MEDICAL SEMINAR 2023

The medical seminar this month (March 2023) focuses on nonpharmacologic ways to control chronic pain which include:

(a) epidural steroid injection

(b) spinal cord stimulation (SCS)

(c) nutrition

(d) exercise

One of our major pushes in 2023 is for patients using more than 150 morphine equivalents to do a trial of spinal cord stimulation (SCS). One major plus for spinal cord stimulation is that the patient must receive more than 50% pain reduction with a trial prior to permanent implantation. Issues with spinal cord stimulation may include insurance approval and doctor acceptance (i.e. Dr. Longton of Pain Medicine Consultants/Bass Medical does not accept Medicare/Medi-Cal). In 2023 our major objective for patients is not to decrease their dosage, we’ve spent more than two years tapering patients with the help of the Stanford empower program and Dr. William Brose. In 2023 our focus is on multidisciplinary pain management which includes a pain management Psychologist for Behavior Medicine, as well as interventional treatments such as spinal cord stimulation. With improvements in pain control there may be an opportunity to taper the patient’s pain medicine. Conversely, improved pain control may result in increased function without the capacity to taper medicines if the medicine taper decreases physical function. For example: a 50% pain reduction with SCS allows the patient to finally be able to work in the garden, take 20-30 minute walks with his wife, and have better sleep – but tapering his pain medicines reverses this improved function. In that case we would not ask the patient to decrease his pain medicines. Our next seminar series, planned for June 2023, will include Behavioral Medicine with a Pain Management Psychologist.