Introducing interventional pain management fellowship

April, 2020 Articles and educational materials

Before introducing interventional pain management fellowship, we will give you a scientific definition of pain in order to get acquainted with the pain definition of the past and then tell you everything you need to know about the Interventional pain fellowship.

The scientific definition of “pain” is ” : pain is an unpleasant sensory or emotional experience that is associated with actual or potential tissue damage.” The emergence of pain has been synonymous with human birth. From the distant past until a few centuries ago, the traditional belief has been that pain is an inevitable phenomenon that has no choice but to endure it. The root of the word pain is Latin poena, which means punishment, and is believed to be a form of punishment that cleanses the person of sins and sanctification.

History of the Interventional Pain Fellowship

The scientific and clinical study of pain goes back to the 1970s and Dr. John Bonica. Pain is a sign and warning means that a part of the body is dysfunctional, but if left untreated, the pain signals and signals often reach the brain and cause changes in brain chemical neurotransmitters and altered activity,the brain region is involved and so one problem turns into two problems:Primary pain at the site of injury and secondary pain in the brain!

Unfortunately, even in this case, even with the primary cause of the pain being treated, the secondary problem remains and no improvement is achieved. Therefore, the most optimal time to control and treat “pain” is the early stages of the disease, and if not treated properly, all aspects of one’s physical and mental life, social life and daily activity will also be affected. 

Based on these necessities, the field of “pain management” has emerged. This young branch of medicine is less than half a century old and has been around for a decade in our country. The duration of this specialty course is 2 years and is the basis of the field of control and treatment of diseases in which patients have chronic pain (pains lasting more than three months). In this field, pain is examined, diagnosed and treated as a main issue. Pain management means controlling and treating all aspects of pain (mental and physical).

The scope of “Pain Fellowship” is very broad and focuses on the following three main areas:

1- Chronic pain :

Control and treatment of diseases associated with pain lasting more than 3 months

2- Spine pain :

One of the major activities of pain fellowship services is the “Minimally Invasive Spinal Surgery (MISS)”, which includes the treatment of disc herniation (Disk endoscopy, Intradiscal decompression,PLDD …), vertebral fractures (kyphoplasty …) and canal stenosis ….

3- Regenerative Medicine :

In this service, soft tissue problems of the musculoskeletal system (muscles / meniscus / ligaments / tendons, etc.) and joints (osteoarthritis, etc.) using growth factors (stem cells, etc.) and inhibitors of cellular destructive factors (ACS or Orthokin).

Each of the services is described in detail in their related articles on this website.

The treatments available by the “Pain Fellowship practitioners” fall into two categories: Some include pharmacological and physical therapies (lasers, magnet, manual therapies, etc.) that address some of the simple and complex problems. The main part of the “pain management” procedure is Interventional or minimally invasive treatments, ie, the procedures performed without open surgery (endoscopic).

In the Intervention, the physician is operated in the operating room in a completely sterile condition using local anesthesia, guided by radiological devices (fluoroscopy, CT scan, ultrasound) and with special equipment (including special needles, endoscopes, epiduroscopes, etc.) enters the region and performs the required technique (discectomy, fixation, injection, etc.).These operations does not alter the natural anatomy of the body and does not result in skin incision, muscles and bones, and minimizes manipulation and damage to the body’s tissues, as well as surgical (bleeding and …) and anesthesia problems( Airway, etc.) and the patient does not have a hospital stay. 

In some cases the treatment of painful syndromes is not complete and requires the management of painful illness (such as rheumatic problems, strokes, some headaches, etc.) In these cases the pain fellowship physician is the leader of medical team with a set of required specialties (including neurosurgery / orthopedics / physical medicine / rheumatology / psychiatry …), the pain physician will be the leader and coordinator of the therapeutic team that performs this at the pain clinics.

The Fellowship of Pain is the most scientific, modern, and comprehensive way in the modern world to treat all aspects of “chronic pain” and results in restoring performance and working efficiency and achieving a good and healthy life.