Dr. Madhan Pandian, a musculoskeletal sonologist and interventional pain specialist from Puducherry, India, joined NYSORA’s Educational Board in April 2023 and has been making significant contributions to NYSORA’s Popular Ultrasound-Guided Pain Interventions App. In a recent interview with Dr. Hadzic, an influential Pain Specialist, Dr. Pandian shared his insights on his career journey and the future of education in ultrasound and pain medicine.
Dr. Hadzic: What motivated you to become a pain physician?
Dr. Pandian: Treating my own father’s cancer pain served as a profound awakening to the importance of addressing chronic pain. The immense burden of chronic pain in India, coupled with my unwavering passion for Ultrasonography, compelled me to pursue a career in Pain Medicine.
Dr. Hadzic: Do you observe significant differences in pain practice between India and the Western world?
Dr. Pandian: Absolutely. Given India’s substantial population, there is an immense demand for pain management specialists. However, challenges such as limited health insurance coverage and a structured pain medicine curriculum present unique obstacles in countries like India. Despite these adversities, Indian pain physicians are highly skilled and proficient due to the sheer number of patients we treat and the interventions we perform on a daily basis.
Dr. Hadzic: Which 10 ultrasound-guided interventions do you find most rewarding in terms of patient outcomes?
Dr. Pandian: Here are 10 procedures that I find particularly rewarding with respect to both ultrasound-guided interventions and patient outcomes:
- Hydrodissection in nerve entrapment syndromes
- Carpal Tunnel Syndrome
- Trigger finger A1 pulley injections
- Regenerative interventions with PRP injections – Lateral Epicondylitis
- Shoulder Interventions – Saline hydrodistension of the glenohumeral joint
- Subacromial bursa injection, Acromioclavicular joint injection
- Cervical selective nerve root injection
- Stellate ganglion block
- Plantar fascia PRP injection
- Joint injections and aspirations
Dr. Hadzic: What are the most effective e-learning resources for enhancing US-guided pain management and MSK medicine skills?
Dr. Pandian: Comprehensive platforms are still somewhat limited, but it’s worth highlighting the initiatives undertaken by NYSORA. With their wealth of experience in teaching regional anesthesia procedures, NYSORA is at the forefront of e-learning in Ultrasound-guided Pain Management and MSK ultrasound. Their launch of the US Pain App, MSK US Knee App, and similar applications positions them as pioneers in this field. Contributions from global leaders have transformed their e-learning platform into a valuable resource for the future.
Dr. Hadzic: Will ultrasound eventually replace most x-ray/c-arm/CT-guided procedures?
Dr. Pandian: Not entirely. Despite the growing popularity of ultrasound-guided interventions and their diagnostic utility, Fluoroscopy and CT still have significant roles to play, particularly in advanced spine interventions.
Dr. Hadzic: If you were granted a 6-month break from work, which institutions/practices would you choose for additional knowledge/experience exchange and inspiration?
Dr. Pandian: Given the opportunity, I would focus on acquiring expertise in newer regenerative techniques, as they are poised to shape the future of pain medicine. Additionally, my lifelong goal is to inspire young upcoming pain physicians by sharing my knowledge on MSK ultrasound and chronic pain interventions. This goal extends beyond any specific time period.
