HOW I TACKLE PROBLEMS IN PAIN MEDICINE

Pain medicine is torn apart by opinions, guidelines and regulations. Interventional pain practice and opioid prescriptions appear to be the most vulnerable and volatile topics. I believe that the standpoint of our discipline is the fundamental knowledge of anatomy, which, unfortunately, often receives minimal attention in the education of non-surgical specialists. Any biomedical problem has an anatomical reason, and any chronic pain starts from a particular injury, surgery, trauma, or illness. Initially, surgical and other specialists make an effort to investigate and treat the problem. Often it is successful, but at times it is not. Patients receive more medications, tests, physical therapy, etc., but all are in vain. The pain does not subside. It is imperative to evaluate a person in a pain clinic as soon as possible. Occasionally, addressing acute pain relating to conditions such as tendon or nerve injury, shingles, and disc herniation, effectively prevents the development of chronic pain and disability. Indeed, multiple biopsychosocial factors coexist and maintain chronic pain. However, it is unlikely that interventional techniques or surgeries would resolve psychological distress and suffering. Over-medicalization of social and personal problems is a slippery slope that leads to unnecessary medical interventions, long wait time, addiction, and swelling of health care expenditures.  

My clinical expertise includes consultations and managing challenging cases of chronic pain (mostly spine) problems, where most patients have already been seen by multiple health care professionals and have undergone multiple procedures and surgeries.  They often turn to a pain clinic as their last resort, and unfortunately, they hear the same “We can’t help you” line. However, I believe in helping a person, regardless of how difficult the situation is. A helpline can be as simple as an opportunity to talk, share the experience, and receive an explanation and diagnosis. Any patient has a right to know what is wrong and what can be done to make it better. The quest is to find the most appropriate individual approach. I also often consult and treat acute spine and sports injuries. It is a great satisfaction to help motivated and driven individuals.