Approximately 8 years ago, I was made aware of a new field of medicine that resonated with the reasons I wanted a career as a doctor. It is a field that also fueled my interest in the complexities involved in the musculoskeletal system of the human body. After spending much time (and money) traveling to the USA to partake in every conference and training program I could get my hands on, I came back to Australia and founded OrthoRegen. Eight years on, I am so proud of what we have achieved. We are providing the community access to ground breaking and innovative non-surgical treatments for musculoskeletal conditions that would only be available in other parts of the world. But most of all, we are helping patients find the root cause of their pain and dysfunction, providing treatment for long term benefit and improving their lives. Whilst the last eight years has had its challenges, what drives me is the thousands of patients we've successfully treated, leading them to an improved quality of life. Being such a new field in Australia, I thought I would write this blog to explain the difference between my sub-specialty, Interventional Regenerative Musculoskeletal Medicine (IRMM) and the conventional medical approach of Pain Medicine.
In Australia, there are very few doctors that are aware of what IRMM actually involves. In fact, more patients are aware of this field than the medical profession! So what is IRMM?
IRMM is an exciting and innovative field of medicine which is really the paradigm shift needed in orthopedics and pain management. It is a branch of medicine that focuses on the use of minimally invasive procedures to repair or regenerate damaged or diseased musculoskeletal tissue. These procedures may include the injection of platelets, growth factors, stem cells, or other biomolecules to stimulate the body's own healing processes, as well as procedural techniques like nerve hydrodissection, intraosseous injections and prolotherapy. Having been convetionally trained in medicine, the biggest difference I noticed after my training in IRMM is that it has a completely different diagnostic model for pain and dysfunction. For example, studies have shown up to 40% of knee arthritis pain is generated by the nerves surrounding the joint? A further 20-40% of knee arthritis pain is said to come from the weakened and injured ligaments supporting the joint! I was taught that knee arthritis pain was solely due to the loss of cartilage within the joint. IRMM is changing the way we diagnose pain and dysfunction. It identifies the pain generators and the biomechanical links that could be causing the condition. It then targets treatment to these structures and functional issues, essentially treating a problem at the root cause, rather than just treating findings on a radiological image or a symptom. It is a far better approach as it gives greater success in achieving long term, positive outcomes for patients.
In contrast, Pain Medicine, also known as pain management, is a branch of medicine that focuses on relieving or managing pain in patients. This may include the use of medications, physical therapy, and other techniques to reduce pain and improve the patient's quality of life. Pain medicine may also involve the use of interventional procedures, such as steroid injections or nerve blocks, to target specific sources of pain. Whilst these methods are sometimes beneficial, they are normally only short term fixes and do carry risks such as addiction to narcotic medication. For example, nerve ablations and spinal cord stimulators are commonly used in pain medicine. This approach essentially tricks the body to not feel pain by stimulating or destroying the 'wiring' that carries pain signals to the spinal cord and brain. There are fundamental issues with this approach. Firstly, pain is not a disease or condition but a signal, or sensory message that something is not right. It is a primordial function of the body that acts as a warning. Secondly, pain is usually due to a multifaceted, complex interplay between the body's tissues and the peripheral and central nervous system. To approach pain as a medical condition and not investigate the what, how or why pain is occurring will ultimately lead to suboptimal therapeutic results and potentially worsen the underlying, undiagnosed condition over time. Therefore, treatments that treat the "symptom of pain" at the root cause would undoubtedly provide patients with longer term positive outcomes and improve their overall musculoskeletal wellbeing, leading to an improved quality of life.
In general, IRMM aims to repair or regenerate damaged tissue to reduce pain and improve function, while pain medicine focuses on relieving pain. However, the two fields may overlap in certain cases, such as when interventional regenerative procedures are used to address the underlying cause of pain, and pain medicine treatments are used to help in the diagnosis of the cause of pain.
For patients who have tried conventional medicine approaches and have failed to respond, regenerative medicine may be an exciting option for them to consider. It's also an exciting medical field to be involved in as a doctor. With the advancements and ongoing research I am witnessing overseas, regenerative medicine is the future of medicine.
At OrthoRegen, we provide a no obligation assessment of your condition prior to a consultation. If this is of interest to you, please feel free to contact us via our Contact Page on our website.
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Dr Paul Schiavo is the CEO, Medical Director and Founder of OrthoRegen. He is a global key opinion leader in Regenerative Medicine and Interventional Orthobiologics.
Blog disclaimer:
NOTE: The reader can better comprehend regenerative medicine, musculoskeletal health, and related topics by reading this blog post's broad information. The language, graphics, photographs, patient profiles, outcomes, and other information included in this blog, website, or any related materials is not intended to be used in place of professional medical advice, diagnosis, or treatment. Please always seek the advice of a qualified healthcare practitioner before deciding whether to pursue a particular course of therapy.