The field of pain management is continually evolving. In some respects the treatments are improving substantially, and once in a while a trailblazing new treatment comes about. One of the more prominent evolutions, however, has simply been a better recognition of treating a person’s pain appropriately rather than either ignoring or under treatment.
Here are five of the most prominent evolutions (or regressions) in pain treatment that we are seeing currently:
1. Refinement in pain management interventions. Over the past few years, there have been some improvements in pain procedure technology that have allowed physicians to get better results. One of these is transforaminal epidural injections. The initial type of epidural injection that was established was called intra-laminar injections. Now pain doctors are able to accurately place their needle into the area where the nerve root travels, getting the pain medication more accurately where it is needed. A second improvement is with radiofrequency ablation machines. When they were first established, they were only able to treat 2 anatomical areas at a time. Now they can do 4, decreasing the patient procedure time.
2. Biologic solutions. Regenerative medicine is not just on the horizon, but is rounding the corner of reality. There are now injection substances that contain numerous regenerative components, including specific cytokines, hyaluronic acid, and stem cells. This will hopefully prove to be instrumental in disc problems, arthritis, and soft tissue and cartilage injuries.
3. Disc treatments have gone down. As the research has come out showing that intradiscal electrothermy and percutaneous discectomies have marginal results, their use is decreasing. In addition, there is some preliminary data showing that discography may promote degeneration of the disc. So its use is decreasing as well. The disc is such an enigma with how to treat it. Surgery is a roll of the dice at times, and interventional nonoperative pain treatments are a question mark too. If there is one area that could use a better option, it is degenerative disc disease.
4. Performing kyphoplasty and vertebroplasty. These procedures are performed as an outpatient, and do not involve incisions. They take about 45 minutes, and can have very impressive quick results for patients with vertebral body compression fractures. More pain doctors are learning how to do them.
5. Comprehensive spine care centers. As more research comes out showing the benefits of multiple specialists participating in a patient’s care, comprehensive centers are becoming more common. This has benefitted patients tremendously by having more providers with varied backgrounds coming together for the benefit of the patient. Patients can end up needing less narcotics and becoming much more functional.
