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Advances in Imaging for Diagnosis of Spinal Chronic Pain

Dr. Chih-Peng Lin speaks on advanced imaging modalities for diagnosing and treating chronic spinal pain. Dr Lin, with over 15 years of experience in interventional pain management, discusses the integration of various imaging techniques like ultrasound, fluoroscopy, and electrosimulation in daily practice. The focus is on the use of hybrid imaging, particularly SPECT CT (single-photon emission computed tomography) and PET CT/MRI (positron emission tomography), for diagnosing spinal conditions. The presentation highlights how these advanced imaging techniques combine metabolic and anatomical data to identify active pain generators, which can be challenging with traditional methods. The speaker emphasizes the role of hybrid imaging in detecting occult fractures, stress fractures, spondylolysis, and infectious or inflammatory processes like spondylodiscitis. He also touches on post-surgical evaluation using these methods.

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Autonomic Interventions for the Non Pain Indications

Dr. Peter Staats shares an enlightening presentation urging viewers to rethink their approach to pain management, drawing a parallel to the Indian fable of six blind men and an elephant. He challenges conventional paradigms of pain treatment, focusing on the evolving understanding of electricity in pain relief. The talk highlights the significant developments over the past 25 years in spinal cord stimulation, including various frequencies and approaches targeting different tissues. Dr. Staats emphasizes reevaluating the role of the autonomic nervous system in pain management, particularly the sympathetic and parasympathetic systems. The lecture delves into the potential of treating diseases beyond pain, such as spasticity, with neuromodulation techniques. He extends to exploring the vagus nerve's integral role in controlling bodily functions and systemic inflammation, highlighting its impact on diseases like arthritis and COVID-19.

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The DRG as a Pain Generator and what to do about it

Marshall Devor, PhD, discusses an innovative interventional procedures targeting the Dorsal Root Ganglion (DRG) for pain management. Professor Devor explores mechanisms of pain generation and transmission, emphasizing electrical impulses in the nervous system. His talk highlights the potential of dilute lidocaine and other membrane stabilizing drugs in selectively blocking pain-causing impulses, offering promising solutions for major pain issues like radicular low back pain, CRPS and phantom limb pain.

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(L) Hegarty – Cervical Epidural Injections – Video Hero Slider

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Cervical Epidural Injections

Dr. Dominic Hegarty discusses the nuances and complexities of cervical epidural procedures in pain management. Working in a busy pediatric unit, he addresses the challenges and reservations his colleagues have about performing cervical procedures, including a lack of training and apprehension about needle placement in the neck. He emphasizes the significance of cervical epidural in treating conditions like radiculopathy, noting that such issues often resolve with conservative management. Dr. Hegarty stresses the importance of patient selection, citing the need for thorough physical examination and the use of imaging like MRI or CT scans to determine the suitability of an epidural.

WIP Guidelines

A comprehensive overview of the World Institute of Pain's (WIP) efforts to establish global guidelines for interventional therapy and neuromodulation in managing intractable headache and facial pain is presented. Dr Miles Day discusses the challenges faced in gathering pain management physicians from various parts of the world to contribute to this initiative. Hi lecture emphasizes the importance of practice guidelines in educating physicians and ensuring effective treatments are covered by insurance. It involves extensive literature reviews, analyzing thousands of articles, and carefully assessing them for bias and relevance. The aim is to create well-rounded, evidence-based guidelines that reflect a global perspective on pain management. It is a candid reflection on the ambitious project's progress and an invitation for more global participation.

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Advances in Imaging for Diagnosis of Spinal Chronic Pain

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Autonomic Interventions for the Non Pain Indications

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The DRG as a Pain Generator and what to do about it

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Cervical Epidural Injections

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WIP Guidelines

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Steven P. Cohen

June 8, 2023

Guideline Development

Dr. Steven P. Cohen discusses guideline development. Dr. Cohen begins his talk with the importance of guidelines in pain medicine as a roadmap to patient care. He provides an overview of the difference between...

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