On March 30, 2009, the House of Representatives passed the National Pain Care Policy Act, a piece of legislation designed to improve, as it is written, “pain care research, education, training, access outreach and care.” The reason? As the most common cause of Americans accessing the health care system, pain is one of the foremost drivers of health care costs. It is also a major cause of disability. Yet despite all of this, people in pain face considerable barriers that thwart the proper diagnosis, treatment and management of their pain.

There are several initiatives that the bill sets forth, among which include the formation of a conference on pain care to be conducted by the Institute of Medicine; an “aggressive” course of research through the Pain Consortium, a program of the NIH; the creation of a grant program to improve the understanding of health professionals; and the implementation of a public, nationwide outreach and awareness campaign.

Like a bone bruise, this is a topic that will persist and linger. To provide essential information on two key areas of this enduring topic — addressing it within a return-to-work scenario and exploring the most innovative therapies designed to treat it — the two ensuing articles delineate the fine lines of pain management and harness the knowledgeable insight of two experts.

The Forest for the Trees

How to Identify the Variables of Chronic Pain to Achieve Holistic Return to Work

By Mary Harris, MS, CRC

Researchers estimate that there are currently at least 75 million Americans who experience some form of debilitating pain; and with the aging of the baby boomers, that number is expected to grow significantly. I have been a disability specialist for the last 20 years. During that time, I have had the opportunity to serve individuals who, because of the direct and indirect affects of a medical condition, were unable to perform their work, and among them were individuals with a chronic pain diagnosis.

Although the service provisions were similar to other disabilities, there were differences that required a different case management approach. In the effort to better understand chronic pain, I looked to the experts for advice and recommendations.

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Pain Sage

A Pain Expert Discusses the Varieties, the Management and the Modern Medical Advances in the Thorny Field of Pain

By Richard Scott

Dr. William Witt, a professor of anesthesiology, neurosurgery and hematology-oncology at the University of Kentucky, as well as the director of the school’s Interventional Pain Associates program, knows a thing or two about pain management.

Also the medical director of the Cardinal HIll Pain Institute, Dr. Witt is a veteran pain management specialist and an expert in the latest line of implantable therapies available to control pain, having helped design some of the most exciting new devices on the market through advising roles with, among others, the biopharmaceutical firm Elan and the chronic disease management company Medtronic.

One of Dr. Witt’s specialties is an area known as intrathecal drug delivery, which is a system of delivering medication directly to the spinal cord, where pain signals move. Commonly used to treat chronic pain, as well as pain derived from cancer, intrathecal drug delivery systems are said to provide greater relief with less medicine than traditional drug delivery systems. Less medicine, of course, means fewer side effects.

To learn more about this and other areas of pain management, I sat down with Dr. Witt to ask him about his enduring work and his stimulating discoveries.

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