthesia and Pain management services in several Hospitals and Surgery Centers in both NY and NJ. She is a member in good standing of various Anesthesia and Pain Management Societies.

Her most recent work history includes:
Pain Physician-Pain Centers of America, Clifton
Anesthesiologist at St. Mary?s Hospital in Passaic, and at Bergen Regional Medical Center in Paramus.

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Dr. Mohsen Michail is Fellowship Trained in Pain Management. Given his orthopedic and gynecological back round allows him the insight and understanding to tackle complex neck and back pain syndromes as well as pelvic pain syndromes.

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Socio- economic status counts - By ANDREA GURWITT, HERALD NEWS

When pain moves in, it feels like an affront. When it lingers, it feels like a punishment.

Love is an easier emotion to describe than pain. Hunger and itching, easier sensations to cure.

Pain is infuriating, anguishing; hard to pinpoint and harder to explain. Pain will drive people to do anything to get rid of it.

Les Sowul of Lyndhurst submitted to general anesthesia, to needles and to cortisone to stop his lower back pain. Four times so far.

Ethel Zorn of Bloomfield agreed to host a spinal cord stimulator in her back. Twice. She'd been in pain for 30 years and at times it was so bad, "I wanted to kill people because it was aggravating."

Both are now patients at the pain management center at St. Mary's Hospital in Passaic.

Americans know pain. More than a quarter are in pain every day, according to a study published this month in the British medical journal The Lancet.

Pain costs an estimated $60 billion a year in lost productivity, the study reports. And it is the culprit of more than 50 million lost workdays a year, according to the American Pain Society.

It is universal, but pain may not always be democratic. How much pain Americans are in may be tied, in part, to how much they earn and how much schooling they've had, the Lancet study found.

Participants who didn't graduate from high school experienced more than twice the amount of pain as those with college educations.

And those whose household incomes were less than $30,000 a year reported twice the pain rating of those whose incomes were $100,000 or more a year.

"I was not surprised that there was an economic divide. I was surprised at the extent of it," said Alan Krueger, the study's co-author and professor of economics and public affairs at Princeton University.

Krueger and co- author Arthur Stone of Stony Brook University in New York, drew up a telephone survey that was a kind of time diary. It was administered by Gallup Organization two years ago. The nearly 4,000 respondents described their previous day and answered questions about three randomly chosen intervals during that day. Then they ranked their pain levels at those times.

Those participants earning less than $30,000 were in moderate to very strong pain nearly 20 percent of the time, while those earning $100,000 or more experienced those levels only 8 percent of the time.

Part of this is probably related to the type of work each group did, the authors write. Blue-collar workers reported feeling more pain during work hours than white-collar workers.

Another reason, said Dr. Jos? Contreras, chairman of the department of pain and palliative medicine at Hackensack University Medical Center, may be the difficulty of getting pain medication in inner cities -- pharmacies might not keep them in stock to avoid robberies.

And, Contreras said, the more physically demanding low-wage jobs may offer spotty access to health insurance -- health care is not available or, if it is, not affordable.

The Lancet study authors also found that pain reaches a plateau for many between their mid 40s and mid 70s, and then it begins to increase once again. And they found people feel more pain when they are alone than with others. And, finally, those participants who were in a lot of pain reported lower levels of satisfaction with their lives.

Krueger has studied well-being for years, but never pain. Stone has looked at pain, but not in the same diary-based way.

"Clearly, pain is an important experience to understand," Krueger said. "Pain has not been studied very much for the general population."

And yet the general population is awash in pain. Low back pain, migraines, joint pain, aching and stiffness are among the most common forms of pain, the Centers for Disease Control and Prevention reports. Forty million Americans have arthritis, and back pain is the leading cause of disability in the U.S. for people under 45, according to the American Pain Society.

Ethel Zorn is 60. Thirty years ago, she fell on her way into the office of the auto parts dealer where she worked delivering merchandise.

She crunched her back when she hit the ground. Later, she said, she had a spinal disk removed. The first seven years she was in constant pain. She had played racquetball and handball. That had to stop. She had repaired cars at a garage. She couldn't do that. And she certainly couldn't return to the delivery job. The workaholic was forced to become a rest-aholic. She hasn't been able to work since.

Which jibes (although more dramatically) with findings in The Lancet study: "people who experience much pain during the day also watch more television and work less than others, possibly consequences of dealing with pain."

Five years ago, Zorn said, she opted to have the spinal cord stimulator implanted in her back. It's a device that creates an electrical field over the spinal cord that helps to block pain.

Recently, her pain grew unbearable, radiating up to her shoulders and down through her legs.

"It would drive me insane," she said. "It brought tears to my eyes."

She couldn't walk.

On May 13, Zorn's new doctor, Mohsen Michail, a pain management specialist at St. Mary's Hospital, removed the old machine and replaced it with a new one.

Several days later, the excruciating pain had disappeared. But that left space to think about the future.

"The only problem is I can't get a job five days a week, and that's depressing. I'm not a lax person, I like to move," Zorn said. "My whole life changed. Now I'm 60, who's going to hire me?"

Krueger, the Princeton University economist, said unlike education and economic status, in which cause and effect go in one direction (the more education you have, the more likely you will earn a higher salary), pain and economic status may go in both directions. People in pain don't work as much, so their salaries may be lower and their promotions rarer, but the kind of jobs they have -- more physically demanding with lower wages -- might lead to pain in the first place.

Sowul, 56, is a technical manager with a pharmaceutical company. He sits a lot. That exacerbates the pain in his back from two herniated disks.

"It is difficult to work, so obviously I slow down," he said before going in for his operation to inject cortisone in his back. It's harder to concentrate, he limps when he walks.

He makes up for it at work, he said, by staying later. Which means more sitting, and so more pain.

If patients are still in pain one to three months after it begins, a kind of vicious cycle develops, Zorn and Sowul's doctor, Michail, said. People with pain don't sleep as well so they're tired. That impedes their social life, so they become more isolated. That leads to anxiety, which may increase the pain, which may then increase the anxiety, and that may lead to depression.

You need to cut the cycle to treat the pain, and these days it might be with different medical disciplines working the case: some combination of a psychologist or psychiatrist, occupational therapist, pain management doctor and physical therapist.

Or just a shot or four of cortisone.

After Sowul's shots he feels better, and so, happier. And concentrating is easier.

"When you're pain-free," Sowul said, "you don't have to think about it."

Reach Andrea Gurwitt at 973-569-7159 or gurwitt@northjersey.com.