Nancy A. Melville

September 17, 2014

PHOENIX, Arizona — The American Academy of Pain Management (AAPM) 25th Annual Clinical Meeting gets under way this week, bringing together experts and practitioners in wide-ranging fields for education on the latest developments in the complexities of chronic pain and its management — all with a heavy emphasis on integrative approaches.

The meeting's theme, as it has been for 5 years, is "Explore the Science, Practice the Art of Integrative Pain Management," which accurately represents the AAPM's mission and what the organizers hope to achieve, Bob Twillman, PhD, deputy executive director of the AAPM, told Medscape Medical News.

"The theme itself is broad, but so is integrative pain management," he said. "We offer excellent, evidence-based education on topics that you probably won't see at other meetings."

With prescription pain medicine addiction a national epidemic, the need for alternative treatment approaches has never been more pressing, and the meeting tackles those concerns with an emphasis on thinking outside of the box in managing chronic pain.

"Because we are not wed to a particular treatment paradigm, we offer as many new, interesting, and evidence-based topics as we can to encourage clinicians to imagine new ways to treat their patients who suffer chronic pain," Dr. Twillman said.

In the keynote address "Emerging Role of the Microbiome in Pain Medicine," for instance, Donald C. Manning, MD, PhD, will discuss the important diagnostic and therapeutic possibilities of the microbiome — a "superorganism" representing "the sum total of all microbial genomes in and on the body with more than 100 times more unique genes than the human genome," according to the program.

At first instance, and finally, the practitioner must trust the patient's narrative. There is no ethically correct alternative. Dr. Peter Moskovitz

In another keynote presentation, Peter Moskovitz, MD, will take on the challenges of accurately gauging a patient's pain in "Trusting Your Patients: Objectivity and Subjectivity in Health and Healthcare." The talk will focus on paradox of being able to objectively analyze the state of a patient's condition, but not the patient's experience of it, which can sometimes be deceptive — whether intentional or not.

"At first instance, and finally, the practitioner must trust the patient's narrative. There is no ethically correct alternative," Dr. Moskovitz asserts in the program's synopsis of the talk.

Another anticipated session, titled "N.O.R.M.A.L.: Neuroplastic Optimization and Reduction of Medications for Adaptive Living," presented by Marla Golden, DO, will propose "appropriate, disease-specific medications as a component of a comprehensive approach to pain care, recognizing neuroplasticity as the hub from which all other treatments arise," according to Dr. Twillman.

Various sessions will explore other medication alternatives, including Christopher R. Brown's talk, "Periauricular Percutaneous Electrical Nerve Field Stimulation (Pnfs): Non-Narcotic Alternatives for Chronic and Acute Post Operative Pain."

In an interactive program titled "Who Is at Risk for Opioid Addiction: How Do I Know?" attendees will be polled on key issues surrounding addiction and then provided with supporting education, Dr. Twillman noted.

"It is a lively and novel approach that allows attendees to self-assess as they learn."

Delving deeper into the physiologic mechanisms underlying chronic pain, integrative pain management expert Gary E. Kaplan, DO, a diplomate of the Academy, will speak on "Total Recovery: Solving the Mystery of Chronic Pain and Depression."

His presentation is expected to provide insights on the origins of pain, Dr. Twillman said.

"The talk will redefine chronic pain and depression as a central nervous system sensitization syndrome issue so that we can understand the process of how people get sick, why they remain sick, and how clinicians can help them recover," Dr. Twillman said.

Bioethcist and filmmaker September Williams, MD, will deliver the ethics keynote presentation, "Pain Disparity: Clinical Medical Ethical Considerations and Progressive Care," discussing pain disparity as a bioethical issue that relates to other health and healthcare disparities.

"The talk will demonstrate bioethical tools for modifying standard pain assessments to improve management of those most affected by pain disparity by directing options for care," Dr. Twillman said.

Attendees will also be invited to take on pressing policy issues in a program new to the meeting this year, called the "Great Pain Policy Debate," an expectedly lively session in which attendees will vote on ideal policy solutions for contentious issues.

Finally, the meeting will feature plentiful scientific posters describing the latest findings in the research of chronic pain management. The program in full can be found at

American Academy of Pain Management (AAPM) 25th Annual Clinical Meeting. September 18-21, 2014. JW Marriott Desert Ridge, Phoenix, Arizona.


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