Pain Physicians: What Was the Most Important Pain Management Research in 2011?

Five pain management physicians talk about the most important pain management research in 2011 and its impact on the specialty.

Standiford Helm II, MD, medical director of Pacific Coast Pain Management Center (Laguna Hills, Calif.): 2011 was a busy year, with the most important document being the IOM report on pain. Unfortunately, there were no interventional pain management physicians on the committee, and the report did not reflect the role of IPM in treating pain, along with medications, functional restoration and complimentary therapies, such as cognitive behavioral therapy. 2011 was not the year that the MILD procedure came out, but during 2011, the use of the MILD procedure has expanded enormously. MILD is an example of an IPM technique which provides cost-effective value. Other examples would be research to extend adhesiolysis to spinal stenosis, the use of peripheral nerve stimulators to treat intractable headaches and efforts to develop effective percutaneous technologies to treat intradiscal disorders. Further on the horizon, but of potential benefit, would be laser endoscopy. All of these technologies exemplify procedures which have the potential to treat chronic and expensive conditions in a manner that is either more effective or more cost effective than any alternative. These options ensure the value of IPM as we transition from medicine as profession to medicine as a process driven sector of the economy.  

Neil Kirschen, MD, Pain Management Center of Long Island (Rockville, N.Y.): The basic science research is still the most important part. To this day, we still don’t know how people get pain messages and how it's tracked throughout the body. 2011 has been a very good year for basic science. The most important thing that we learned is that the peripheral nerves' own stimulations can send very painful messages that can mimic pain signals coming from muscle or tissue. Neuropathic pain is probably going to be the most studied pain problem in the future. Once the nerves get irritated and develop changes internally, it's very hard to treat those patients.

Marc E. Lynch, DO, medical director for Casa Colina Surgery Center (Chino, Calif.): I think the most important thing in pain management that has come out in the last year is that St. Jude came out with a new device, and of course the research that went with it. It allows non-neurosurgeons, allows pain physicians to place a laminectomy spinal lead into the epidural space without performing a laminectomy.

Laxmaiah Manchikanti, MD (Pain Management Center of Paducah, Paducah, Ky.):
The most important pain management research in 2011 has been a major impetus in proving that nerve blocks and epidurals work with or without steroids. Now we have provided a definite answer that they are not a long-term solution but they do provide appropriate relief when they are performed properly when meeting indications and medical necessity.

Frank J. E. Falco, MD (Mid Atlantic Spine, Bear, Del.):
High frequency spinal cord stimulation, peripheral nerve stimulation, and platelet rich plasma.

This is an ongoing series which will feature five pain management physicians' responses to questions about the specialty.

Next week's question is: What treatments are you having the most difficulty receiving pre-approval from payors for?

Submit responses to before Jan. 31.

Related Articles on Pain Management:
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Older Patients More Likely to be Given Only Painkillers for Lower Back Pain

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