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(L) Dr. David E. Reece – CDC Opioid Prescribing Guidelines Update – Video Hero Slider (1)

CDC Opioid Prescribing Guidelines Update

This presentation reviews the updated 2022 CDC opioid prescribing guidelines and their impact on pain management. It outlines the consequences of the 2016 guidelines—such as abrupt discontinuation, rigid dose limits, and patient abandonment—and emphasizes safer, evidence-based practices. Key updates include eliminating strict MME thresholds, tailoring therapy for new and legacy patients, prioritizing non-opioid and interventional modalities, and avoiding abrupt tapers. The talk stresses risk assessment, patient education, strategic short-term dosing, and integration of naloxone and PDMP monitoring. It also addresses the ongoing opioid crisis, rising fentanyl-related deaths, and the importance of collaboration, access to treatment, and expanding alternative pain management strategies.

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(L) Dr. David Reece – Military & Veteran Healthcare – Video Hero Slider

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Military & Veteran Healthcare

This presentation explores the unique healthcare challenges in the U.S. military and veteran systems. Drawing from 15 years of military medical experience, the speaker highlights critical distinctions between the VA and DOD systems, barriers to care access, staffing shortages, and referral inefficiencies. He underscores the impact of limited resources, geographic constraints, and service-specific policies on medical readiness, treatment continuity, and career retention. The talk advocates for improved provider awareness, responsible opioid prescribing, and expanded use of non-opioid, minimally invasive therapies, particularly in deployed settings. Enhanced collaboration between military, VA, and civilian sectors is essential to optimizing outcomes for this underserved population.

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(L) Dr. Ricardo Plancarte – New Concept Osteogenic Pain – Video Hero Slider

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This presentation introduces the concept of osteogenic pain, emphasizing that bone is more than a structural tissue—it is richly innervated with nociceptive fibers, making it a significant pain generator. Evidence from human and animal studies shows dense sensory innervation in bone, similar to skin, involving C fibers. Conditions such as metastasis, fractures, and osteoedema can disturb this nociceptive system. Clinical implications include minimally invasive strategies like polymethylmethacrylate (PMMA) applications, vertebral stabilization, and combined approaches (e.g., RF ablation with PMMA) to reduce pain and enhance stability. The talk calls for further research and the adoption of new diagnostic and therapeutic methods for bone pain.

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New Concept Osteogenic Pain

(L) Dr. Corey Hunter – How to Think about New Wave Forms – Video Hero Slider

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How to Think about New Wave Forms

Dr. Corey Hunter discusses the evolving landscape of neuromodulation for chronic pain management. Highlighting the shift from limited options pre-2015 to today's expanding field, he emphasizes individualized therapy selection based on condition, features, and patient preferences. Hunter critiques reliance solely on waveform efficacy and encourages considering device attributes like battery type, MRI compatibility, and remote monitoring. He introduces a decision-making framework tailored to patient needs and demonstrates that switching between neuromodulation modalities can restore effectiveness. The talk concludes with a strong message: failure of one system doesn't mean failure of the therapy—innovation and patient-centered customization are key.

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(L) Dr. George Chang Chien – The Functional Unit – Video Hero Slider

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The Functional Unit

This presentation highlights the concept of biotensegrity—the interconnected nature of muscles, ligaments, fascia, and joints—and its role in chronic pain management. Dr. George Chien emphasizes that pain often arises from multiple structures, not a single pathology, requiring a shift from isolated treatments to a comprehensive approach targeting the entire functional unit. Using examples like spine degeneration, SI joint dysfunction, and knee or shoulder injuries, he advocates for precision techniques such as ultrasound-guided injections, regenerative therapies (PRP, BMAC), and fascial considerations. The key message: pain management should address the system holistically, acknowledging the structural and biomechanical relationships that contribute to persistent pain.

Slide

This presentation reviews the updated 2022 CDC opioid prescribing guidelines and their impact on pain management. It outlines the consequences of the 2016 guidelines—such as abrupt discontinuation, rigid dose limits, and patient abandonment—and emphasizes safer, evidence-based practices. Key updates include eliminating strict MME thresholds, tailoring therapy for new and legacy patients, prioritizing non-opioid and interventional modalities, and avoiding abrupt tapers. The talk stresses risk assessment, patient education, strategic short-term dosing, and integration of naloxone and PDMP monitoring. It also addresses the ongoing opioid crisis, rising fentanyl-related deaths, and the importance of collaboration, access to treatment, and expanding alternative pain management strategies.

CDC Opioid Prescribing Guidelines Update

Slide

This presentation explores the unique healthcare challenges in the U.S. military and veteran systems. Drawing from 15 years of military medical experience, the speaker highlights critical distinctions between the VA and DOD systems, barriers to care access, staffing shortages, and referral inefficiencies. He underscores the impact of limited resources, geographic constraints, and service-specific policies on medical readiness, treatment continuity, and career retention. The talk advocates for improved provider awareness, responsible opioid prescribing, and expanded use of non-opioid, minimally invasive therapies, particularly in deployed settings. Enhanced collaboration between military, VA, and civilian sectors is essential to optimizing outcomes for this underserved population.

Military & Veteran Healthcare

Slide

New Concept Osteogenic Pain

This presentation introduces the concept of osteogenic pain, emphasizing that bone is more than a structural tissue—it is richly innervated with nociceptive fibers, making it a significant pain generator. Evidence from human and animal studies shows dense sensory innervation in bone, similar to skin, involving C fibers. Conditions such as metastasis, fractures, and osteoedema can disturb this nociceptive system. Clinical implications include minimally invasive strategies like polymethylmethacrylate (PMMA) applications, vertebral stabilization, and combined approaches (e.g., RF ablation with PMMA) to reduce pain and enhance stability. The talk calls for further research and the adoption of new diagnostic and therapeutic methods for bone pain.

Slide

Dr. Corey Hunter discusses the evolving landscape of neuromodulation for chronic pain management. Highlighting the shift from limited options pre-2015 to today's expanding field, he emphasizes individualized therapy selection based on condition, features, and patient preferences. Hunter critiques reliance solely on waveform efficacy and encourages considering device attributes like battery type, MRI compatibility, and remote monitoring. He introduces a decision-making framework tailored to patient needs and demonstrates that switching between neuromodulation modalities can restore effectiveness. The talk concludes with a strong message: failure of one system doesn't mean failure of the therapy—innovation and patient-centered customization are key.

How to Think about New Wave Forms

Slide

This presentation highlights the concept of biotensegrity—the interconnected nature of muscles, ligaments, fascia, and joints—and its role in chronic pain management. Dr. George Chien emphasizes that pain often arises from multiple structures, not a single pathology, requiring a shift from isolated treatments to a comprehensive approach targeting the entire functional unit. Using examples like spine degeneration, SI joint dysfunction, and knee or shoulder injuries, he advocates for precision techniques such as ultrasound-guided injections, regenerative therapies (PRP, BMAC), and fascial considerations. The key message: pain management should address the system holistically, acknowledging the structural and biomechanical relationships that contribute to persistent pain.

The Functional Unit

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Videos

March 31, 2020

Plantar Fascia

Dr. Brian Allen shows us his technique of using cryoanalgesia to treat pain of the plantar fascia on a cadaveric foot. He explains the initial incision, probe placement, and freezing times. Dr. Allen also...

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March 9, 2017

RX-2 Technique

Dr. Racz demonstrates, in great detail, the proper technique using the RX-2 Coude needle for cervical catheter advancement.

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November 24, 2015

Hypogastric Plexus Block

Dr. Miles Day perform a hypogastric plexus block using a 20g Blunt Coudé® needle.

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November 24, 2015

Ganglion Impar Block

Dr. Miles Day performs a ganglion impar block using a 22g Bella-D® Needle.

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March 23, 2015

Trans-S1 Infralaminar “Scarring Triangle” Technique

Dr. Gabor Racz performs the trans-S1 infralaminar "Scarring Triangle" technique using an 18g RX-2 Coudé® needle and a VERSA-KATH.®

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April 14, 2014

Interventional Pain Workshop: Coudé® Blunt Needle

Interventional Pain Workshop: Coudé® Blunt Needle.

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January 21, 2014

Interventional Pain Workshop: RX-2™ Cervical with VERSA-KATH®

Dr. Gabor Racz uses an 18g RX-2 Coudé® Epidural Needle and the VERSA-KATH® to demonstrate cervical injections.

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