" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

May 8, 2013


  1. Be Prepared for Dr. Oz Show Backlash
  2. So, What Are You Waiting For? Register for 15th Annual ASIPP meeting Today
  3. NEJM publishes Insightful Articles in May 2 issue
  4. Poor Prognosis for Privacy
  5. Predicting Carpal Tunnel Syndrome
  6. Florida Approves Cap on Physician-Dispensed Drugs for Workers Compensation
  7. Emergency Visits Due To Ambien Skyrocket
  8. Print Issue of 2013 ASIPP Spinal Interventional Techniques Guidelines Available
  9. Case Study Links 'Pot' to Pituitary Damage
  10. Medicare Reset On Coverage With Evidence Development
  11. Gang of Eight Plots Path to Senate Supermajority
  12. Pay no tax, live abroad... and get a UK pension
  13. Rand Paul, Marco Rubio Face 2016 Bind
  14. FDA: Migraine Drugs Dangerous in Pregnancy

ozBe Prepared for Dr. Oz Show Backlash


Yesterday, the Dr. Oz show aired a show covering epidural injections. Dr. Paul Lynch, a very good interventional pain physician from Arizona presented the pro side and Dr. Jan Friedly, the con view.


This show turned out to be an investigative report intended to harm interventional pain management. As a result, ASIPP wanted to give its members a heads-up to questions that might come to as a result of this show.


A few of the points that were made in an "Undercover Investigative Report" on the show is that physicians:

· Are not adequately educating the patients about the risks and benefits

· Are telling patients that steroids are approved for FDA use when they are not

· Are often motivated by financial gain

· Are inadequately trained

· That Epidural steroid injections are high risk and not efficacious


These types of statements do lead to confusion with patients. Please arm yourselves with the proper responses. We have attached Dr. Lynch's response to the show, a text version of the story on Dr. Oz and a link to the online episode.


 ASIPP Fact Sheet:

Facts for Physicians to Address Dr Oz Pain Clinic Investigative Report Questions


Dr. Manchikanti had the opportunity to address the misinformation that was provided on the Dr. Oz show during a "Liveline" medical segment today for our local (Paducah) television station.



Here is a link to the online Dr. Oz story on Pain Drs and Epidural Injection

Here is a text version of their story



Here is the Dr. Lynch's response



annualSo, What Are You Waiting For? Register for 15th Annual ASIPP Meeting Today!


 There just a little bit over a week left to take advantage of the room block and early registration discounts available when you register to attend this year's exciting annual meeting in Arlington, VA June 8-11.


For the past several weeks, ASIPP has tantalized you with tidbits of items on the agenda for this year's meeting.


The ASI PP 15th Annual Meeting titled "IPM: Strategies to Prevent Falling Over the Cliff," is geared to help both you and your staff prepare for all the changes coming with the Affordable Care Act (ObamaCare). The strategies and informaiton you will gather at this meeting will be unparalleled.


So, take advantage of this opportunity to Arm Yourself for the Future!


Click HERE to register

Click HERE to view Brochure



nejmNEJM publishes Insightful Articles in May 2 issue


The May 2 issue of New England Journal of Medicine features articles of interest to IPM physicians.


Discrimination at the Doctor's Office

Doctors dedicate themselves to helping others. But how selective can they be in deciding whom to help? Recent years have seen some highly publicized examples of doctors who reject patients not because of time constraints or limited expertise but on far more questionable grounds, including the patient's sexual orientation, parents' unwillingness to vaccinate (in surveys, as many as 30% of pediatricians say they have asked families to leave their practice for this reason), and most recently, the patient's weight. N Engl J Med 2013; 368:1668-1670May 2, 2013DOI: 10.1056/NEJMp1211375



Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis

Whether arthroscopic partial meniscectomy for symptomatic patients with a meniscal tear and knee osteoarthritis results in better functional outcomes than nonoperative therapy is uncertain.

N Engl J Med 2013; 368:1675-1684May 2, 2013DOI: 10.1056/NEJMoa1301408




Distributions of Industry Payments to Massachusetts Physicians




poorPoor Prognosis for Privacy


John Halamka, who co-heads a federal committee on data standards, said technology to make only part of a patient file visible isn't widely available.


The sharing of Americans' health information is set to explode in coming years, with millions of patients' medical records converted to electronic form and analyzed by health-care providers, insurers, regulators and researchers.


Wall Street Journal


tunnelPredicting Carpal Tunnel Syndrome


People with short, wide hands and square-shaped wrists may be more prone to carpal tunnel syndrome, a painful condition of the hands and wrists that often develops in workers who perform repetitive hand motions, says a study in Archives of Physical Medicine and Rehabilitation. Carpal tunnel syndrome, or CTS, affects three times as many women as men and is caused by pressure on the median nerve that runs through the wrist into the hand. Symptoms include numbness, tingling and sudden, shooting pain up the arm.


Researchers in Greece compared hand and wrist characteristics in 50 people with CTS and 50 people without CTS. Each group included 40 women and 10 men about 50 years of age who were employed in a variety of occupations. Gardening and knitting were frequent hobbies. The subjects' hands, wrists and palms were measured. The size of the carpal-tunnel passageway, through which the median nerve passes, was determined with ultrasound tests. Nerve-impulse speed was assessed in the more severely affected hand in CTS patients and the dominant hand in controls.


Wall Street Journal


floridaFlorida Approves Cap on Physician-Dispensed Drugs for Workers' Compensation


After years of struggling to rein in the cost of physician-dispensed drugs, Florida workers' compensation insurers finally reached a compromise with physicians and drug companies that is projected to reduce costs by some $20 million.


Florida lawmakers today approved the compromise (SB662) that for the first time will place a cap on what physicians can charge for prescription drugs they provide to injured workers.


Insurance Journal

ambienEmergency Visits Due To Ambien Skyrocket


The number of people taking Ambien (zolpidem) and ending up in hospital emergency departments increased by nearly 220% between 2005 and 2010, from 6,111 to 19,487 visits, says a news report issued by SAMHSA (Substance Abuse and Mental Health Services Administration, USA).

SAMHSA added that 74% of all emergency department visits involving adverse reactions to Ambien were made by people aged at least 45 years.

According to public records, 4,916,328 Americans made drug-related visits to emergency departments in 2010.


Medical News Today


 Guidelines Print Issue of 2013 ASIPP Spinal Interventional Techniques Guidelines Available



 This is your exclusive opportunity to own your own print copy of the Spinal Interventional Techniques Guidelines Issue.

The Guidelines contain the following:

  •  An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain. Part I: Introduction and General Considerations
  • An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain: Part II: Guidance and Recommendations
  • And Abstracts of 10 Systematic Reviews
  • Over 90,000 words, 2400 references, 50 Tables,  20 Figures, and 300 Formatted Pages


Click here to Order Your Copy!


An additional $20 for US and a minimum of $50 plus costs based on country will be added to the cost on any orders placed after Monday, April 29 at 8 a.m.


potCase Study Links 'Pot' to Pituitary Damage


PHOENIX -- Chronic, daily pot smoking over 15 years may be draining on pituitary hormones, and may explain the "pot-head" image popularized in movies and TV, according to a case report presented here.


A hormonal evaluation of a patient with symptoms of loss of libido, fatigue, and dyspnea showed luteinizing hormone concentration of 0.2 mIU/mL, follicle-stimulating hormone concentrations of 1.8 mIU/mL, and testosterone concentrations of 22 ng/dL, according to Richard Pinsker of Jamaica Hospital Medical Center in Queens, N.Y., and colleagues.

The patient also showed deficiencies in thyroxine and cortisol production, Pinsker said during an oral presentation at the meeting of the American Association of Clinical Endocrinologists.


MedPage Today

resetMedicare's Reset On 'Coverage With Evidence Development'


Medicare is poised to revise its "coverage with evidence development" (CED) policy, which has important implications for beneficiaries' access to new medical technology as well as manufacturers' reimbursement for their products.


For years, Medicare has employed CED, under which the program provides conditional coverage for new technology while it collects additional evidence on the technology's effectiveness. The concept has great intuitive appeal in that it promises to provide access to promising technology for which the evidence base may be immature. As Medicare officials and other experts have argued, by linking coverage of new technologies to requirements that patients participate in registries or clinical trials, CED can help identify the circumstances in which patients are most likely to benefit and potentially accelerate access to innovations.


Health Affairs


gangGang of Eight Plots Path to Senate Supermajority


Senate immigration negotiators are targeting as many as two dozen Republicans for a show-of-force majority - which they believe may be the only way a reform bill will have the momentum to force the House to act.


Reform proponents are looking for votes far beyond the usual moderate suspects to senators in conservative bastions such as Utah, Georgia and Wyoming. The senators landed on the list because they're retiring, representing agricultural states, anxious to get the issue behind the party, important to persuading skittish House Republicans or all of the above




payPay no tax, live abroad... and get a UK pension


Steve Webb, the pensions minister, said that those receiving British pensions overseas include many foreign citizens who have "never set foot in Britain at all".


The pensions can be worth £3,500 a year for the entire length of a person's retirement, and are costing taxpayers £410 million a year - a rise of more than a third over the past decade.


Mr Webb revealed the figures ahead of this week's Queen's Speech, which will include a proposed law that will stop new claims for such pensions.



The Telegraph


randRand Paul, Marco Rubio Face 2016 Bind


Sens. Rand Paul and Marco Rubio are facing a big obstacle if they seek the White House in 2016 - and it's not each other.


State laws could force the two GOP senators into a difficult choice: run for president or run for reelection to the Senate that same year. Because in their home states of Kentucky and Florida, neither Republican can be on the ballot for both offices at the same time.




FDAFDA: Migraine Drugs Dangerous in Pregnancy


Pregnant women should not use valproate sodium and related drugs to prevent migraine because of the potential for lower IQ scores in children exposed in the womb, the FDA warned.


The contraindication applies to valproate sodium (Depacon), divalproex sodium (Depakote, Depakote CP, and Depakote ER), valproic acid (Depakene and Stavzor), and all generic equivalents.


Each of the drug's labels will be changed to reflect a change in the pregnancy category for migraine use from D (the possible benefits might outweigh the potential risks) to X (the risks clearly outweigh any potential benefits).



MedPage Today




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American Society of Interventional Pain Physicians ®
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Phone 270.554.9412, Fax 270.554.5394
E-mail asipp@asipp.org