Jacob R. Hascalovici MD, PhD, Division Director of Pain Management, Department of Neurology, Hackensack Meridian Health
Jacob R. Hascalovici MD, PhD, Division Director of Pain Management, Department of Neurology, Hackensack Meridian Health
Jacob Hascalovici, MD, PhD, also known as “Dr. Jacob,” is a board-certified neurologist, interventional pain specialist, neuroscientist, and healthcare innovator dedicated to transforming the future of pain care. He serves as Division Director of Pain at Hackensack Meridian Health at the Hackensack Meridian Neuroscience Institute. Dr. Hascalovici is the cofounder and chief medical officer of Relief Medical Group (Bliss Healthcare; blisshealth.care), a national telehealth platform fully covered by health insurance specializing in at-home chronic pain care. An Associate Professor at Albert Einstein College of Medicine and Hackensack Meridian School of Medicine, he is also a published researcher, frequent keynote speaker, and trusted thought leader featured in outlets such as Forbes, Business Insider, and Healthline.
Through this article, Hascalovici highlights a transformative shift in pain medicine, emphasizing breakthroughs in precision diagnostics and targeted therapeutics that promise more effective and objective pain management.
Pain is one of the most common reasons people seek medical care, yet it remains one of the most elusive to measure objectively and treat effectively. Historically, clinicians have had to rely on subjective reports to assess pain and make therapeutic decisions—often with a trial-and-error approach. However, recent breakthroughs in diagnostics and therapeutics suggest that we are on the brink of a paradigm shift in pain medicine.
The FDA’s recent approval of Journavx, a novel peripheral-acting sodium channel blocker for acute pain, represents a pivotal moment for the field. Unlike traditional analgesics such as non-steroidal anti-inflammatory drugs (NSAID), muscle relaxants, neuropathic agents (like voltage-gated calcium channel blockers), serotonin-norepinephrine reuptake inhibitors (SNRI), or even off-label low-dose naltrexone, Journavx targets the root of pain signaling with an entirely new level of specificity. While the concept of blocking sodium channels is not new—this is, after all, the mechanism behind well-established local anesthetics like lidocaine and bupivacaine—Journavx distinguishes itself by selectively binding to the Nav1.8 sodium channel subtype.
Nav1.8 is highly expressed in peripheral sensory neurons, particularly those involved in pain pathways. This selectivity enhances efficacy and significantly reduces the risk of systemic side effects seen with less targeted sodium channel blockers. Even more exciting is the fact that Journavx is orally bioavailable, allowing for convenient administration, and does not possess the addictive properties that have plagued opioid-based therapies. This development marks the emergence of a much-needed new class of non-opioid pain medications, with the potential to transform the treatment landscape for acute pain— and, hopefully, chronic pain shortly.
But innovation doesn’t stop at treatment. I’m particularly energized by the rapid progress in pain diagnostics, an area that has long remained stagnant. Imagine a world where pain could be seen, localized, and objectively quantified. This is the vision behind Lutroo Imaging (https://www.lutrooimaging.com), a company I’ve been advising since its inception.
Lutroo is developing a groundbreaking PET radiotracer called Radiocaine—a lidocaine analog that, like Journavx, selectively binds to sodium channels implicated in pain states. But Radiocaine is radiolabeled, allowing it to be visualized through PET imaging. In preclinical studies, this molecule has demonstrated the ability to identify injured nerves and correlate radiotracer signal intensity with pain behavior, creating a potential objective biomarker for pain.
With IND approval from the FDA and funding from private investors and the NIH HEAL Initiative, Lutroo is poised to launch its first-in-human clinical trials. If successful, this technology could radically improve clinical decision-making by allowing providers to pinpoint pain generators, guide targeted nerve blocks, inform surgical planning, and objectively measure pain symptoms. For the millions of patients suffering from chronic pain without a precise diagnosis, this could be life-changing.
These developments underscore a broader shift in the pain medicine landscape—from empiric treatment and subjective assessment toward precision diagnostics and targeted therapies. As a neurologist and neuroscientist deeply embedded in this space, I believe we are witnessing the dawn of a new era where pain is no longer invisible, and patients are no longer left to suffer in silence.
The convergence of advanced therapeutics like Journavx and cutting-edge diagnostics like Lutroo’s Radiocaine represents incremental progress and a fundamental transformation in how we understand, diagnose, and treat pain. The future is bright—and for the millions living with pain, it couldn’t come soon enough.
