International Conference and Exhibition on Pain Medicine June 08-10, 2015 Chicago, USA

Biography:

Michelle Layton is full-time clinician working at Bethesda Physiocare and a senior instructor for the dry needling seminars through Myopain Seminars. She became certified in dry needling in 2009 and shortly after became involved with the courses as an examiner and lab instructor. She is also a board certified clinical specialist in orthopedics and a certified cervical and temporomandibular therapist. In 2013 she had a chapter published, Deep Dry Needling of the Trunk Muscles, In: Trigger Point Dry Needling: An Evidenced and Clinical-Based Approach and she is co-author of the dry needling seminar workbook for Myopain Seminars. She is a contributing co-author for a new quarterly review column for the Journal of Bodywork and Movement Therapies. She is involved in writing book reviews through the Orthopedic section of the APTA and Journal of Musculoskeletal Pain. She also serves as a manuscript reviewer for the Journal of Manual and Manipulative Therapy. Since 2006 she has been actively involved with the Federation State Boards of Physical Therapy as an item writer for the national physical therapy exam, the orthopedic practice review tool and other areas of need. She has also presented on the topic of dry needling at several conferences and to the Pennsylvania physical therapy board.

Abstract:

The use of trigger point dry needling (DN) is one technique that has a growing body of evidence demonstrating its usefulness in many pain conditions, including fibromyalgia, headaches, migraines, shoulder pain, pelvic pain, and plantar fasciitis. TrPs have been established as persistent sources of nociceptive input contributing to local and referred pain, and peripheral and central sensitization. TrPs can also contribute to restrictions in range of motion, loss of muscle strength, and altered movement activation patterns. Participants will learn the neuro-physiological basis for DN in the context of pain sciences and recognize how dry needling can be of benefit for many different patient populations with long-standing pain issues. While the focus will be on pain management and DN of myofascial trigger points (TrPs), DN can also be used to treat fascial adhesions, scar tissue, tendons, enthesopathies, and ligaments, among others.

Biography:

Dr. Feng Tao is an Associate Professor in the Department of Biomedical Sciences at Texas A&M University Baylor College of Dentistry. Dr. Tao received his RO1 award and Independent Scientist Award from NIH in 2012 and 2014, respectively. He has published more than 30 papers in peer-reviewed professional journals and he is serving as an editorial board member for some professional journals. Dr. Tao also served as an invited reviewer for Johns Hopkins ACCM Seed Grant, NSF-sponsored Pilot Funding at Louisiana State University, Arizona Biomedical Research Commission, Britain Israel Research and Academic Exchange Partnership Regenerative Medicine Initiative, Wings for Life−Spinal Cord Research Foundation in Austria, and NIH NRCS Study Section.

Abstract:

Chronic postsurgical pain is a serious issue in clinical practice. After surgery, patients experience ongoing pain or become sensitive to incident, normally nonpainful stimulation. The intensity and duration of postsurgical pain vary. However, it is unclear how chronic postsurgical pain develops. Here we showed that social defeat stress enhanced plantar incision-induced AMPA receptor GluA1 phosphorylation at the Ser831 site in the spinal cord and greatly prolonged plantar incision-induced pain. Interestingly, targeted mutation of the GluA1 phosphorylation site Ser831 significantly inhibited stress-induced prolongation of incisional pain. In addition, stress hormones enhanced GluA1 phosphorylation and AMPA receptor-mediated electrical activity in the spinal cord. Subthreshold stimulation induced spinal long-term potentiation in GluA1 phosphomimetic mutant mice, but not in wild-type mice. Therefore, spinal AMPA receptor phosphorylation contributes to the mechanisms underlying stress-induced pain chronification.

Biography:

Kailash Kothari is pioneer spine and pain consultant in India. He has completed his MBBS and MD from Pune University, Maharashtra, India. He is founder and director of Pain clinic of India Pvt. Ltd. (PCI) with 9 branches in Mumbai and Goa, India. He is practicing interventional pain management since 2000. He has travelled to many countries to treat patients and deliver lectures on pain management. He is a renowned teacher, conducts one of the most popular cadaveric pain training course called Comprehensive Interventional Pain Management (CIPM) for last 8 years and he is the director of pain fellowship at PCI. He is active member of many national and international pain societies. He is invited faculty for more than 100 national and international conferences in many countries. His interest is mainly in minimally invasive and endoscopic spine procedures.

Abstract:

Back pain due to Lumbar Disc Disease is a huge burden on healthcare system. The treatment options range from physiotherapy to fusion surgery. A number of minimally invasive procedures have also been developed in the recent past for its management. Disc-FX is a new minimally invasive technique that combines multiple mechanisms to treat this percutaneous discectomy, nuclear ablation and annular modification. Literature on its role in the management of lumbar disc pathology is limited. We have treated 30 consecutive patients with the Disc-FX discectomy for back pain due to lumbar disc pathology non-responsive to non-operative treatment. Based on Magnetic Resonance Imaging (MRI) we divided patients in 2 groups – those with degenerative disc disease (DDD) and those with a contained lumbar disc herniation (CLDH). The patients with diffuse disc prolapsed, extruded and migrated disc, facet pain were excluded. Patients were evaluated pre and post operative at various intervals. The surgical technique involves proper skin markings, under local anaesthesia and minimal sedation ipsilateral insertion of Disc-FX cannula in the dorsal part of the disc (from disc pathology and painful side), under fluoroscopy guidance provocative discogram, manual removal of disc material, nucleus ablation and annulus modulation performed Disc FX RF electrode. Significant improvement was seen in all outcome measures in most patients. Few patients needed further open operative procedures. Early results after the Disc-FX procedure suggest that it s a good treatment option for patients with back pain due to lumbar disc herniation and degeneration, especially for those with DDD & CDD where conservative treatment fails. This procedure is good for both low back and leg pain due to lumbar disc disease. This procedure involves combined 3 in1 approach to treat disc pathology. This treatment method looks very promising and in future larger, longer prospective studies will be needed to evaluate its efficacy.

Biography:

Weiya Ma completed her PhD from Dept of Pharmacology and Therapeutics at McGill University, Canada. After finishing two Postdoctoral Fellowships in Canada, she went to Wake Forest University in States to take a Faculty position in Dept of Anesthesiology. Then she moved back to Canada to continue her research at Douglas Mental Health University Institute. Now she is an Assistant Professor at Dept of Psychiatry, McGill University. She has published novel studies unraveling the role of neuropeptides in nociception, neuropathic pain and morphine tolerance. Her pioneer work exploring the role of inflammatory mediator PGE2 in the genesis of chronic pain has let her become a leader in this field. She was frequently invited to present her work at seminars, to contribute review articles and book chapters to introduce her research works.

Abstract:

Chronic pain is an unmet clinical need which severely deteriorates the quality of life of individuals and imposes heavy financial burden on the health care system. Its treatment is rather challenging due to the unclear underlying mechanism. Growing evidence indicates that peripheral (nociceptor) and central sensitization caused by inflammatory mediators plays an essential role in the genesis of chronic pain. Pain mediator prostaglandin E2 (PGE2) abundantly produced in inflamed tissues is known to sensitize dorsal root ganglion (DRG) neurons and potentiates sensitizing effects of other pain mediators such as capsaicin and its receptor, transient receptor potential vanilloid-1 (TRPV1). We hypothesized that facilitating the long-term synthesis, axonal and cell surface trafficking of PGE2/EP4 receptor and capsaicin/TRPV1 channel in DRG neuronsis involved in nociceptor sensitization and transition from acute to chronic pain. In cultured DRG neurons, PGE2 and EP4 agonist increased cell surface trafficking of EP4 receptor and TRPV1 channel, events mediated through PKA and PKC signaling transduction pathways and coupled with enhanced nociceptive activities of EP4 and TRPV1. In a model of transition from acute to chronic pain, pre-exposure to PGE2 prolonged mechanical allodynia evoked by subsequent PGE2 or capsaicin challenge. This event was blocked by pre-injection of EP4 antagonist. Intraplanar (i.pl.) injection of PGE2 increased the levels of EP4 and TRPV1 in DRG neurons, sciatic nerves and plantarskin, which was suppressed by co-injection of EP4 antagonist. In inflammatory pain models, i.pl.co-injection of COX2 inhibitor or EP4 antagonists with carrageenan or complete Freud’s adjuvant blocked or shortened mechanical allodynia evoked by subsequent PGE2 challenge. Inflammation-increased EP4 and TRPV1 in DRG neurons were reversed by COX2 inhibitor or EP4 antagonists. These data suggest facilitating synthesis, axonal trafficking and cell surface trafficking of EP4 and TRPV1 through PGE2/EP4 signaling contributes to nociceptor sensitization and potentiation as well as transition from acute to chronic pain.

Biography:

Ziad Elchami, Director of Pain & Headache Management Center at the International Medical Center (IMC), Jeddah, KSA, is a Pain & Headache Management Consultant, who specializes in chronic pain and neurology. His clinical interests include: clinical neurophysiology, neuromuscular disorders, and pain. He completed his medical degree at the University of Damascus. He then joined Kansas University Neurology Residency Program where he completed both his residency and fellowship programs in Clinical Neurophysiology and Neuromuscular Disorders. During this period, he served as Chief Residents and Chief Fellow, as well. He has a Pain & Headache Fellowship from Cleveland Clinic Foundation where he worked from 2003-2005. He deals with all cases related to chronic pain, chronic spine pain, and chronic migraine. He achieved many awards and is well-published in both major national and international journals. He also has presented more than 70 abstracts in various conferences and seminars world-wide.

Abstract:

Introduction: Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals. 

Objective: The objective is to discuss the effectiveness of Extracorporeal Shockwave (ESWT), by applying either 9 or 12 sessions, for the treatment of fibromyalgia.

Aim: The aim is to establish the efficacy of ESWT in the management of fibromyalgia.

Methods: 50 female patients were evaluated; with generalized muscle pain with tenderness, over the fibromyalgia trigger points, randomly allocated to receive either 9 or 12 sessions of ESWT (trial was conducted for a period of 4 years in Pain & Headache Center, IMC, KSA). ESWT applied to the affected trigger points and radiating triggered muscles. Inclusive criteria: Group A: age: 25-70; mean age = 48 (for patients who had 9 sessions); Group B: age: 35-80; mean age = 57 (for patients who had 12 sessions). Exclusive criteria: Pediatric patients, anyone with pacemaker and has a history of bleeding tendencies and as per the other exclusive criteria of ESWT.

Results: Average improvement of 70% was appreciated in patients approaching 9 sessions of treatment (A). ESWT was applied to the trigger point and up to 80% approaching 12 sessions attained after one month and sustained up to 9 months in group A and at least 12 months in group B.

Conclusions: ESWT therapy was proven to improve fibromyalgia pain, other trigger points and radiating pain patients without the need for further medication or PT treatments.

Biography:

Kailash Kothari is pioneer spine and pain consultant in India. He has completed his MBBS and MD from Pune University, Maharashtra, India. He is founder and director of Pain clinic of India Pvt. Ltd. (PCI) with 9 branches in Mumbai and Goa, India. He is practicing interventional pain management since 2000. He has travelled to many countries to treat patients and deliver lectures on pain management. He is a renowned teacher, conducts one of the most popular cadaveric pain training course called Comprehensive Interventional Pain Management (CIPM) for last 8 years and he is the director of pain fellowship at PCI. He is active member of many national and international pain societies. He is invited faculty for more than 100 national and international conferences in many countries. His interest is mainly in minimally invasive and endoscopic spine procedures.

Abstract:

Chronic neck and arm pain or cervicobrachialgia commonly occurs with the degeneration of cervical spine. Cervical medial branch block is commonly done pain management procedure for relieving this pain. We will discuss the application of radiofrequency (RF) neurotomies of cervical medial branches in patients with cervicobrachialgia and the factors which can influence the treatment outcome. Surgeon’s understanding of fluoroscopic anatomy is very important in placement of the RF needle, and in turn achieving better results. Demographic data, types of pain distribution, responses of double controlled blocks, and long term relief of pain after one or two diagnostic blocks, electrical stimulation parameters, numbers and levels of neurotomies, and surgical outcomes at 6 months are important parameters to discuss. It is recommended to do a good sensory and motor stimulation before ablation to improve the long term results. It is important to ablate a level above and below the suspected painful level to achieve good results. Cervical medial branch neurotomy is considered useful therapeutic modality for the management of cervicobrachialgia in selected patients, using good clinical and diagnostic pain management techniques in patients with degenerative zygapophyseal disorders.

Biography:

Boaz G Samolky Dekel works at the University of Bologna Teaching Hospital, Italy, where he is responsible of the hospital chronic and acute pain center. As an Assistant Professor of Anesthesiology, Intensive care and pain Medicine of the University of Bologna, Italy, he does research and teaches Anesthesiology, Intensive care and Pain Medicine at the Bologna’s University Medical School. He graduated cum laude from the University of Bologna school of Medicine and from its post-graduate school of Anesthesia and Intensive care. His main research interests are Post-operative pain control; cancer pain, chronic non-cancer pain; invasive and non invasive analgesia techniques, and public pain medicine evaluation. His research work is nationally and internationally published.

Abstract:

In patients with chronic pain, Breakthrough pain (BTP) is a transient exacerbation of pain that occurs either spontaneously or in relation to a specific predictable or unpredictable trigger despite relative stable and adequately controlled background pain; BTP is usually related to background pain and is typically of rapid onset, severe in intensity and generally self limiting with a mean duration of 30 minutes and has traditionally been managed by the administration of supplemental analgesia at a dose proportional to the total background opioid dose. BTP shows variable prevalence in different clinical contexts both among cancer and non-cancer patients. While the considerable clinical burden of BTP is generally recognized, available common pain assessment tools are insufficient for its identification and diagnostic tools for BTP with demonstrated formal validation and prognostic capability are lacking. An innovated approach for BTP diagnosis may come from its prognosis features. Prognosis refers to the risk of future health outcomes in people with a given health condition. Prognosis research seeks to recognize and ameliorate future outcomes in patients with a given health condition and it provides crucial evidence for translating findings from clinical research to clinical practice. A useful prognostic model provides accurate predictions that inform stakeholders, supports clinical research, and allows for informed decisions to ameliorate patient outcomes. We have developed and validated a simple prognostic/diagnostic tool which may easily predict the likelihood of the presence of BTP in patients with potential clinical features of BTP. This has an important impact on therapeutic decisions.

Biography:

George Grant, who is known as The Caring Doctor, is considered the Canadian authority in integrative medicine and a wellness ambassador. He is an expert in biofeedback, stress, anti-aging and natural pain management. He is the founder & CEO of the Academy Of Wellness. He enjoys a stellar academic and a fascinating career in research. He is a Scientist, Professor, Chemist, Toxicologist, Nutritionist, Biofeedback, Stress management and a Pain specialist. He worked as a Senior Consultant for Health Canada, FDA and CDC as well as in private practice. He has helped 6000 clients naturally worldwide including clients at Sunnybrook hospital in Toronto to recover naturally from clogged arteries within few months. He has helped fortune 500 companies, nonprofit organizations and Olympic athletes along with 5000 clients worldwide. He has over 100 published articles, conference presentations, book reviews and 10 bestselling books/ DVDs.

Abstract:

Dr. George Grant discusses the results of a case study to evaluate the efficacy of IPM transdermal cream made with hyaluronic acid along with natural herbal ingredients in the reduction of prostate inflammation over 3 months for 12 male subjects ranging from mid-forties to mid-seventies. After using the natural IPM transdermal cream for 3 months by 12 volunteer subjects, the improvement in the reduction of frequent urination during the day and at night was over 12.5% using both biofeedback and PSA testing. Using natural herbal formula to reduce BPH instead of using prescription medications with unpredictable and sometimes serious side effect is an innovative approach with promising successful management of BPH among men.

Biography:

Douglas J Spiel, MD, a Board Certified Radiologist, was the first radiologist in the country to become a Diplomat of the American Board of Interventional Pain Physicians. He currently serves on the executive board of ABBIP and also holds certification as a fellow of Interventional Pain Practice (FIPP). As a member of the editorial board of Pain Physician, he frequently reviews publications prior to submission in this international peer reviewed journal. His practice covers the continuum of interventional pain – including simple procedures utilizing needles, probes, and catheters and more complex surgeries utilizing endoscopes, lasers, burrs and fusion materials. For five years he was the team physician for a professional baseball team and continues to see professional athletes in his private practice. He credits his unique background and medical-cross training as the keys to his “out of the box” practice of pain medicine.

Abstract:

Chronic Pelvic Pain (CPP) affects 15% of women between the ages of 18 and 50. From bladder symptoms of frequency, urgency and dysuria to gynecologic complaints of dyspareunia and vulvodynia, multiple organ systems can frequently be involved. The associations with prior conditions are myriad and many practitioners have been left “chasing their tails “treating anatomic bases that don’t pan out. Only by understanding the neurobiology of chronic pain, can we hope to effectively treat what amounts to be upwards of 20 million women (in the US alone). In stepwise progression, Dr. Spiel walks the listener through the associated diagnoses, important facts, key hypotheses, requisite neurobiology and the mechanisms of chronic pain so that the attendees can visualize what goes on within the body and the nervous system. With numerous audiovisual aids and diagrams, Dr. Spiel lays the groundwork necessary to understand the algorithmic approach he utilizes. By comparing CPP with another well known chronic pain entity, his theories are substantiated by similar treatment protocols accepted the world over. Case studies of treated patients are introduced to emphasize and elucidate many of the key points. Finally, a novel product is demonstrated allowing prolonged neural blockade which could not be successfully performed without it. The lecture will offer doctors and other professionals hope, while offering patients an opportunity to regain their lives. An eye-opening, sentinel presentation which will change the way CPP is managed from now on.

Biography:

Enrique Latorre Marques, MD,Com. Spanish Royal Navy (exc.), completed his studies in Universities Complutense of Madrid, Zaragoza and Barcelona. He was in the Naval Academy and Underse as School of Spanish Royal Navy, Air-Space Medicine Center of Air Force, National Health Service School, Madrid. He was the Head of Health Services in Submarine Base, Anesthesiology in the Air-Naval Fleet, Bosnia and Kosovo O.Z., and actually Consultant 3 Dept. of Anesthesiology, Trauma Center “Miguel Servet” Hospital & School of Medicine,University of Zaragoza. He is the Chair of Newsletter Committee,SIG onNeuromodulation, International Association for Study of Pain. He received many Awards: Spanish Royal Navy, Army, Dept of Defense, NATO, United Nations, Spanish Prime Minister, Spanish NHS and International Red Cross. Currently, he is working as the Director of Pain Clinic “Montpellier Clinic”, Zaragoza.

Abstract:

Low back pain is one of the most prevalent diseases and generates great amounts of health costs. During the last 30 years different efforts from National Health Services around the world have been intended to minimize overuse of health resources and obtain better results not only in symptoms and functional status but finally in the quality of life. Clinical Guidelines pretend this goals from 30 years ago, however new techniques e.g. Neuromodulation have reached in the last ten years high levels of efficacy in the treatment when others have failed. IASP (International Association for Study of Pain) created two years ago the special Interest group on Neuromodulation whit interdisciplinary basis integrated for scientist and professionals interested in this area. Goals are not only investigation but clinical application. On another hand The European Union created in 2000 the COST projects (Co-Directorate from European Commission) that pretends around a panel of experts obtain better results in the most prevalent areas of health. One of this was “The COST B 13 project for Low back Pain Management” that launched from 2001 to 2005 “The Clinical Guidelines for its Management”. The Spanish Working Group adapted, completed and also included the Neuromodulation in their clinical guideline of management based on scientific evidence. Today we have an interesting focus of discussion around National Health Systems (in Europe is universal and public, it differs for example to USA that it is private) about high cost of Neuromodulation and scenary of economic crisis. We need investigate and generate studies that obtain results in outcomes, cost-effectiveness and put the Neuromodulation in the right place. For this reason, IASP SIG on Neuromodulation include between their goals create The Scientific Based Guideline for Management of Neuromodulation in Chronic and Failed Back Pain because it is one of the emergent areas.

Biography:

Rômulo José Soares Bezerra is graduated in Pharmacy from the University Estacio de Sá – Rio de Janeiro - Brazil (2004), Master in cell and molecular biology by FIOCRUZ (2008) and PhD in cell and molecular biology by FIOCRUZ (2012). He is the invited member of the American Chemical Society (ACS), participating as a reviewer of the journal “Journal of Biomolecular”. He has experience in the biochemistry and pharmacology area in the following topics: Leishmania amazonensis, nitric oxide, arginase, anti-Leishmania experimental chemotherapy, and biochemistry of trypanosomatids. Actually, his research is focusing in the context of High Throughput Screening of natural products to find an active molecule, which could be useful in the future to treat some diseases related to the purinergic receptors.

Abstract:

The search for new medicines with less side effects and more efficacy to treat the pain states and inflammatory diseases continues to be a challenge difficult to solve. In this context, the search of new molecules with antagonistic action on the P2X7 receptor (P2X7R), which is a purinergic receptor that is physiologically activated by ATP released from apoptotic or necrotic cells during an inflammatory process, emerge as a promising therapy. Since its activation promotes the release of pro-inflammatory and pro-nociceptive cytokines, i.e. IL-1β and other inflammatory mediators as NO and ROS. Our group has been focusing in the context of the High Throughput Screening of Natural Products to find a possible new analgesic and anti-inflammatory compound with antagonistic profile on the P2X7R. Actually, we found three compounds with such in vitro and in vivo activities.

Biography:

Ziad Elchami, Director of Pain & Headache Management Center at the International Medical Center (IMC), Jeddah, KSA, is a Pain & Headache Management Consultant, who specializes in chronic pain and neurology. His clinical interests include: clinical neurophysiology, neuromuscular disorders, and pain. He completed his medical degree at the University of Damascus. He then joined Kansas University Neurology Residency Program where he completed both his residency and fellowship programs in Clinical Neurophysiology and Neuromuscular Disorders. During this period, he served as Chief Residents and Chief Fellow, as well. He has a Pain & Headache Fellowship from Cleveland Clinic Foundation where he worked from 2003-2005. He deals with all cases related to chronic pain, chronic spine pain, and chronic migraine. He achieved many awards and is well-published in both major national and international journals. He also has presented more than 70 abstracts in various conferences and seminars world-wide.

Abstract:

Introduction: Allodynia is believed to be a hypersensitive reaction that may result from central sensitization that could be associated with entities such as fibromyalgia, traumas, neuropathic conditions and others. The pain signals originate with specialized nerves, called nociceptors, that sense information about things like temperature and painful stimuli right from the skin.

Objective: The objective is to manage allodynic pain and to attain better functionality and lifestyle for the patients.

Aim: The aim is to establish the efficacy of managing allodynia with combination treatment of Botox Injection and Cymbalta.

Methods: 20 patients with chronic allodynia pain affecting either upper or lower extremity were evaluated in Pain & Headache Center, KSA. Diagnosed clinically and by imaging as chronic pain, all received localized injection of 100 units, applied to the affected region, each trigger point was injected with 5-10 units, followed by starting patients on Cymbalta taper up to 60mg daily and sustain patients for 6 months.

Inclusive criteria: 12 males, 8 females, ages ranging from 40-70; mean age = 55. Exclusive criteria: Pregnant women, children, anyone who is allergic to any of the medication ingredients, and patients who have liver and kidney disease and contraindicated for Botox injection or Cymbalta.

Results: Average improvement of 85% was appreciated, as per numeric pain scale, within 4-6 weeks and sustained for at least 12 months, with no evidence of major side

Biography:

George Grant, who is known as The Caring Doctor, is considered the Canadian authority in integrative medicine and a wellness ambassador. He is an expert in biofeedback, stress, anti-aging and natural pain management. He is the founder & CEO of the Academy Of Wellness. He enjoys a stellar academic and a fascinating career in research. He is a Scientist, Professor, Chemist, Toxicologist, Nutritionist, Biofeedback, Stress management and a Pain specialist. He worked as a Senior Consultant for Health Canada, FDA and CDC as well as in private practice. He has helped 6000 clients naturally worldwide including clients at Sunnybrook hospital in Toronto to recover naturally from clogged arteries within few months. He has helped fortune 500 companies, nonprofit organizations and Olympic athletes along with 5000 clients worldwide. He has over 100 published articles, conference presentations, book reviews and 10 bestselling books/ DVDs.

Abstract:

The amethyst bio belt was used by 12 subjects for one hour three times per week as well as using the amethyst Bio Mat during sleep daily over 3 months period. We used two different biofeedback devices to measure pain reduction, BMI [body mass index] to measure fat reduction and blood cortisol levels to measure stress reduction. The Bio belt and the Far Infra-Red/Negative Ions Amethyst Bio Mat reduced pain by 18% and reduced BMI by 10% and reduced Stress by 82% of 12 subjects in 3 months as validated by Pre and Post Biofeedback Brain Scans as well as fasting blood test to measure the stress hormone cortisol. Thermotherapy was enhanced when the bio belt was combined with the bio mat use during sleep to reduce stress, pain and abdominal fat. The bio-belt made from the amethyst is a small bio mat wrapped around the abdomen to reduce abdominal fat and around the back to reduce pain and stress. The Bio Mat technology is a combination of far infrared rays, negative ion effects and the conductive properties of amethyst channels. These three powerful health stimulators are combined in a single, easy-to-use product with remarkable healing properties. The Bio Mat delivers soothing, deep-penetrating heat while stimulating the regeneration of damaged cells in the body. It’s a safe and natural way to achieve optimal health now and maintain a stronger, more resilient body in the future. The combination of the bio-belt and the bio mat is a highly effective thermotherapy available to medical professionals and home consumers who want to reduce pain, stress and abdominal fat. The Bio Mat is an approved medical device by FDA.

Biography:

Ziad Elchami, Director of Pain & Headache Management Center at the International Medical Center (IMC), Jeddah, KSA, is a Pain & Headache Management Consultant, who specializes in chronic pain and neurology. His clinical interests include: clinical neurophysiology, neuromuscular disorders, and pain. He completed his medical degree at the University of Damascus. He then joined Kansas University Neurology Residency Program where he completed both his residency and fellowship programs in Clinical Neurophysiology and Neuromuscular Disorders. During this period, he served as Chief Residents and Chief Fellow, as well. He has a Pain & Headache Fellowship from Cleveland Clinic Foundation where he worked from 2003-2005. He deals with all cases related to chronic pain, chronic spine pain, and chronic migraine. He achieved many awards and is well-published in both major national and international journals. He also has presented more than 70 abstracts in various conferences and seminars world-wide.

Abstract:

I. What is Chronic Pain II. What is Allodynia and its Impact on Muscles and Nerves III. What is Centralized Pain IV. What is Botulinum Toxin and its Mechanism of Action in Pain Management V. Indications of Botulinum Toxin in Pain Management and Current Indications and Previous Experiences and Data

Biography:

Alen J Salerian is the medical director of Salerian Center and the President of Doctors for Equal Rights for Mental and Physical pain. He is a psycho pharmacologist who currently divides his energy between research and advocacy for people with chronic and mental pain. He has practiced in Washington DC for four decades, taught at George Washington University medical Center, served as the FBI's medical director of Mobile Psychiatric Emergency Response Team and is the medical director of Salerian Center for Neuroscience and Pain. He has published numerous articles in peer-reviewed journals including Lancet, Psychiatric Research, CNS Spectrum, Medical hypotheses, Journal of Psychology and Clinical Psychiatry contributed to Washington Post LA Times. He also appeared on CBS 60 minutes, Panorama (BBC). He has published two books, Viagra for your brain and Honest Moments with Dr. Shrink (cartoons). His forensic study of JFKs assassination JFK images will soon to be released.

Abstract:

Salerian Center for Neuroscience and Pain is a private institution in Washington DC with a dual mission of Hippocratic medicine and science. This presentation reviews endorphins and endorphin agonists in treatment of chronic pain, addiction, depression chronic pain with depression and psychosis with endorphins as the common crucial variable. There is compelling evidence that endorphins and endorphin agonists are of vital importance in the genesis and treatment of chronic pain, addiction, depression, chronic pain with depression and psychosis. This presentation reviews biology of regional brain dysfunction, neurotransmitters, mechanism of action of antidepressant strategies, preclinical data over antidepressant effects of endorphins, clinical data of antidepressant effects of endorphins, common pathways of pain and depression and addresses common challenges associated with therapeutic interventions with endorphin like substances. The engineering of slow-release endorphins agonists have enabled possible effective treatments for diverse neuropsychiatric conditions with relatively low risk of overuse or adverse events. Further double-blind studies will be helpful to validate these findings.

Biography:

James D Adams received a PhD degree in Pharmacology from the University of California San Francisco in 1981. He has been a faculty member at the University of Southern California, School of Pharmacy since 1987. He has over 230 publications and has done research on several pain medications. He received training from a California Indian Healer and is an expert on plant medicines. He will discuss his work on a pain liniment made from California sagebrush that is effective even in severe pain such as broken bones. Several hundred patients have used the liniment. He will discuss the chemistry and pharmacology of the liniment and will discuss safety issues of the liniment in comparison to opioids and NSAIDs.

Abstract:

A pain cycle exists in the body that can begin in skin sensory neurons, continues to the spinal cord and the brain, and then returns to the spinal cord and the skin. Analgesia can occur at any of these neurons to break the pain cycle. Upon initiation of the pain cycle in chronic pain, several changes occur including cyclooxygenase 2 induction in the skin. Cyclooxygenase 2 is the major source of PGE2 that enhances pain at transient receptor potential cation channels in the skin. A traditional California plant medicine, made from Artemisia Californica, was found to be an effective treatment of severe and chronic pain including broken bones, cancer pain, back pain, fibromyalgia, diabetic neuropathy and more. The liniment contains monoterpenoids and sesquiterpenes. Transient receptor potential cation channels are the major pain receptors in the skin and can be inhibited by monoterpenes such as camphor, menthol and eucalyptol. These monoterpenes cross the skin and provide pain relief for several hours. Sesquiterpenes can cross the skin and inhibit cyclooxygenase 2. The combination of monoterpenes and sesquiterpenes in the liniment provides several hours of pain relief.

Biography:

Vahid Mohabbati got his primary medical degree (MD) from Shiraz University of Medical sciences in 1997. Then he was trained as an Emergency Physician and worked as chief emergency physician in different parts of Iran for 8 years. He then moved to Australia and continued practicing in Emergency Medicine as locum in rural and remote hospitals and general practices for 2-3 years. He commenced postgraduate training in pain medicine in Brisbane and then moved to Sydney to complete his fellowship. Immediately after that he started training in palliative medicine and completed his fellowship in Sydney. Currently he is a staff specialist in Palliative Medicine at Royal Prince Alfred Hospital and a Visiting Pain Specialist at Liverpool hospital. He is a clinical lecturer at the University of Sydney.

Abstract:

Pain and palliative medicine are underdeveloped in most of the world, and outside North America, Europe, and Australia; access to quality pain and palliative care is very rare. Pain and palliative medicine are expanding in the developed world, but it is only the beginning to be available in the developing world where it is presently needed the most in terms of population access. Collaborative effort is essential to position pain medicine and palliative care higher in global and national health agendas. Significant barriers exist, in the lack of clear policies establishing pain and palliative medicine, the lack of educational programs to teach, the lack of essential medications needed to deliver pain and palliative medicine, and the lack of organized service delivery programs in both fields. Existing resources are available that can be adapted to individual countries and to fill existing needs. Lack of recognition, however, hinders progress in addressing services to alleviate suffering for those in needs and who are amongst the most vulnerable in a society. We conducted a population base study on prevalence of chronic pain in Shiraz, Iran (not published yet). In our study, 6.95% of the 1050 respondents who were willing to participate in the study had suffered from chronic pain (CP) for ≥6 months. According to the results, 54% of the participants with CP used analgesics, mostly NSAIDs and narcotic analgesics. Besides these, 37% of the patients used other pain relief methods, such as traditional medicine and acupuncture. The results also showed an acceptable rate of satisfaction with treatments. Larger population base studies at a national and regional level are needed to gain more accurate data on chronic pain (cancer and non-cancer) and also to explore other aspects of chronic pain including cancer treatment-related chronic pain, neuropathic pain, health related costs, disease burden, barriers to development of pain and palliative services in Middle Eastern communities.

Biography:

In 2004 I founded a medical centre for pain management and outpatient surgery center. ( called “Zentrum SchmerzLOS” that’s a german word for painfree and for the fate of painpatients synonymious). Since that time I could establish the pain centre in a large part of Austria as a centre for interventional pain therapy: in Vienna with the centre in Baden/Vienna and Upper Austria with the centre in Linz. At now we are a team of 16 ambitious doctors and nurses specialized for anaesthesia and pain therapy and we trat about 3500 patients a year. Our treatment with fluoroscopy guided interventions is strictly following the ISIS guidelines. Large priority of SchmerzLOS is set on scientific research, on the one hand for quality improvement, on the other hand for improvement of interventional pain therapy.

Abstract:

Background Facet joints and the sacroiliac joint (SIJ) complex have been identified as a common source of chronic low back pain. Low back pain is a commom problem. The prevalence of facet joint (FJ) mediated low back pain is 31% i - 45%ii, the prevalence for the SI Joint as a source of chronic axial low back pain is reported between 18% and 30%iii. Radiofrequency (RF) neurotomy has been investigated in recent years as a minimally invasive treatment option for FJ –and SIJ-mediated low back pain. The use of atestblock as a predictive factor is well documented. Predective co-factors like BMI, gender, and comorbidities for successful and long term pain decrease have not been well established. Objective This retrospective study was designed to illustrate the general outcome after radiofrequency neurotomy of lumbar medial branches and rami posterior of the SI Joint in patients with low back pain 1, 6 and 12 months after treatment. Outcomes were stratified by BMI, gender and age to determine their effect on the reduction of opioids and NSAIDS. Study Design. The records of 164 patients with chronic low back pain who underwent treatment with RF medial branch Neurotomy (parallel needle technique) and/or cooled RF LBN in case of SI Joint mediated low back pain were identified. Subjects were selected for treatment based on physical examination and positive response (>50% pain relief) to an lumbar medial branch block/Ramus dorsalis L5 block or intraarticular SIJ block. Lumbar medial branches L3 and L4 and the ramus dorsalis L5 were lesioned in „ISIS“ parallel needle technique (N=36), Cooled RF LBN involved lesioning the L5 dorsal ramus and lateral to the S1, S2, and S3 posterior sacral foraminal apertures (N=87). Visual analog scale (VAS) pain scores, quality of life, BMI, medication usage, and satisfaction were asked before the procedure, at 1 month postprocedure (N = 164), and again after 6 (N= 75) and 12 months (N=89) postprocedure. Results A VAS decrease in the total group was seen from 8 to 4 after 6 months and 4.5 after 12 months, and lower medication usage (opioids decreased 40%, NSAIDS decreased 60%). Pain decrease can be shown in this study for 12 months. Our data illustrate a significant better outcome for patients with a BMI lower than 30. There is no difference in VAS decrease between male and female. There were no severe or moderate complications during or after all procedures. Conclusion The data may suggest the use of RF treatment in case of low back pain as a proper treatment option as well as the probability of 95% to have a VAS decrease of 3-4 points on a 0-10 scale.Treatment of chronic low back pain with RF modalities is a safe, long term effective, pain reducing treatment option. Public insurance should be encouraged to provide reimbursement for this safe and reliable method of treating low back pain. Key Words Low back pain, Lumbar medial branch and ramus dorsalis L5 Neurotomie, Cooled RF LBN, BMI / Sex Dependence

Biography:

Richard Kaul graduated in 1988 from the Royal Free Hospital School of Medicine, London University in 1988 with degrees in both surgery and medicine MBBS. He then underwent eight years of Postgraduate training in both the UK and the US in the fields of general surgery, anesthesiology, interventional pain and minimally invasive spine surgery. From 2002 to present he has continued to actively engage in the education and teaching of the skills of percutaneous and minimally invasive spinal intervention all over the world. He was the first physician to successfully perform a percutaneous outpatient lumbar interbody fusion using an expandable device inserted via the transforaminal approach under fluoroscopic guidance. This procedure carried out in 2005 in the US revolutionized the practice of spinal care leading to the current statistics of affairs in which the majority of spine cases are performed in ambulatory surgical centers. He has several patents that relate to future designs for improved and portable intraoperative tissue visualization and environmentally aware state of the art mobile surgical facilities.

Abstract:

The evolution of the understanding of pain producing spine pathology in conjunction with the development of improved video-endoscopic instruments and technology are some of the foundational factors that allowed the innovation of outpatient surgical technique. The first outpatient lumbar inter-body fusion was successfully performed in 2005 in New Jersey and forever shifted the paradigm of spine surgery demonstrating the fact that lumbar fusion surgery could safely and effectively performed in the ambulatory surgical setting. The presentation entitled ‘Minimally invasive multi-level fusions in the ASC’ describes the five year experience of a single practitioner in two clinical facilities in NJ, USA. The surgical outcomes of a total of approximately eighty patients were reviewed and analyzed in this retrospective study which used the post evaluation tools of the Qswestry and VAS scales to gauge clinical outcome with CT to assess the degree of bony fusion. The complication rate is presented and demonstrated to be significantly lower when compared to the same operation performed using the wide open approach of traditional spine surgery. In addition the presentation describes the various technologies that have been employed in the emerging field of minimally invasive spine surgery ranging from the instruments of endoscopic discectomy to instrumented fusion. The effective management of pain requires a multi-disciplinary and multi-modality approach, of which the fluoroscopically guided minimally invasive technique is an essential tool that the modern interventional pain physician should possess, and which if preceded by a comprehensive diagnostic plan, will lead to improved patient outcomes.