By Jan Hoffman
June 10, 2016

PATERSON, N.J. — Brenda Pitts sat stiffly in an emergency room cubicle, her face contorted by pain. An old shoulder injury was radiating fresh agony down to her elbow and up through her neck. She couldn’t turn her head. Her right arm had fallen slack.

Fast relief was a pill away — Percocet, an opioid painkiller — but Dr. Alexis LaPietra did not want to prescribe it. The drug, she explained to Mrs. Pitts, 75, might make her constipated and foggy, and could be addictive. Would Mrs. Pitts be willing to try something different?

Then the doctor massaged Mrs. Pitts’s neck, seeking the locus of a muscle spasm, apologizing as the patient groaned with raw, guttural ache and fear.

“Quick prick,” said Dr. LaPietra, giving Mrs. Pitts a trigger point injection of Marcaine, used as a numbing, non-opioid analgesic.

Within seconds, Mrs. Pitts blinked in surprise, her features relaxing, as if the doctor had sponged away her pain lines. She sat up, gingerly moving her head, then beamed and impulsively hugged the doctor, vigorously and with both arms.

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