Keeping up with the latest developments in pain management can be a challenge. The American Society of Interventional Pain Physicians (ASIPP) helps doctors with this. Every two years, a committee updates the ASIPP guidelines. The focus is on the evaluation and management of chronic pain.
The committee recently released the 2007 updated guidelines. They review studies on every type of treatment for pain relief. They compiled the evidence for treatment that gives short-term, moderate, and long-term pain relief.
In this most recent update, the task force reviewed all of the minimally invasive (MI) spinal procedures. These experts offered current and helpful recommendations based on the limited data.
There was no change or improvement in the use of spinal (facet) joint injections. Likewise, there was nothing new to suggest for the use of radiofrequency neurotomy or intradiscal electrothermal therapy (IDET). And there were no updates regarding the use of percutaneous disc decompression, spinal cord stimulation, and intrathecal implants for pain control.
But even reporting that there’s no new evidence about a procedure can be helpful. Doctors using these techniques are reassured that they are on the right track in patient care.
The work of the committee also helps point out areas where further research is needed. There is a need for more studies using fluoroscopy to administer epidural injections. Fluoroscopy is a type of X-ray imaging that allows the surgeon to see inside the spine to guide the needle to the right spot.
Doctors hope for more studies on the treatment of chronic sacroiliac pain, intradiscal therapies, and newer percutaneous disc decompression. Guidelines offered based on limited evidence should be approached with caution.
The documents can be viewed on-line at www.guideline.gov. Type in: ASIPP in the search window.