Creekside Physical Medicine

Dr. Tanner has been a pain management physician in the Boulder area since 1999. He went to medical school at the University of New England and completed a residency and board certification in neuromusculoskeletal medicine. During his residency he was trained in medical acupuncture through UCLA and was trained in the related Craig PENS (percutaneous electrical nerve stimulation). This training laid the foundation for his understanding of the central nervous systems role in chronic pain conditions.

He started practicing as a staff physician at the Boulder Center for Osteopathic Medicine. There he honed his skills as a pain management physician integrating his manual manipulation skills with pharmacological management and massage therapy. At this point the state of the art focused on decreasing the activity of primary pain generators which was beleived to be from injury sites. However, his clinical experience and training started to point him toward the CNS as a pain generator.

He had a car accident in 2001 that left him with a developing migraine condition that was not being successfully treated. Coincidentally, as he investigated personal treatment options, migraine treatment was evolving towards addressing the central nervous system for the relief of migraine symptoms. The CNS was found to be best treated by the manual, pharmacological and injection therapies that he already employed putting him in the unique position to empathize with and broadly treat migraine and its many variants.

In 2003 he started his pain management clinic that became Creekside Physical Medicine. Up to this time head and neck pain was treated using one of two medical theories. One postulated that chronic muscle tightness was at the root of this pain and was caused by some form of injury. This theory was opposed by the knowledge that injury follows a linear healing pattern and resolves within three months. The other theory was based in the idea that a nerve in the neck is pinched causing shoulder, neck and head pain. Neuroanatomical facts made this an improbability and consequently left doctors with a very low success rate in treating these conditions.

As Dr. Tanner gained exposure to the latest advances in migraine/CNS based conditions it became clear that this was the source of the majority of head and neck pain. This pain is caused by increased nerve activity traveling through nerves that leave the base of the brain and go directly to the muscles and structure that are painful. These understandings brought him to the forefront of the treatment of head and neck pain.

Since then he keeps himself apprised of the latest in migraine treatment and theory through personal study, a clinical practice that is largely directed to the treatment of head and neck pain, as well as attending national and international conferences.

ALEX REISH D.O.
Dr. Reish joined Creekside Physical Medicine (CPM) returned to Colorado where he was born and raised in 2008. He completed medical school at University of New England College of Osteopathic Medicine. He completed a residency and is board certified in Family Medicine (FM) and Osteopathic Manipulative Medicine (OMM). He completed a fellowship in Neuromusculoskeletal Medicine (NMM) with a focus on pain management.

Drawing on his experience from Family Medicine and Neuromusculoskeletal Medicine, gave him his first clinical exposures to head and neck pain. His exposure to post herpetic neuralgias and arthritis based while working in a geriatric treatment clinic broadened his understanding of the breadth of chronic head and neck pain.

During his fellowship in NMM he broadened his skill set for the treatment of pain conditions. This is where he gained his training in prolotherapy. Prolotherapy is a technique developed in the 40's in which chemicals such as dextrose and phenol are injected into painful tissues with the injection goal being ligament. These treatments are used to treat chronic pain and have been theorized to work by creating temporary inflammation that subsequently produces healing.

Dr. Reish found that prolotherapy complimented his trigger point injections and OMT approach as part of a comprehensive pain treatment program. His family practice skills in treating mood, sleep and nutrition added an additional dimension to his pain management programs. These skills helped him to respect the goals of the patient and work together reaching them.

After joining Dr. Tanner at CPM, Dr. Reish began to focus more on treating the Central Nervous system (CNS). Until that time his training and clinical experience focused mostly on addressing the Peripheral Nervous System (PNS) for pain treatment. At this time advances in pain was showing that chronic pain was anchored in CNS dysfunction. Integration of these advances brought about the understanding that pain must be addressed through treating the peripheral and central nervous systems.

As he embraced the critical role of the nervous system in chronic pain he reevaluated the proposed mechanisms of prolotherapy. In his research he verified his understanding that the chemicals used decrease nerve activity through focally stopping nerve conduction. With this information he formulated that these are the most probable mechanisms that produce prolotherapy's pain control properties making it fall into a treatment class called chemodenervation. His and other researcher's findings have brought a long useful technique into the 21st century.

Dr. Reish continues to adapt these skills to the specialty of head and neck pain. He advances his skills through research, attending conferences and an extensive head and neck pain practice.