HJNO Jan/Feb 2021

HEALTHCARE JOURNAL OF NEW ORLEANS I  JAN / FEB 2021 15 How do you categorize pain, and which type of pain is most difficult to treat? Pain is categorized by nociceptive, neu- ropathic, central pain syndrome, acute and chronic. By far, the most difficult pain in the world to treat is chronic central pain syn- drome, meaning pain that originates from the brain and spinal cord. Is being in more pain an inevitable part of aging? If so, what can be done about it? Yes, pain is an inevitable part of becoming more mature. We can combat suffering pain as we age by exercise. Exercise has shown to be the fountain of youth. Patients who exercise every day or at least three to four days per week live happier, healthier lifestyles with little to no pain. What are the challenges of treating pain in young individuals versus older? Challenges of treating pain in young in- dividuals arise when the plan of care for treatment is determined. In general, pain medication is relatively contraindicated in treatment of young patients due to higher prevalence of medication misuse, abuse and addiction. Interventional pain treat- ments are used with greater success. Chal- lenges of treating pain in older individuals become complicated as older patients have more comorbid issues that prevent or post- pone treatment. Also, the older population tends to be on fixed income, and financial hardship limits availability to certain treat- ment. What is your opinion of regenerative medicine, and are you currently using it in your practice? Regenerative medicine is the future of our industry. Yes, we are currently using stem cell therapy to treat soft tissue injury with great success. Regenerative medicine has allowed us to treat patients with success and avoid surgery. Much has been written about the mind-body connections of pain, where uncomfortable thoughts trigger pain in certain points of the body. What are your thoughts on this? The mind-body connection to pain is a valid concept. I usually refer my patients to a pain psychologist for evaluation and treatment when my clinical suspicion is high that psychological factors are influ- encing pain. Pain has been linked to the opioid crisis in the U.S. Do you think that is accurate? Do you think it is a crisis? And if so, what can be done to stop it? Yes, pain is linked to the opioid crisis in the United States. Yes, there is a crisis, and I believe the current system is doing a good job to combat the crisis. Because of the addictiveness ofmany pain killers, pain seems to be one of the few medical conditions where a patient’s motive is questioned. Do you think that is a reasonable thing for a practitioner to do, and how do you handle this? Yes, treatment of pain using opioid medi- cation is a critical topic in pain manage- ment. I screen all my patients for chronic medication misuse and abuse prior to en- gaging in treatment with opioidmedication. The use of strict compliance and frequent urine drug screens aides my ability to de- termine if patients have developed medi- cation misuse issues and addiction issues. Also, consultation with a pain psychologist is indicated to determine if patients have risk factors for treatment with opioid medi- cation and help determine the best practice in treating these types of patients. What treatments have you found most successful in targeting patients’ specific conditions? My clinic is a full-service pain clinic. I use all the tools in my toolbox when treating patients. My tools consist of interventional pain procedures, medication management, physical therapy and chiropractic adjust- ment as well as psychological support. What do you see on the horizon for pain management practitioners? I see the growing use of regenerative medicine changing the way we treat pa- tients. Regenerative medicine has been proven to repair the damaged tissue and restore normal function on a more perma- nent basis rather than simply treating the pain for a limited amount of time. n