People suffering from back trouble complain that doctors appear indifferent to unbearable pains inflicting them. True, many physicians regard pains as inevitable for some diseases and focus on treatments.

Dr. Ryu Ju-seok, a neuropathy expert, is not one of them. Ryu has recently won the Best Paper award by the Association of Academic Physiatrists of the United States. AAP gives the award once a year to the thesis with the most significant impact in the world.

The reason for citation: the Korean doctor has found the link between different types of pain and medicine effectiveness.

Neuropathy provides a vast research field, but experts have often overlooked neuropathic pain, according to Ryu, an associate professor at Seoul National University Bundang Hospital, south of Seoul. Titled “Symptoms-based treatment of neuropathic pain in spinal-cord-injured patients,” his paper was novel and significant in this regard.

“A common problem in neuropathic treatment is doctors prescribe medication for back pain, and if deemed insufficient, they just add more medication,” Ryu said in an interview with The Korea Bio Medical Business Review Thursday. “As a result, patients often end up taking the unnecessary and undue amount of drugs.”

What inspired Ryu was an article that divided neuropathic pain into seven different categories. “I started to wonder if neuropathic pain symptoms reflected different mechanisms,” Ryu said. “Then I questioned whether these mechanisms indicated a particular phenotype.”

The resultant discovery of the link between “evoked pain” (stimulus-based pain) and medicine effectiveness was a boon for both patients and doctors. Doctors can now prescribe effective medication with less trial-and-error, and patients take less medication to alleviate back pain.

Ryu receives the Best Paper award from Walter Frontera, editor of the American Journal of Physical Medicine and Rehabilitation, during a ceremony organized by the U.S. Association of Academic Physiatrists in Las Vegas, from Feb. 9-11.

The study findings prompted follow-up research by others in the field. Treatment algorithms based on phenotypes (symptoms) and holistic treatment guidelines are the next step, he said.

Ryu divides pain into two categories: resting pain and evoked pain. Resting pain is characterized by prickling, numbness, or “spontaneous pain.” Evoked pain develops after a stimulus, such as light touch, heat, or cold.

“We can also analyze neuropathic pain. If the patient suffers from allodynia (hypersensitivity to stimulus), then we can prescribe opioids, which target the higher spinal cord,” he said. “If the patient has resting pain, then we can prescribe carbamazepine which acts as a sodium blocker.”

Ryu, who has focused on two areas of dysphagia (swallowing problem) and neuropathy, also received the “Earnest W. Johnson excellence in research writing in-training award” for his paper on dysphagia, in 2004.

Asked about how he finds his research topic, Ryu said, “I think all the time. I wonder why a patient presents a symptom. I question the reason, and if I don’t know the reason, then I keep thinking until I find out, which naturally develops into a research topic.”

Research is his profession. The driving force behind Ryu, 42, however is his family. “Motivation is the key for tireless work, and the key to the motivation are my kids,” Ryu said, pointing to a letter on his desk written by his daughter.

“I enjoy my work and life itself,” he said. “Also, I feel honored to get awards, but awards are just the result, not the purpose of research.”

Ryu recently signed a technology transfer contract to make a new medical device for dysphagia. The device will be the first to be produced domestically, probably in a couple of years. Ryu also currently holds two patents undergoing approval.

These days, Ryu is looking to develop new exercises for scoliosis patients, which have been ineffective to date.

A graduate of Ulsan University, Ryu served as an assistant professor at Cha Medical Center in Bundang before moving to the SNU Hospital.

yjc@docdocdoc.co.kr

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