Spinal Cord Stimulation (SCS) is an essential part of the treatment algorithm for patients suffering from neuropathic pain. Once thought to be a treatment of last resort, it is now evident that SCS is an efficacious, cost-effective option that should be used much earlier in the treatment continuum in many disease states. This educational review will discuss patient selection criteria and will identify disease states where SCS can be used.
JULY, 2010

SI joint pain is a common cause of axial low back pain, affecting between 15% and 25% of people. In patients who obtain significant but short-term benefit from diagnostic blocks, RF denervation may provide a reasonable treatment alternative.
JUNE, 2010

Cancer pain results from the growth of cancer in human tissues, as well as the therapies implemented to treat a malignancy. Adequate pain control can be achieved in the great majority of patients by implementing an aggressive pharmacologic treatment strategy using opioids and adjuvants. The implementation of such a strategy may achieve adequate pain control in 90% to 95% of patients. Consequently, 5% to 10% of patients will require some form of invasive therapy.
APRIL, 2010

The benefits of providing regional anesthesia for patients undergoing a variety of surgical interventions have been well established. What is less clear is whether individuals who manifest a preexisting neurologic condition in general, or a neuropathy specifically, are likely to benefit from the provision of regional anesthesia without incurring undue risk in terms of exacerbating that neuropathic process.
FEBRUARY, 2010

Diabetes remains the most common cause of nontraumatic limb loss in the United States, with diabetic peripheral neuropathy (DPN) the most prominent culpable factor. Of the 42,500 nontraumatic amputations in the United States in 2004, neuropathy was considered the major contributing factor in 87%.
DECEMBER, 2009

Methadone is a valuable but potentially hazardous tool for managing pain conditions that are difficult to control. It is not simply another opioid. However, when properly employed, methadone can be an effective—and cost effective—analgesic.
DECEMBER, 2009

The evolving field of pain management has shifted toward more targeted delivery of medications, with a localized effect. The change in prescribing habits has been fueled by the controversies regarding adverse event data for over-the-counter and prescription nonsteroidal anti-inflammatory drugs.
DECEMBER, 2009

In 2007, ASIPP published a comprehensive review of interventional techniques, critically evaluating them for efficacy. Although the reviewers also looked at cervical and thoracic procedures, this discussion is limited to a review of low back procedures.
DECEMBER, 2009