Each September, we watch as social media abounds with messages about the impacts and challenges of pain during this designated “Pain Awareness Month.” In fact, for the estimated 50 million people in the United States alone who suffer from chronic pain (according to the Centers for Disease Control and Prevention) and the increasing numbers of patients with opioid use disorder and opioid-related deaths, especially with this unrelenting COVID epidemic, this is a year-round struggle. With each passing year, we take a moment to reflect on the progress made since the previous September. And each year, we know there is still so much further to go.

Perhaps more than any other specialty area, chronic pain management encompasses nearly every aspect of medical care. It has so many root causes, so many complications, and so many effects on our lives, our relationships, our mental health, our financial health, and our society. Because of these broad-ranging effects, ASRA approaches pain from a broad-ranging perspective. Although we are best known as an organization that represents acute and chronic pain practitioners, we continue to expand our reach across the disciplines as we seek continually evolving evidence and innovation to help us reduce the global burden of pain and give people back their lives.

Here are just some of the ways that ASRA is leading the effort to find solutions for chronic pain:

• Transitional pain: ASRA is leading the effort to build and reinforce the bridge between acute and chronic pain. Throughout the perioperative period, pain control, along with aspects like diet and exercise, medication management, and mental health, among others, all contribute to success. When we work together and across disciplines to effectively transition patients through the stages, we offer our patients the greatest potential for healthy outcomes. Learn how to build and improve your transitional pain service with our first-ever, fully virtual, Persistent Perioperative Pain Symposium being held September 25^th.
• Buprenorphine Guidance: ASRA has led an effort in collaboration with four other societies to provide guidance on buprenorphine management in the perioperative period. Based on an extensive literature search and assessment, the recommendations address patients who are already taking buprenorphine in the perioperative setting as well as patients who are suspected of having an opioid use disorder in the perioperative setting. Anesthesiologists and pain specialists must be prepared to manage patients at the point of care to “serve as a bridge to comprehensive treatment and ultimately save lives,” as the authors state. The American Society of Anesthesiologists, American Academy of Pain Medicine, American Society of Addiction Medicine, and American Society of Health System Pharmacists have all participated in and signed on to these recommendations.
• Consensus Guidelines: The past two decades have witnessed a surge in the use of lumbar facet blocks and radiofrequency ablation to treat low back pain, yet nearly all aspects of the procedures remain controversial. ASRA’s Consensus Practice Guidelines on Interventions for Lumbar Facet Joint Pain, published in 2020, are based on input from a multisociety committee of experts, which reached consensus on 17 topical questions about the procedures. ASRA will be releasing its consensus guidelines on cervical facet procedures very soon as well. Through expert-developed guidelines, ASRA is leading the way on providing safe and effective care to patients.

When you are looking for chronic pain resources, don’t forget about these helpful links:

• Resource Center: Check out our collection of resources, including articles written by ASRA members and external resources of interest in the ASRA Resource Center Chronic Pain section.
• Help your patients better understand chronic pain management and treatments with ASRA’s Patient Information resources.

Finally, be sure to check out ASRA’s 20^th Annual Pain Medicine Meeting being held November 18-20 in San Francisco and virtually where we’ll tackle some of these tough issues and collaborate on ways we can work together to find meaningful solutions.

Samer Narouze, MD, PhD, is the president of ASRA. He is a professor of anesthesiology and surgery at NEOMED and Ohio University and chairman of the Center for Pain Medicine at Western Reserve Hospital in Cuyahoga Falls, OH.