20 April 2020

MIRROR Program’s Pain Management Expertise Sought in Response to COVID-19 Pandemic

Best practices for pain medicine physicians during COVID-19 featured on cover of ‘Pain Medicine’, the official journal of the American Academy of Pain Medicine


Dr. Steven P. Cohen, an investigator for the Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) program, and his colleagues were asked to provide best pain management practices during the COVID-19 pandemic. Recommendations from the team and additional collaborators will be published in Pain Medicine as the cover page in the July 2020 issue. MIRROR, managed by The Geneva Foundation (Geneva) in partnership with the Uniformed Services University of the Health Sciences (USU), provides critical infrastructure, operational and research support to advance the treatment and preventive care for service members with non-combat related musculoskeletal injuries (MSI).

The COVID-19 pandemic has strained medical resources across many different types of practices which presents a unique set of challenges for physicians treating their patients while limiting the spread of the novel virus. According to the publication, “The COVID-19 pandemic represents an unprecedented global health crisis that requires carefully weighing the dynamic balance between access to pain care, which can have long-term personal and socioeconomic benefits, with the immediate goal of minimizing exposure risk for frontline healthcare providers and vulnerable patients.”

The recommendations made by Dr. Cohen and his peers from the military, Veterans Health Administration, and academia provide a framework for pain practitioners to address risk mitigation for patients and health care providers, conservation of resources, and access to pain management services. Specific issues discussed include general and interventional-specific risk mitigation, patient flow issues and staffing plans, telemedicine options, triaging recommendations, strategies to reduce psychological sequelae in health care providers, and resource utilization.

The article was reviewed and endorsed by the American Society of Anesthesiologists (ASA) American Academy of Physical Medicine and Rehabilitation (AAPMR), American Society of Regional Anesthesia & Pain Medicine (ASRA), American Academy of Pain Medicine (AAPM), Spine Intervention Society (SIS), North American Neuromodulation Society (NANS), and the World Institute of Pain (WIP). The Pain Management Specialty Leaders for the U.S. Army, Navy, Air Force and VA Health Administration also participated in these guidelines.

Dr. Brad Isaacson, Chief of Research & Operations for MIRROR and a Geneva Principal, commented, “Dr. Cohen’s expertise in pain management was instrumental in the quick turnaround of this important article.” Dr. Isaacson added, “Pain management is a main reason people seek medical care. We are pleased to support this collaborative effort during this unprecedented global health crisis.”

MIRROR supports a broad scope of projects, including epidemiological investigation, investigator initiated pilot trials, and prospective randomized multisite clinical trials. Areas of clinical evaluation will comprise general MSI care process models and highly prevalent anatomically-specific (e.g. back, knee, shoulder pain, etc.) targeted interventions with protocols examining effective return to running and return-to-duty activities.

In addition to his role at MIRROR, Dr. Cohen serves Professor of Anesthesiology & Physical Medicine & Rehabilitation, USU, Professor of Anesthesiology & Critical Care Medicine, Neurology, and Physical Medicine & Rehabilitation, Johns Hopkins School of Medicine (JHU), and Chief, Pain Medicine Division & Director of Pain Medicine Clinical Operations, JHU.