Opioid overdoses are now the leading cause of death in people under age 50, killing about 64,000 Americans in 2016.
While short on specifics, President Donald Trump addressed this “national emergency” in his first State of the Union address, saying, in part, “My administration is committed to fighting the drug epidemic and helping get treatment for those in need. The struggle will be long and difficult — but, as Americans always do, we will prevail.”
What pain management physicians must do to treat chronic pain is to retrain patients’ – and even practitioners’ – thinking that narcotic painkillers are the first course of action.
“To fight the opioid epidemic, you need to dissuade people from using them in the first place,” said Abraham Rivera, M.D., chief medical officer for Physician Partners of America (PPOA). He will address this subject at the Florida Academy of Pain Medicine at an April 28 Opioid Update summit in Clearwater, Fla.
Interventional pain management, a core practice of PPOA, remains a little-discussed part of the solution. Rivera points out that not everyone in the healthcare community understands the meaning of that key word, interventional. “Our providers get to the root of the problem,” he said. “We don’t just mask the pain with medication. That is at the heart of what we do.”
Interventional pain management, as practiced by PPOA physicians, focuses on minimally invasive procedures such as nerve blocks, radiofrequency ablation, injections, spinal cord stimulators and pain pump implants to treat the pain at its source.
Laser-assisted Spine Surgery
PPOA recently launched laser-assisted, minimally invasive spine surgery. This outpatient procedure, reserved for cases that interventional techniques may not be able to address, are not like open-back surgeries of the past.
- It requires incisions that are less than one inch long
- Muscles surrounding the spine are gently spread with small dilating instruments instead of being cut and retracted
- Narrow endoscopic instruments, guided by tiny video cameras that project magnified images onto a screen, further spare tissue trauma
- Patients can get back to work or activities in days or a few weeks, not months
Physician Partners of America is actively adding spine specialists to its team, including James St. Louis, D.O., surgical founder of Laser Spine Institute in Tampa.
Cutting-edge Orthopedic Procedures
Orthopedics is another interventional aspect of PPOA’s medical services. Led by PPOA physicians Brian McGraw, D.O., and Chad Gorman, M.D. in Florida, our services help patients with trigger point injections and other minimally invasive procedures, PRP (platelet-rich plasma) therapy to aid in soft tissue recovery, and stem-cell regeneration.
Interventional pain management also seeks to lessen the likelihood of pain that traditionally requires oral medication. To this end, PPOA physicians routinely use intraoperative neuromonitoring, a real-time monitoring of the nervous system during surgical procedures. This offers nerve-damage protection to a degree that neither a physician nor fluoroscopy can detect with accuracy. The result is usually minimal pain and reduced risk of temporary or permanent nerve damage.
Another interventional tool is used at the clinical level: test can determine which medications are safe, unsafe or ineffective based on the individual patient’s genome.
“Cutting-edge technology, such as intraoperative neuromonitoring and drug genes testing, ensure patient safety and reduce pain,” said Dr. Rivera.
As word gets out about interventional methods of controlling and avoiding pain, the goal is for patients to ask for it – instead of opioids – by name, and for primary care physicians and specialists alike to refer patients to an interventional pain management specialist.
This lesser-known area of medicine is a key to solving the opioid crisis, and will, to use the president’s words, prevail.