Steven P. Cohen, MD, an international leader in pain medicine who recently joined Feinberg’s faculty as the first Edmond I. Eger Professor of Anesthesiology and Vice Chair for Research and Pain Medicine, works to foster collaborations to advance pain medicine through new targeted treatments and precision care strategies.
Since joining the Feinberg faculty this summer, Cohen has focused on creating cross-departmental research collaborations across Feinberg, including in the Ken and Ruth Davee Department of Neurology, the Department of Physical Medicine and Rehabilitation, the Department of Psychiatry and Behavioral Sciences, and the Department of Neurological Surgery.
Cohen is also a retired U.S. Army colonel and was deployed four times in support of operations in Bosnia, Iraq, and Afghanistan. His research supported the passage of the Military Pain Care Act of 2008, and he was a founding member of the U.S. Army Medical Advisory Board. In 2024, he organized and chaired the largest pain conference in Ukraine since the start of the Russia-Ukraine war.
Cohen is also director of pain research and adjunct professor at Walter Reed National Military Medical Center of the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and president-elect of ASRA-Pain Medicine, the largest pain organization in the United States.
Read a Q&A with Cohen below.
What is painkiller?
It is a specialized discipline that focuses on the prevention and treatment of pain and affects almost all medical specialties. Poorly managed acute pain becomes chronic pain and is one of the main reasons why people seek medical help.
Pain is made up of different components. There is the sensory component called sensory-discriminative, an emotional component called affective-motivational, and a cognitive component called cognitive-evaluative. There are efforts to measure things like depression, anxiety, fear, and somatization and find out how they contribute to pain.
How has your work changed the field of pain medicine?
In some ways, the research efforts and international guidelines I have led have helped transform pain management worldwide. These include the first description and randomized trial of radiofrequency ablation of the lateral branch for sacroiliac joint pain, the development and validation of the IV ketamine test and cervical non-organic signs, conducting the first trials of the use of injectable cytokine inhibitors in chronic pain, and, when Congress mandated it in the National Defense Authorization Act (NDAA) of 2014, leading the widely publicized study showing that compounded pain creams are ineffective for chronic pain.
In response to the 2024 NDAA, we are working on new treatments for PTSD, traumatic brain injury, and post-amputation pain, and just submitted the first study to treat the latter for war injuries in Ukraine. As a follow-up to our cover article in The Lancet that highlighted the most common reasons for medical evacuation of people from Iraq and Afghanistan and their return-to-duty rates, I helped Lt. Col. Ron White open the first pain clinic in a war zone. I also led or co-led international guidelines on the treatment of lumbar and cervical facet arthritis (spine) and ketamine for pain management.
Where is the journey going in the field of pain medicine?
One area our group is currently focusing on is precision medicine, and we are starting to look at predictors of health outcomes. Precision medicine positively changes the risk-benefit ratio of invasive and expensive procedures and, more importantly, it positively changes the cost-benefit ratio. This is the direction medicine is heading in, and this is the direction pain medicine must go in, because the results of pain medicine are subjective and the results of studies are often contradictory.
There is also a big movement towards regenerative medicine, which my group is involved in. In most cases, the cause of pain is wear and tear or natural degeneration, and therapies such as platelet-rich plasma or stem cells could potentially change the course of treatment; however, the evidence for this is currently weak. Another focus is finding animal models that translate better to humans, because when we test treatments in animal models, we are not really measuring pain. Instead, we are measuring behaviors that may or may not be associated with pain, and these models also do not take into account the “affective” and “cognitive” components.
What are you most looking forward to at Feinberg?
I am an instructor in the departments of neurology, psychiatry and behavioral sciences, and neurosurgery, so I will hopefully be collaborating across departments on our upcoming studies. I also continue to work at Walter Reed National Military Medical Center in Bethesda. I also hope to soon be approved to volunteer at the Jesse Brown VA Medical Center so I can treat veterans here in Chicago. I am very excited to work with and continue to mentor my outstanding group of attendings and fellows to advance the field of pain medicine.
