Top 5 Exciting Pain Management Advances in the 21st Century

1. Regenerative Medicine

2. Spinal Cord Stimulation

3. Radiofrequency Ablation

4. Increased education techniques

5. Better imaging

In this day and age, the predominant focus in pain management is on symptom suppression, not disease modification. The holy grail of pain management is to regenerate soft tissue and cartilage. The current standard of care for most injection treatments is steroids for joints and the epidural space. The problem with that approach, however, is it doesn't cure anything. It simply alleviates pain for a period of time and puts the proverbial "bandaid" on it.

Regenerative medicine on the other hand, involves a disease modifying approach. Cartilage may be regenerated and soft tissues may be healed faster and more completely than what occurs naturally now. This is an exciting time for regenerative medicine as some of these products are being introduced into clinical practice with promising results. Stem cell injection treatments are now available that are made from the amniotic fluid of consenting donors in an FDA regulated process. Amnion is an unbelievable source of stem cells along with numerous other factors for joint health such as hyaluronic acid.

Spinal cord stimulation has come of age and represents an excellent treatment option for patients in pain who no longer have a surgical option. Considering that narcotics are tough to handle on a chronic basis due to side effects and tolerance, the electric stimulation can decrease pain and reduce the need for narcotics. These devices continue to improve with the enhanced programming, slimmer profiles, longer rechargeable batteries, and various anatomical areas for clinical use.

Radio frequency ablation has advanced significantly over the past decade. The results for lumbar, cervical, and sacroiliac pain have been excellent after these procedures. The thermal deadening of the tiny little nerve endings that supply joints (hence causing pain) has been shown to alleviate pain for up to 2 years. Injections typically work for 3 to 6 months, however, an RFA may allow longer term relief and in this day and age, an outpatient procedure with 2 years is a welcome outpatient option.

The education that patients receive has improved substantially over the past decade. With the advent of iPads and other digital technology, the animations and online education that is available has expanded substantially. Knowledge is power, and the more that patients accumulate the better treatment outcomes may be.

Imaging techniques continue to get better. In the past decade, higher resolution MRI's have come into existence which may play out to help with better diagnosing capabilities. Also, fluoroscopic x-ray machines continue to improve resolution which may improve procedure accuracies. If pain doctors are more accurate with their interventions, patients will receive better pain relief.