Dr. Scott Martin: 5 Challenges Facing Spine Pain Management Physicians

Scott Martin, MD, a pain management physician at Chapman Neurosurgical and Spine Institute in Orange, Calif., discusses five challenges currently facing spine pain management physicians.

1. The influx of new patients.
One of the primary issues with spine and back pain is the growing baby boomer population. As people grow older and remain active longer, they begin to experience more back pain, arthritis and degeneration of the spine. "Pain doesn't mean people want to stop participating in activities," says Dr. Martin. "With the advances in medicine, we have to keep up with the times, and our patients' active lives. Now, we are trying to be as minimally invasive as possible while planning for our patients' well-being down the road," he says.

2. Staying on top of the latest trends.
Spinal pain management is now focused on minimally invasive techniques to fix the problem and relieve back pain where applicable. Many of the new surgical and non surgical solutions diagnose and treat spine pathology without the traditional approach of a rigid spinal fusion. "We have found that if we perform a rigid fusion of the spine, there is a chance the spinal segments above and below the fused level will suffer more stress and potentially fail down the road," says Dr. Martin. "Additionally, some of the newer surgical techniques are focusing on minimally invasive surgery and dynamic fusions to prevent undue stress on the other healthy segments of the spine. Minimally invasive surgery may also be a more cost effective treatment for both patients and healthcare providers as some of these procedures are done on an outpatient basis with days to weeks of recovery, and not months of post operative recovery."

3. Fostering a relationship with patients.
Physicians are now more invested in working with their patients and learning as much information as possible to treat the patient's whole condition instead of just the symptoms. In addition to relieving the physical pain, physicians dealing with patients who have back pain are also helping the patient through the economic, social and vocational problems related to their pain. "It used to be that a physician told a patient what to do and the patient for the most part just did it," says Dr. Martin. "Now there's much more of a relationship between the physician and the patient. We treat the patient as a whole and we really involve the patients in their care. It is a decision to work not only for the patient, but with the patient. Both of us are part of a winning team."

4. Providing the best model for patient care. The literature coming out of clinical and academic centers is also showing that patients do better in multidisciplinary clinics, because there are several specialists to treat the patient as a whole, says Dr. Martin. These services may include pain management, physical therapy, psychology, chiropractic care and neurosurgery. "The specialists surround the patient with as much care as possible and as much medical knowledge as possible" he says. "I think as the years progress, we'll see the independent providers joining together or we'll see by virtue of mandate — either from evidence-based literature or payor mix — neurosurgeons, neurologists, pain physicians, therapists and psychologists grouping together. What will drive the market will be superior patient care, and physicians grouped together, I think, will be the standard of care."

5. Managing pain medication appropriately.
There are several new spinal pain interventions that are relatively new, and there isn't enough long term data to bring these practices into the mainstream. "In pain management, there is still very much an art of medicine," says Dr. Martin. "Because we have no objective measure for pain, and a considerable number of patients suffer from chronic pain that can not be cured, the best we can do is preserve a patient's quality of life. Looking at a patient's with chronic pain, we have to weight the benefits of long term narcotic use. I believe I am at the forefront of recent trends supporting narcotic rotation, so patients don't get tolerant to one class of pain medication. And the medical literature is supporting this."

Read Articles Related to Spine Pain Management:

10 Biggest Trends in Spine Pain Management

4 Points on Medication Management for Back Pain

Multi-Pronged Therapy Including Spinal Decompression Reduces Chronic Back Pain

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