At the 11th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference on June 14, Laxmaiah Manchikanti, MD, chairman of the board of the American Society of Interventional Pain Physicians and medical director for the Pain Management Center of Paducah (Ky.), discussed the most important issues facing pain management.
Dr. Manchikanti began the presentation by discussing myths surrounding the cost of chronic pain, which totals about $560 billion to $635 billion per year. Of that total cost, about 10 percent is comprised of moderate pain while 11 percent is comprised of severe pain. That means the combined cost of moderate and severe pain is roughly $100 billion for 44 million Americans. Joint pain accounts for 33 percent of the cost, arthritis accounts for 25 percent and functional disability makes up 12 percent.
Of newly disabled workers, 44 percent are out of work due to back injuries, said Dr. Manchikanti. The annual rates for spinal fusion are also increasing. "People are saying back pain and neck pain haven't increased," Dr. Manchikanti, but he said that's not so. The severity for Grade 1 pain in both cases has increased. For instance, there was a 162 percent increase from 1992 to 2006 in the prevalance of chronic low back pain.
Dr. Manchikanti said another myth in pain management involves research and studies, specifically "the placebo effect." The placebo effect refers to an often-debated clinical and scientific issue, in which the human brain can process pain differently when people believe they have been given pain relief treatment.
"It's very difficult to find a pure placebo for pain management studies in the U.S. There's a lack of understanding of the interventional pain management technique," and Dr. Manchikanti said this can result in a bias in studies. "They're calling anything other than the steroid a placebo control. They call local anesthetic a placebo. That is the wrong impression," he said.
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Dr. Manchikanti began the presentation by discussing myths surrounding the cost of chronic pain, which totals about $560 billion to $635 billion per year. Of that total cost, about 10 percent is comprised of moderate pain while 11 percent is comprised of severe pain. That means the combined cost of moderate and severe pain is roughly $100 billion for 44 million Americans. Joint pain accounts for 33 percent of the cost, arthritis accounts for 25 percent and functional disability makes up 12 percent.
Of newly disabled workers, 44 percent are out of work due to back injuries, said Dr. Manchikanti. The annual rates for spinal fusion are also increasing. "People are saying back pain and neck pain haven't increased," Dr. Manchikanti, but he said that's not so. The severity for Grade 1 pain in both cases has increased. For instance, there was a 162 percent increase from 1992 to 2006 in the prevalance of chronic low back pain.
Dr. Manchikanti said another myth in pain management involves research and studies, specifically "the placebo effect." The placebo effect refers to an often-debated clinical and scientific issue, in which the human brain can process pain differently when people believe they have been given pain relief treatment.
"It's very difficult to find a pure placebo for pain management studies in the U.S. There's a lack of understanding of the interventional pain management technique," and Dr. Manchikanti said this can result in a bias in studies. "They're calling anything other than the steroid a placebo control. They call local anesthetic a placebo. That is the wrong impression," he said.
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