Pain Management Center
A pain medicine specialist is a medical or osteopathic doctor who treats pain caused by disease, disorder, or trauma. Although called pain medicine or interventional pain management specialists, many of these doctors are anesthesiologists or physiatrists. Pain medicine is a mutlidisciplinary team effort often involving the patient's primary care physician or other treating doctor, and specialists in radiology, psychiatry, psychology, oncology, nursing, physical therapy, complimentary alternative medicine, and other fields.
Education and Training
After graduating medical school and completing a one-year internship, the doctor enters a residency program typically in anesthesiology or physical medicine but sometimes from other fields such as neurology and psychiatry. Upon completion of a residency program (typically 3 years long), the doctor completes a one-year fellowship for advanced training in pain medicine.
Many pain medicine specialists are board certified. The organizations that board certify anesthesiologists, physiatrists, neurologists, and psychiatrists all cooperate to provide the board examination for the subspecialty of Pain Medicine. Pain medicine specialists continue their medical education and training throughout their careers. There are many opportunities for pain management specialists to stay current with technical and medical advances in pain medicine, such as society meetings and scientific journals.
Goals of Pain Management
The goal of pain medicine is to manage acute or chronic pain by reducing pain frequency and intensity. Besides addressing pain issues, a multidisciplinary pain management program may address your functional goals for activities of daily living. Overall, a pain medicine program aims to give you a feeling of well-being, increase your level of activity (including return to work), and reduce or eliminate your reliance on medication.
Many Types of Pain Treated
Pain medicine specialists treat all types of pain. Acute pain is described as severe or sharp and may signal something is wrong. The pain experienced during dental work is an example of acute pain. Pain lasting 6 months or longer is defined as chronic. This type of pain varies from mild to severe and is consistent. Spinal arthritis (spondylosis) pain is often chronic. Although chronic pain is difficult to manage, combining different treatments often produces a good outcome.
- Degenerative disc disease
- Facet joint pain
- Cervical and/or lumbar spinal stenosis
- Vertebral compression fracture
What to Expect During an Appointment
Your appointment with a pain or interventional pain management specialist is much like other doctor visits. Although there are many similarities, the focus is on your pain, the cause or contributing factors, and quickly managing it.
Pain medicine doctors perform a physical and neurological examination, and review your medical history paying particular attention to pain history. You may be asked many questions about your pain, including:
- On a scale from zero to 10, with 10 being the worse pain imaginable, rate your pain.
- When did pain start? What were you doing when pain started?
- Does pain spread into other areas of the body?
- Is its intensity constant, or is it worse at different times of the day or night?
- What helps to relieve the pain? What makes pain worse?
- What treatments have you tried? What worked? What failed?
- Do you take over-the-counter medications, vitamins, or herbal supplements?
- Do you take prescription medication? If so, what, how much, and how often?
Most pain medicine specialists use a standardized drawing of the front/back of the body to enable you to mark where pain is felt, as well as indicate pain spread and type (eg, mild, sharp). You may be asked to complete the form each time you visit the pain doctor. The completed drawing helps to evaluate your treatment progress.
Accurate Diagnosis Key to Treatment
Pain medicine involves diagnosing the cause or origin of pain. Making the proper diagnosis may involve obtaining an X-ray, CT scan, or MRI study to confirm the cause of your neck pr back pain. When treating spine-related pain (which may include arm or leg symptoms), other tests, such as discography, bone scans, nerve studies (electromyography, nerve conduction study), and myelography may be performed. The correct diagnosis is essential to a successful treatment plan.
Some spinal disorders and pain treatment requires involvement of other specialists, such as your primary care physician, neurosurgeon, orthopaedic surgeon, and practitioners in radiology, psychiatry, psychology, oncology, nursing, physical therapy, and complimentary alternative medicine. The pain medicine specialist may consult with and/or refer you to a neurosurgeon or orthopaedic spine surgeon to determine if your pain problem requires spine surgery.