Dear AAPM members and colleagues,

On this recent July 4th holiday celebration of our country’s commitment to freedom and equality, I was able to venture into the White Mountains in New Hampshire for some needed adventuring and time for reflection. As we navigate the future challenges to pain care access considering research funding cuts and imminent changes to healthcare coverage for our patients with acute and chronic pain, the future can seem bleak. I am confident, however, that we can accomplish so much more if we work together.

We see first-hand the challenges our patients face in accessing team-based pain care as insurance constraints often drive access. Our Academy is dedicated to ensuring our patients get the treatments they need and that we continue to promote pain research and best practices for the future. Check out our recent advocacy efforts on NIH research funding and patient access to care! Despite the challenges, I am grateful to all of you for your dedication to pain medicine and supporting pain care for all.

My two patient stories from clinic last week may resonate with your own experience and highlight some of the challenges we are all facing as we advance the care our patients deserve.

My 72 year-old patient who I’ll call Maria has had three spinal surgeries and suffers from low back and radicular, neuropathic pain. We have tried everything from physical therapy to medications (except opioids) to injection procedures to mind-body strategies to acupuncture. She is motivated to move but cannot walk more than a few minutes before she must sit down. I have known her for over 5 years. Another spine surgery is not in her future. We reviewed a spinal cord stimulation trial and expectations, and she is ready to proceed. This FDA-approved procedure with robust evidence for efficacy was as of May 16, 2025, considered a non-covered benefit by a local private payor in MA, even for patients with post-laminectomy neuropathic pain. I have filed an appeal and remain hopeful. Insurers may be impeding access to non-opioid alternatives for pain relief, and I am grateful to our Academy and members for advocacy efforts and member resources to benefit our patients like Maria.

My 25-year-old patient and athlete with many years of vulvodynia and dyspareunia is completing her masters in sports leadership but has difficulty sitting during class time, cannot be sexually active or feel she can be in a relationship, or exercise as much as she would like because of pain. Many of the multimodal treatment strategies such as behavioral medicine, pelvic floor physical therapy, and suppositories that I would like her to pursue are too costly given high co-pays, poor reimbursement, and her student budget. We are hopeful that when she finishes her studies, she may be able to afford the treatments that she can benefit from. I am confident that together we can advance access and coverage of a personalized approach to pain care.

I look forward to our continued advocacy and partnerships through our Academy as we ensure our patients get the treatments they need.

Thank you to AAPM’s Advocacy and Policy committee, our Board, and all of you for your collective efforts on behalf of our patients! We are grateful for your membership and expertise.

Do you have a challenge you would like to advocate for through our Academy? We want to hear from you! Here’s to the future.