Feature Articles: Interventional Algology |
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 Associate Editor's Note:Algology is the art and science of diagnosing and managing pain. Pain has always been a part of human reality, and seeking relief from it has always been a natural response. Efforts to diagnose and manage pain date back to the early part of human history. Throughout the ages, pain is closely intertwined with magic, superstition and religion. Even early physicians believed that to be in pain is to be human, and pain was part of the natural experience that one must endure. As centuries passed, there was a gradual evolution regarding our understanding and approach to pain and its management. Today, modern intervention is capable of relieving more than 90 percent of human pain. Unfortunately, antiquated thoughts and ideas still linger such that only 50 percent of pain receives adequate treatment. Doctors often find chronic pain a disappointing and frustrating problem to deal with. Indifference, paranoia regarding drug misuse and malingering, patient avoidance, and direct refusal to treat this malady are not uncommon. One notable physician in the past said that the medical practitioner has two primary functions: to heal the sick and alleviate human suffering. We are successful in the first but still a dismal failure in the second. The recognition that we are not successful in relieving pain leads to the evolution of the algologist, a specialist primarily dealing with the management of pain. Presently, fellowship programs are available for pain management that involve primary specialties such as Anesthesiology, Neurology, Psychiatry, Rehabilitation Medicine, and others. There are now efforts by medical educators and the specialty board to create a separate residency program that deals primarily with pain medicine. Currently, there are several methods available to provide pain relief. These range from the simple use of drugs, nerve blocks, chemical and surgical disruption of nerve pathways, use of implantation technology, fiberoptic spinal/epidural endoscopy, psychological management, physical therapy, and other non-conventional methods such as acupuncture and other alternative medicine. The use of drugs remains the cornerstone in the management of pain. However, pain management does not end there. Although eighty five to ninety percent of patients with pain will have resolution of their pain problem, ten to fifteen percent will progress to the point of having chronic pain syndrome. This is this problematic group of patients that may require special means of pain control. This issue of Jacksonville Medicine provides a glimpse of interventional pain treatment modalities that are available in our area. I asked several practicing physicians in pain management to contribute their expertise in putting together this issue. It is my ardent hope that the medical community will be more cognizant of the fact that pain is a major health concern and services are available in our community to deal with this universal, often times frustrating problem. Orlando G. Florete Jr., M.D. |
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Jacksonville Medicine / October, 1998 |
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