The American Society of Interventional Pain Physicians (ASIPP) announced they have
released the 2009 updated Interventional Pain Management (IPM) guidelines.
Dr. Manchikanti, primary author of the guidelines stated that, "The purpose of the IPM
guidelines is to address the issues of systematic evaluation and ongoing care of chronic or
persistent pain, and provide information about the scientific basis of recommended
procedures. The guidelines are expected to increase patient compliance, dispel
miscommunications among providers and patients, manage patient expectations
reasonably, and form the basis of a therapeutic partnership between the patient, the
provider and payers."
ASIPP first developed treatment guidelines in 2000, and since then there have been four
subsequent updates. These guidelines have been developed utilizing a comprehensive, all
inclusive approach with systematic assessment of available literature. The guideline
authors include various specialists practicing interventional pain management from
multiple disciplines, both academic and private practice. ASIPP assessed the strength of
evidence by US Preventive Services Task Force criteria. Following a formal process, they
also developed multiple systematic reviews along with multiple associated documents
describing in detail the process in the literature search and systematic reviews.
Dr. Manchikanti added that, "These guidelines follow the principles laid out by the scientific
community including the Institute of Medicine, American Medical Association, and multiple other
organizations. Further, we utilized strict criteria of relief of at least six months as short-term,
except for certain procedures in which case the relief of one year was considered as short-
term."The guidelines facilitate the provision of appropriate care, which is extremely important in
interventional pain management considering numerous geographic variations and potential fraud
and abuse. Utilizing these criteria, the indicated evidence varied from previously published
guidelines by other organizations, with accuracy of various diagnostic interventional techniques
ranging from moderate for certain procedures to weak for others. Similarly, for therapeutic
interventions, the evidence ranged from moderate to strong for certain interventions and for others
there was weak evidence.
Dr. Manchikanti acknowledged that there are
limitations to these guidelines as similar to
various other guidelines, due to lack of
literature in some areas. However, these
guidelines are a step forward compared to
many other guidelines published by ASIPP
and other organizations.
About The American Society
of Interventional Pain
Physicians
ASIPP's mission statement is to promote the
development and practice of safe, high
quality, cost-effective interventional pain
management techniques for the diagnosis
and treatment of pain and related disorders,
and to ensure patient access to these
interventions. Founded in 1998 by current
CEO Laxmaiah Manchikanti, MD, ASIPP is a rapidly growing not-for-profit organization that supports
the needs of physicians who practice Interventional Pain Management across the country.
Since its inception, the organization has had substantial impact on the practice of interventional pain
medicine, resulting in an impressive list of major achievements. In 2005, ASIPP succeeded in
passing The National All Schedules Prescription Electronic Reporting Act (NASPER),
which provides and improves patient access to quality care, and protects patients and
physicians from the deleterious effects of controlled substance misuse, abuse, and
trafficking. ASIPP is headquartered in Paducah, KY and currently has over 5,000
members.
Source: American Society of Interventional Pain Physicians
Pain Rating Scales
1. Wong-Baker Scale
2. Numerical Scale
3. FLACC (face, legs, activity,
cry, consolability) Scale
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