Treating pain the right way

Dr. Fishman © 2010 UC Regents
Chief of Pain Medicine Scott Fishman has been at the forefront of shaping state and national health-care policy for pain medicine.

Posted Sept. 15, 2010

George Mironenko suffered progressively worsening back pain for 20 years after he fell while moving a large tree. Following two unsuccessful back surgeries, the self-employed engineer was forced to retire.

Today, thanks to UC Davis pain medicine expert Scott Fishman, Mironenko’s pain is under control, and he is back at work. Fishman first treated him with medication injected during office visits, then with daily pain medication delivered through a patch worn on the skin.

“The results have been very good,” says Mironenko’s wife, Rimma. “He can walk. He can sit. He can drive … he is able to live life again.”

According to Fishman, undertreated pain like that suffered by Mironenko is a growing health crisis in America.

“Patients in chronic pain outnumber those with cancer, diabetes and heart disease combined and, despite the fact that pain is the most common reason a patient goes to a doctor, physicians aren’t often well trained to manage it.”
— Scott Fishman

“Patients in chronic pain outnumber those with cancer, diabetes and heart disease combined and, despite the fact that pain is the most common reason a patient goes to a doctor, physicians aren’t often well trained to manage it,” says Fishman, professor of anesthesiology and pain medicine and chief of the UC Davis Division of Pain Medicine. “All pain can be managed so that no one should have to suffer unnecessarily from pain.”

Fishman is past-president of the American Academy of Pain Medicine, a researcher and the author of several books. His most recent book, Responsible Opioid Prescribing: A Physician’s Guide, was published last year. The Federation of State Medical Boards commissioned the book, and state medical boards are distributing it to their licensed physicians.

“The boards are letting physicians know what they expect in terms of the safe use of controlled substances,” Fishman says.

Mr. and Mrs. Mironenko © UC Regents

George Mironenko has returned to work after pain specialist Scott Fishman helped end 20 years of chronic back pain. Mironenko and his wife, Rimma, now enjoy a higher quality of life.

Fishman also has been working to shape state and national health-care policy on the use of pain medicine.

He is the current president of the American Pain Foundation, the largest advocacy group for patients in pain.

Fishman worked on getting the Veterans Pain Care Policy Act passed in 2008 and the Military Policy Act passed this past year. These bills guarantee that veterans and soldiers get the pain care they need.

“The wars in Iraq and Afghanistan have had low death rates, but high injury rates,” Fishman explains. “People are surviving injuries that they otherwise would have died from, and the care they were getting was completely inadequate.”

Recently, Fishman helped to craft the National Pain Care Policy Act that has become part of the Health Care Reform Act being considered by Congress. The bill provides guidelines for pain care, as well as resources to fund awareness campaigns and pain management research.

“We don’t know what will happen with health-care reform,” Fishman says, “but we’re optimistic that major improvements in pain care will make it into law, and we are proud to have gotten this legislation to this point.”