Myopia is rampant in healthcare. There are more than 120 specialties and sub-specialties for medical students to choose which career path to take. Treatment for chronic pain follows this focused approach. Anesthesiology and Physical Medicine & Rehab are the two most recognized accredited pathways to pain management. According to the Pain Medicine Fellowship description at Johns Hopkins, “The pain fellow is expected to make more independent decisions with respect to pharmacotherapeutic and interventional management of pain patients as the training period progresses”. It goes on to say that trainees will become proficient within 1 year in 17 interventional procedures, e.g., spinal cord stimulation, epidural steroid injections, facet blocks. In other words, drugs, needles and devices are the main elements being used to manage chronic pain. A few weeks ago I received the June issue of Pain Medicine, The Official Journal of the Academy of Pain Medicine. And while Massachusetts and most of the country struggle with an opiate epidemic, attached to the cover was a marketing brochure for ZohydroER, a 12 hr hydrocodone (opiate) formulation that promotes its effectiveness while warning about addiction, abuse, and misuse. Enough said!
Solving the Rubik’s Cube of chronic pain is improbable using this narrow approach. This is supported by the fact that the US spends more than $300 billion a year in medical costs treating chronic pain, yet the chronic pain epidemic continues to spread. One of the comments to my last post, How the Stress-Response is a “Root Cause” of Chronic Pain, was “Ah, wish it was that simple: treating chronic pain is a complex endeavor”. This same statement could be said about infectious disease 100 years ago, yet clinicians who saw the problem from a different perspective created simple solutions such as penicillin and the Tetanus vaccination.
A few years ago, while serving as a health & wellness consultant of a large hospital system, I was researching ways to impact their multi-million dollar musculoskeletal pain problem. I came across reports of an IRB-approved clinical research study performed onsite at Chrysler with 96 participants with chronic back pain. Utilizing Somatic Functional Therapy (SFT) in twelve, 2-hr group sessions, 55% of those completing the SFT group program had complete resolution of their back pain, compared to 0% of those in the randomized control group. I was intrigued while at the same time knowing, from a current medical thinking perspective, that it was not possible given my experience in sports medicine treating over 10,000 patients with back pain.
I then, by chance, met the developer of SFT, Ramon Nunez, Sensei, at an employee health conference in Las Vegas where he was a speaker. (He prefers to use the title “Sensei”, meaning teacher, as he believes that education is key to resolving chronic pain and related illness). I knew right away that this was something that I wanted to know more about, and he challenged me to come to Michigan to see and experience SFT firsthand. So I flew out to Detroit, where the clinical research on SFT was being done at Henry Ford Health System. What I learned opened my eyes to what had been in front of me the whole time, and I began training in SFT. His insights provided the missing link to understanding the puzzle of chronic pain and a whole new way to help the millions suffering with chronic pain. Continue reading