After more than four decades working across anesthesiology and clinical pain management, Jordan S. Fersel, MD, has come to view chronic pain less as a single mechanism and more as a complex system that unfolds over time. According to him, much of his current work is shaped by thousands of patient encounters and years spent observing recurring diagnostic features and treatment outcomes. “When you see enough patients over enough years, patterns begin to emerge,” Dr. Fersel explains. “Repetition in clinical practice can reveal gaps that textbooks and instruction do not always address.”
Dr. Fersel’s medical background spans traditional anesthesiology training and extensive work in interventional pain settings. Earlier in his career, he conducted various independent medical evaluations following workplace injuries and motor vehicle accidents. From his perspective, this period provided an unusual window into chronic pain recovery trajectories. “It felt like I was experiencing a long-term case study in real time,” he says. “Seeing the same injury patterns persist over time pushed me to question why pain continues for so many patients long after the structural issues appear to be resolved.”
That reexamination eventually led him to ask deeper questions about pain management. Dr. Fersel explains that imaging tools such as MRIs can identify structural abnormalities, but they do not always explain persistent patient symptoms of pain. He notes that studies have shown that some individuals have evidence of herniated and bulging discs without pain, while others can experience severe discomfort without obvious structural damage on MRI. “This disconnect raised broader questions about how clinicians interpret sources of pain,” he says. “If imaging doesn’t always explain what the patient is experiencing, then perhaps something else may be contributing.”
Over time, Dr. Fersel focused closely on the peripheral nervous system. He suggests that nerve irritation or inflammation outside the central nervous system (brain and spine) could play a larger role in persistent pain than is sometimes recognized due to the microscopic nature of the damage. According to him, these nerves often pass through tight anatomical spaces, where injury or strain could contribute to ongoing inflammation and sensitivity. “There are far more nerves in the body than the large ones we typically focus on,” Dr. Fersel says. “Identifying these areas often requires hands-on clinical assessment rather than imaging alone.”
His approach draws on techniques he learned during anesthesia training, including targeted nerve blocks. While these methods are traditionally used for surgical anesthesia, Dr. Fersel believes they may also help reduce localized inflammation around irritated nerves. “The same principles we use to temporarily block pain during surgical procedures can also be applied therapeutically,” he says. ” Over time, my clinical experience has shaped how I adapt these techniques for outpatient pain care.”
This perspective emerges at a time when chronic pain remains a widespread public health issue. In 2023, The New York Times reported, citing CDC data, that more than 50 million adults in the United States live with chronic pain, highlighting the scale of demand for effective long-term pain management strategies. While Dr. Fersel emphasizes that his views reflect personal clinical experience rather than large-scale trials, he believes the growing prevalence of persistent pain underscores the importance of continued discussion and exploration.
Dr. Fersel has also begun expanding into education. He recently developed online coursework designed for healthcare-adjacent professionals and individuals seeking to better understand pain mechanisms and physiology. According to him, these resources are intended to help broaden awareness rather than replace conventional medical treatment. “Education is one way to start conversations that otherwise might not happen,” he says.
In addition to his clinical work, Dr. Fersel has also authored a book, When Bad Backs Happen to Good People, where he outlines his perspectives on pain mechanisms and physiology and shares observations drawn from decades of patient care. Looking ahead, Dr. Fersel explains his goals in practical terms. While growing his patient base remains important, he says, broader impact matters more. “If I retire and these ideas are not brought to light, then there’s no benefit to having made these observations,” he explains. “My priority is encouraging dialogue around underexplored contributors to pain.”
For Dr. Fersel, the future of pain care may depend less on certainty and more on continued inquiry. “Medicine doesn’t have all the answers,” he says. “But if clinicians remain open to reexamining what they think they know, patients may ultimately benefit from more targeted approaches.”
