Johns Hopkins University economists, writing in The Journal of Pain, estimated that the annual cost of chronic pain in the United States is $635 billion a year—essentially larger than orthopedics, cancer and heart disease—combined!
Innovations in Pain Management

The data for the Johns Hopkins analysis came from the 2008 Medical Expenditure Panel Survey which collected data from 20,214 individuals 18 and older.
Orthopedics this Week has maintained for a long time that innovations in pain management are the single most consequential medical innovations in orthopedics. As a result, in conjunction with the Drexel University School of Medicine, the Allegheny Health Network and its Head of Neurosurgery, Boyle Cheng PhD., we have organized CME programs which focus exclusively on the subject of Innovations in Pain Management.
We STRONGLY encourage every orthopedic physician to take this course because it explores the full range of new pain management, pharma and non-pharma, which are in advanced clinical studies and nearing commercialization. The next Innovations in Pain Management course is scheduled for October 21, 2021. Please watch for registration information in future emails and postings in OTW.
At this meeting, registrants will learn about the remarkable progress being made in nerve stimulation, ablation and even approaches which target the vascularity of nerves. Also, a new generation of more powerful, but more manageable pharma treatments are reviewed.
One significant innovator in Pain Management is Flexion Therapeutics, Inc. which is a sponsor of the Innovations in Pain Management course. Flexion, as OTW readers know, is the supplier of ZILRETTA, the first truly significant change in steroid therapy in 70 years. Coming through R&D pipeline are other groundbreaking, novel pain treatments.
In its own words, here is a description of Flexion and a way to contact the firm.
Flexion Therapeutics, Inc. (Nasdaq: FLXN) is a biopharmaceutical company focused on the discovery, development and commercialization of novel, local therapies for the treatment of people with musculoskeletal conditions, beginning with osteoarthritis, the most common form of arthritis. The Company’s core values are focus, ingenuity, tenacity, transparency and fun. Visit: www.flexiontherapeutics.com

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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