Parallel Session 1: Pain management in advanced disease states
Moderator: Oscar de Leon-Casasola, MD

Pain Management for Advanced Cancer: Optimizing the role of intraspinal therapies.
Oscar A. de Leon-Casasola, MD
• To discuss the indications for intraspinal therapy in advanced cancer pain; To present the pitfalls for success of this therapy in advanced cancer pain.

Questions & Discussion

Pain Management for Severe Osteoarthritis of the spine: The role of the interventional pain physician.
Bupi Saini, MD
• To describe the different therapeutic alternatives for the management of pain in advanced osteoarthritis of the spine; To present the different techniques to undertake such therapeutic approaches.

Parallel Session 2: Opioids in chronic non malignant pain
Moderator: Scott M. Fishman, MD

Update on medical legal issues associated with chronic opioid therapy
Mark S. Wallace, MD
• Discuss some of the legal issues surrounding chronic opioid therapies

Evidence based use of the opioid contract
Scott M. Fishman, MD
• Understand basic components and usages of opioid contracts

The controversial use of opioids in headache
Zahid Bajwa, MD
• Examine appropriate and controversial usages of opioids in headache management.

Endocrine abnormalities with chronic opioids
Robert Presley, MD
• Review some of the endocrine consequences of chronic opioid therapy and necessary treatments

Parallel Session 3: Physical therapy and physical fitness in the treatment of chronic pain
Moderator: Douglas G. Merrill, MD

The value of physical therapy in CRPS
Andrew Friedman, MD
• The attendees shall be able to assess and decide which patients with CRPS are appropriate candidates for physical therapy, examine which P.T. modalities are of best value in the patient with CRPS, and what the proper timing and outcome measures are to evaluate the efficacy of the therapy they have ordered.

The Professional Athlete: Physical therapy and conditioning in the care of overuse injuries
Brent Rich, MD
• The attendees will discuss the value of various techniques in physical conditioning and physical therapy in the care of the athlete who has repetitive overuse injuries. Distinguish which techniques should be chosen for specific common injuries in the athlete and to understand how such treatment algorithms may be applicable to a practice of pain medicine among patients who are not professional athletes.

The value of physical therapy in the patient with chronic back pain
Nancy Cutter, MD
• The attendees will determine which physical therapy modalities are of use in the treatment of patients with chronic back pain. Specific measures of outcomes will be discussed in the process and this will enable the attendees to determine when P.T. should be used and when it should be terminated.

The value of water therapy in the treatment of chronic pain
Douglas G. Merrill, MD
• The attendees will evaluate the applicability of water therapy to the various patients with chronic pain who they may encounter in their own practice. Valid outcome measures for such therapy will be reviewed.

Parallel Session 4: Neck and back pain
Moderator: Sunil J. Panchal, MD

Evaluation and diagnosis of neck and back pain
Robert D. Monsey, MD
• Recognize relevant anatomy in the diagnosis and treatment of neck and back pain. The key elements of a problem focused history and physical exam will be reviewed for the multiple etiologies of neck and back pain. Appropriate use and interpretation of spine imaging techniques will be discussed.

Radiofrequency denervation for facet and sacroiliac joint pain
Sunil J. Panchal, MD
• Discuss relevant anatomy and evidence of nociception from the facet and sacroiliac joints. The participant will gain an understanding of how radiofrequency machines work and indications/contra indications of use. Technical aspects of denervation will be discussed with the use of fluoroscopic images as well as existing data for outcomes.

Outcomes of discectomy, laminectomy, fusion, and SCS for back and radicular pain
Kenneth Follett, MD, PhD
• Indications and contra indications will be discussed for each procedure. Optimal patient selection criteria will be reviewed. Comparative outcome data will be discussed for each technique, as well as needs for future investigation.

Emerging therapeutic options for spine related pain-IDET vs. Coblation
Charles Laurito, MD
• Technological differences between IDET and Coblation will be reviewed. Patient selection criteria for each technique will be discussed. Success rates, current outcome data, and needs for future investigation will be discussed.

Parallel Session 5: Translating mechanisms for postoperative pain
Moderator: Timothy J. Brennan, MD
• Mechanisms for pain and hyperalgesia even from a simple incision are not well understood but are relevant to all anesthesiologists. The mechanisms for how incisions cause pain and hyperalgesia will be discussed; potential future directions for therapy may result.

Perioperative use of current analgesic adjuncts to modulate postoperative pain.
Patricia Lavand'homme, MD, PhD
• Ketamine (NMDA antagonist), clonidine (adrenergic agonist) and COX inhibitors (classical and COX-2s) are currently available for the clinician. The lecture will review the practical aspect of perioperative use of these adjuvant drugs to modulate postoperative pain at both short and long-term. The different routes of administration for these adjuvants will also be discussed.

Continuous Peripheral Nerve Blocks for Acute Pain: Avoiding secondary block failure by stimulating the needle and the catheter.
André Boezaart, MD, PhD
• Review secondary continuous peripheral nerve block (and catheter failure) for acute pain management. It explores the reasons for this, give a brief overview of the worldwide experience with continuous nerve blocks. Finally the talk will further introduce the technique of placing both the needle and the catheter with the aid of a nerve stimulator to minimize catheter failure for acute pain management.

The acute postoperative pain service
Eugene R. Viscusi, MD
• Describe the organizational models for an acute pain service emphasizing the role of nurses. It will also present a "glimpse of the future" on acute pain technologies.

Parallel Session 6: Pediatric pain
Moderator: Santhanam Suresh, MD

Peripheral nerve blocks in children
Santhanam Suresh, MD
• Discuss and demonstrate using video a variety of peripheral nerve blocks in children that can be used for postoperative pain management. Discuss pros and cons of peripheral nerve blocks placed under general anesthesia

Central neuraxial blockade in children and adolescents
Myron Yaster, MD
• Central neuraxial blocks in children including caudal, lumbar and thoracic epidural analgesia. Awake vs Asleep placement of epidural catheters.

Alternative medicine in children
Yuan-Chi Lin, MD, MPH
• Alternative medical therapies including acupuncture for management of acute and chronic pain in children. Nutraceuticals and their effect on pain management.

Chronic pain in children and adolescents
Melissa Wheeler, MD
• Chronic pain syndromes diagnosed in children. Diagnosis and management of CRPS-1, non-migraine headaches and cancer pain in children.

Parallel Session 7: Rational use of imaging in pain medicine
Moderator: James P. Rathmell, MD

Rational use of imaging in the evaluation of back pain
Robert D. Monsey, MD
• Discuss the timing and indications for use of radiographic imaging in the evaluation of the patient with back pain

What is the role of fluoroscopy in the pain clinic: translaminar, transforaminal, and other x-ray guided techniques?
James P. Rathmell, MD
• Review the techniques and clinical outcomes associated with use of x-ray guided injection techniques in treating painful disorders of the spine

Kyphoplasty and vertebroplasty in the management of vertebral fractures metastasis
Suresh K. Mukherji, MD
• Describe the emerging role of kyphoplasty and vertebroplasty in managing pain associated with vertebral compression fractures and vertebral metastases

Rational use of imaging in the evaluation of headache
Zahid H. Bajwa, MD
• Discuss the timing and indications for use of radiographic imaging in the evaluation of the patient with headache

Parallel Session 8: Current controversies in pain management
Moderator: Richard W. Rosenquist, MD

Intrathecal Drug Infusions: Should we be using multiple drugs?
PRO: Timothy Deer, MD
CON: Kenneth Follet, MD
• Describe the drugs currently available for intrathecal administration and the rationale for multiple drug administration. Review the difficulties associated with multiple drug administration and defend the use of single drugs for intrathecal administration.

Pain and the Law: What happens when pain medicine physicians run afoul of the law?

Pain and medical malpractice
Richard L. Rauck, MD

Fraud and prescription abuse
Richard W. Rosenquist, MD

• Illustrate common problems that lead to medical malpractice in pain medicine. Review recent examples of pain medicine practice that has produced charges of fraud, prescription abuse and manslaughter.