By Palanisamy Vijayanand
Relieving pain is a multi-disciplinary endeavour. Better management of pain is far more than simple administration of an adequate opioid or a nerve block done in a jiffy. It entails regulatory reform, humane care of the sufferer, and importantly championing evidence-based practices. It is clear that we are not consistently meeting the challenge of optimal pain management for a variety of reasons, including lack of knowledge.
The Indian Society for Study of Pain’s (ISSP) annual scientific meeting takes place at Mumbai in February 2014. In the previous years the well attended workshops and panel discussions were testament to the high quality discussions carried out in an Indian context. The crew at Traveling Pain School have been an integral part of it in the past. This year too we will be at Mumbai. We caught up briefly with Dr. Kailash Kothari, Organizing Secretary of ISSPCON 2014.
The theme of the conference is ‘Manage Pain – Be aware. Do care.’ What made the organizing committee to choose this theme?
Our prime objective as specialists in Pain Medicine is to manage pain well. Whether it is acute pain or persistent pain or cancer pain, we all do it to the best of our abilities. But there are also many barriers among physicians to carry out this singular objective. Chief among this is pain knowledge. At one end of the spectrum are physicians who struggle with even the basic assessment and management of pain. At the other end are practitioners who perform advanced interventions (some downright dangerous) without the evidence to do so.
The way pain management is practised in India, the public get whatever the doctor, the nurse or the physiotherapist was trained to do; not necessarily what the patient needed, and the results, not surprisingly, are usually poor. The intention of our theme, therefore, is to assess evidence (Be aware), and provide the best treatment with respect and dignity (Do care).
Could you tell us something about the faculty you have assembled?
Knowledge of pain management has a significant positive relationship with the extent of clinical care. The greatest good could be accomplished by disseminating the knowledge we already have about pain disorders and their treatment. We have national and international faculty who have consented to do this. There are close to a hundred lectures and panel discussions spread out over four days, where the current best evidence and information on state-of-art care would be put forth. We are sure that the delegates would cherish it. There is something in it for everyone.
This is the 29th Annual National Conference of Indian Society for the Study of Pain; do you think it would be different from others before?
There are many similarities to the past conferences as far as the topics are concerned. We still have to stick to the core topics, as every year a new group of pain physicians enter the medical workforce, and we still have to cater to this new group. What is novel is the way it is presented, with emphasis on evidence-based care. This method extends beyond talks and panel discussions to include video sessions and meet the expert sessions. Like the previous conferences we would also be exploring difficult topics such as neuropathic pain, central pain, placebo analgesia and the likes through ‘for and against’ debates.
There are some crucial differences, or shall we say upgrades, this time around. We have decided to have a larger focus on acute pain, as managing acute pain well is the key to prevent chronicity. In addition, there will be a larger coverage on the role of ultrasound in managing chronic pain. Besides, we have debates comparing various treatments for the same pain condition. Furthermore, there would be better coverage of psychological and alternative treatment methods (including a practical session on yoga for pain). Moreover, leading specialists from specialties like spine surgery, orthopaedics, neurology, neurosurgery, physiotherapy, psychology, psychiatry, nursing, palliative care etc have been invited so as to ensure that pain management is discussed in a multimodal context. Finally, we have a certification course for family physicians and nurses on the basics of pain management.
How about the workshops?
There are plenty to choose from. We have seven workshops – three fluoroscopy guided workshops, three ultrasound guided workshops and an endoscopic spine workshop. They are getting filled quickly, and some might not be available.
You have advertised for a seminar for the general public…
Yes. When it comes to pain, there is not only apathy among doctors, but also widespread fear among the public. The aim of the seminar is to create awareness among the general public that pain, particularly persistent pain and cancer pain, could be managed effectively, and there is no reason to suffer. We are not perfect, but our current understanding of pain along with the modern treatment methods should go a long way in alleviating the suffering. We have the senior members of ISSP along with international faculty addressing them. We hope that this would bring about a change, however small, among lay people.
Thank you. We look forward to the event.