What is your approach to pain management? How do you view interventional pain, medication management and complementary therapies?

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What is your approach to pain management? How do you view interventional pain, medication management and complementary therapies?

The field of pain medicine has evolved rapidly over the last two decades. Initially, the approach was merely to alleviate pain. However, this has evolved to goals that are far more significant. The ultimate goal is to restore function with alleviating pain as merely one component of a program designed to provide the patient with an opportunity to once again become a vital person. Restoring function can mean return to work, or for others, it may merely signify return of the abilities to perform activities of daily living. Certainly, pain management plays a role in comprehensive rehabilitation to enhance the ability of the program to achieve its goals. For patients with a history of chronic pain, they cannot participate in rehabilitation until the pain is reasonably controlled. However, merely controlling the pain, in a patient with a long history of chronic pain will not achieve the goal of restoring function.

For patients with chronic intractable pain, interventional pain therapy may be the essential ingredient that allows the patient to participate in meaningful rehabilitation. Often, without the benefit of interventional pain management, it is impossible to participate in treatment such as physical therapy, the key ingredient to comprehensive rehabilitation. Interventional therapies such as neuromodulation in our practice, facilitate rehabilitation that would be impossible without this form of treatment. The key is to have an interdisciplinary team that recognizes that interventional treatment must be carefully planned so that the right procedure is performed on the right patient at the right time. Improper treatment selection is doomed to failure. Similarly, prematurely implementing an interventional approach can also produce failure. The role of the interdisciplinary team is to work together to determine the appropriate treatment for the patient at the optimal time in a treatment algorithm.

Modern pain management utilizes high-technology interventional approaches complemented by a variety of behavioral and physical therapy techniques. The key to success is the communication among various disciplines to collaborate as the patient progresses, working to motivate the patient and ultimately produce functional rehabilitation. Each component is essential and collaboration is absolutely required.

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