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Purpose: Injectable biologics have not only been described and developed to treat dermal wounds, cardiovascular disease, and cancer, but have also been reported to treat chronic pain conditions. Despite emerging evidence supporting regenerative medicine therapy for pain, many aspects remain controversial. Methods: The American Society of Pain and Neuroscience (ASPN) identified the educational need for an evidence-based guideline on regenerative medicine therapy for chronic pain. The executive board nominated experts spanning multiple specialties including anesthesiology, physical medicine and rehabilitation, and sports medicine based on expertise, publications, research, and clinical practice. A steering committee selected preliminary questions, which were reviewed and refined. Evidence was appraised using the United States Preventive Services Task Force (USPSTF) criteria for evidence level and degree of recommendation. Using a modified Delphi approach, consensus points were distributed to all collaborators and each collaborator voted on each point. If collaborators provided a decision of "disagree" or "abstain", they were invited to provide a rationale in a non-blinded fashion to the committee chair, who incorporated the respective comments and distributed revised versions to the committee until consensus was achieved. Results: Sixteen questions were selected for guideline development. Questions that were addressed included type of injectable biologics and mechanism, evidence in treating chronic pain indications (eg, tendinopathy, muscular pathology, osteoarthritis, intervertebral disc disease, neuropathic pain), role in surgical augmentation, dosing, comparative efficacy between injectable biologics, peri-procedural practices to optimize therapeutic response and quality of injectate, federal regulations, and complications with mitigating strategies. Conclusion: In well-selected individuals with certain chronic pain indications, use of injectable biologics may provide superior analgesia, functionality, and/or quality of life compared to conventional medical management or placebo. Future high-quality randomized clinical trials are warranted with implementation of minimum reporting standards, standardization of preparation protocols, investigation of dose–response associations, and comparative analysis between different injectable biologics. [ABSTRACT FROM AUTHOR]

Abstracts, and Scopus to identify and compile the evidence for diabetic neuropathy pain treatments (per section as listed in the manuscript) for the treatment of pain. Manuscripts from 2000-present were included in the search process. Results: After a comprehensive review and analysis of the available evidence, the ASPN SWEET guideline was able to rate the literature and provide therapy grades for most available treatments for PDN utilizing the United States Preventive Services Task Force criteria. Conclusion: The ASPN SWEET Guideline represents the most comprehensive review of the available treatments for PDN and their appropriate and safe utilization. [ABSTRACT FROM AUTHOR]

The article discusses the concerns surrounding the field of pain medicine and its shift towards a focus on procedures and interventions, rather than holistic patient care. The authors argue that the rise of social media and the emphasis on showcasing advanced procedures have distorted the perception of pain medicine. They also highlight the increase in unaccredited fellowships that prioritize procedural training over comprehensive pain management. The authors call for a reevaluation of the field's direction and a return to patient-centered care to maintain the credibility and identity of pain medicine as a legitimate specialty. [Extracted from the article]

The article discusses the challenges faced by pain medicine fellows and proposes an extension of the fellowship duration to address these challenges. The authors argue that the current one-year fellowship structure is insufficient to provide comprehensive training in pain medicine due to the evolving landscape of the field and the increasing complexity of treatments. They suggest that a multi-year training program would allow for a more in-depth education and mentorship, better preparing fellows for their future careers. The authors acknowledge that their proposal may not be universally accepted but hope to initiate a discussion within the pain medicine community about the need for training program adaptations. [Extracted from the article]