Pain conference explores new therapies
Pain conference explores new therapies
New pain treatments, including neurostimulation and intrathecal pain therapies, were among the topics discussed at the Worldwide Pain Conference, an international pain conference attended by more than 1,500 physicians and caregivers from 45 countries in July.
Chronic pain afflicts approximately 70 million Americans, costing the nation nearly $100 billion a year. Those annual costs, according to medical economists, include 40 million doctor visits and 515 million lost workdays — the equivalent of 1.4 million people being out sick for 365 days in a row.
"The undertreatment of chronic pain stems in part from the traditional practice of medicine that focuses mainly on treating the underlying disease or ailment, not the symptoms," said Elliot Krames, MD, medical director of the Pacific Pain Treatment Center in Fremont, CA. "Now we know we need to treat the symptoms — especially pain — to fully meet our patients’ needs."
Among the chronic pain treatments discussed at the pain conference, which was held in San Francisco, were neurostimulation and intrathecal pain therapies. Both therapies work directly on nerve receptors in the patient’s spinal cord to interfere with pain signals before they reach the patient’s brain.
Intrathecal pain therapy uses a small pump and catheter that are surgically placed under the skin of the abdomen to deliver medication directly to the fluid around the spinal cord. The medication binds to receptors in the spinal cord, blocking pain signals traveling up the spine to the brain and providing pain relief for the patient. Researchers believe that because the medication is delivered to the spinal cord, intrathecal pain therapy can often provide dramatic pain control with a fraction of the dose required for oral medications and minimizing side effects.
Neurostimulation pain therapy, including both spinal cord stimulation and peripheral nerve stimulation, uses either a small neurostimulation system that is surgically placed under the skin or an external stimulator to send mild electrical impulses to the spinal cord or to a specific nerve. The electrical impulses block pain signals from reaching the brain, providing relief for the patient.
Also presented during the conference were results of a study of spinal cord stimulation used in the treatment of neuropathic pain, a type of moderate-to-severe chronic pain characterized by a burning or stretching sensation. The study followed 130 patients, all of whom had received neurostimulation pain therapy for an average of six years. Sixty-two percent of the patients received good- to-excellent pain relief, with the best results experienced by patients suffering from lower back pain.
Other topics being addressed at the conference included how various pain treatments work; the cost-effectiveness of various pain therapies; treating the patient, not just the pain, as well as pain and quality of life. "One of the greatest challenges facing caregivers is that the experience of pain is highly subjective," said Scott Ward, president of Minneapolis-based Medtronic Neurological, which is developing the new pain therapies. "The Worldwide Pain Conference is an important step in advancing our knowledge of chronic pain therapies because it brings together a wealth of research that can help physicians identify the best options for patients."
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