Pain Management Doctor

Kinds of Pain

Pain management doctors work with a variety of types of pain from back pain to hand pain. Different conditions cause different levels of pain. Acute pain, for example, usually has a severe, sudden onset but usually only lasts for a limited period of time. Chronic pain, on the other hand, can come from conditions that worsen gradually or affect you for long periods – even years. While all pain management doctors have experience in treating any kind of pain, many of them focus on working with patients whose pain is chronic or stems from chronic conditions. This is because chronic pain requires more complex treatment plans that must be implemented over a period of weeks or even months.

Pain Management Training

You can expect that a pain management doctor is well educated. Some doctors do not complete any extra training in this area and rely on their learning from medical school, but many seek schooling from organizations that require stringent study in order to be recognized as highly qualified. Doctors who complete such training become recognized as board-certified practitioners, and they are required to continue their education in order to retain their certification. You can also be sure that they have completed medical school, specialized residency training, a specialized certification exam, and specific training in the area of pain management.  

Pain Management Options

Some people worry that pain management doctors will do little more than prescribe pills and are understandably wary in the face of the national opioid epidemic. However, medication is just one of many potential treatments a pain management specialist may consider. The options your pain management doctor will suggest will depend on the kind of pain you are experiencing, the condition from which the pain is originating, and other factors like your pre-existing health, lifestyle, and other circumstances.

Some common treatments that pain management specialists provide include:

• Medication prescriptions for painkillers that cannot be purchased over the counter
• Makes referrals to physical therapy, where a trained physical therapist will use specialized techniques to target your pain
• Orders other therapies to support your pain management, such as electrical stimulation therapy, which treats muscle pain, or even cognitive-behavioral therapy to help you with the mental and emotional aspects of pain
• Performs injections for the treatment of pain symptoms
• Performs minimally invasive nerve blocks
• Makes referrals for surgery if appropriate

Pain Management Patients

The kind of people who require support for pain management vary in age, lifestyle, and health conditions. They usually begin seeking help from a pain management specialist after a referral from their primary care doctor, usually after other attempts at pain management have failed. You may also receive referrals to a pain management specialist after certain procedures like surgery and from other specialists like neurologists, oncologists, or surgeons. 

If you are experiencing chronic pain or have a serious chronic condition that causes significant, long-term pain, you should consider seeking a referral to a pain management doctor. These specialists have training in diagnosis and treatment that primary care doctors and other specialists may lack. If, however, surgery is required for pain relief, your pain management specialist will refer you to another specialist.

Preparing for a Pain Management Specialist

Documentation

This is especially important for anyone dealing with a chronic pain condition. You should gather any documentation related to your condition that you have from previous doctors. This could include patient summaries, test results, a list of medications that you are currently taking or have taken in the past, and anything else that you think might be relevant for your pain management specialist to see. Do not assume that your pain management doctor already has access to this information.

Ask Questions

It is a good idea to write down any questions you have as they come to you, even if they come to mind weeks in advance of your appointment. You can do this by keeping a list in a notebook that you keep nearby or by adding a note in the notes app on your cell phone. There is nothing worse than having a great appointment but realizing days later you forgot to ask about something you have been worrying about!

Pain Journal

Ahead of your first pain management specialist, it can be helpful to keep a pain journal that tracks the extent of your pain and other symptoms, as well as relevant information like the amount of sleep you had the night before or the foods you ate. This kind of information can help your pain management specialist find patterns in your flare-ups and can help them make a more informed decision about the next steps. 

Here is how to keep a pain journal:

1. At the end of each day, rate your pain from 0 to 10, with 0 being pain-free and 10 being extreme pain. Children experiencing pain can use a simplified version of this, such as the Wong-Baker FACES Pain Rating Scale, which you have most likely seen in a doctor’s office.
2. If you have experienced pain that day, use descriptive language to explain where and how the pain occurred. Words like burning or sharp or dull can help your pain management specialist narrow down the potential culprits at work.
3. If possible, try to write down the time of day your pain occurred, as well as the length of time you experienced it.
4. If your pain worsens or improves with certain activities, be sure to note it. Does sitting for a long time aggravate your lower back? Does doing a yoga class help with the tension in your shoulders? Write it down.
5. To the best extent possible, include what you ate and drank that day as specifically as you can. It is especially important to take note of certain things like consumption of caffeine and alcohol, as these are known triggers for pain.
6. Note your mood. Stress and anxiety can make the pain worse, and any intense emotion can cause your pain to flare up

What to Expect During Pain Management Appointment

Before making an official diagnosis, your doctor will first want to discuss your pain with you. They will ask you questions about the extent of your pain, the frequency, the average level of pain you experience, and other information that can help them determine your diagnosis. Your doctor may need bloodwork or other kinds of tests to be completed.

Some of the tests that pain management doctors use to help them make a conclusion about your pain are:

• Imaging – includes x-rays, MRI scans, and CT scans, helps doctors see “inside” your body
• Lab work – may require taking blood or other tissue from your body to be sent to a lab and more closely examined for specific information
• Certain studies of your muscles and nerves – can measure the speed at which your nerve sends messages to your brain or how your muscles respond to stimuli
• Neurological exams – study how your brain works with the rest of your body to perform certain functions
• Pain surveys – these are a series of questions that help doctors understand specific information about your pain

You may be expected to visit your doctor multiple times before a diagnosis is made or before a solid treatment plan can be created. This is because most pain conditions are complex and involve multiple body systems, and even though medicine has made enormous advancements, every person’s body is different, and their pain and health conditions can manifest in different ways.

Pain-Related Conditions

There are several categories of common conditions that may cause or are correlated with chronic pain. These are arranged into groups according to the cause of the pain.

Tissue Injuries

Your body tissue is any group of similar cells that perform as a single unit. Blood, bone, muscle, and adipose (fat) are all examples of the kinds of tissues that exist in your body. Injuries to your tissues can cause extended periods of pain that require specialized treatment.

• Arthritis and other forms of joint pain are caused by damage to cartilage and other connective tissues that hold your bones together
• Some cases of myofascial pain syndrome, which affect the fascia, or muscles, in a particular area of the body, can cause long term chronic pain

Disorders of the Nervous System

Nerve damage and other disorders related to your nervous system can cause a significant amount of damage. Sometimes, the nerves that report pain to your brain send mixed signals, or sometimes they are over- or under-sensitive in a way that results in chronic pain.

• Fibromyalgia is a poorly understood condition that causes widespread body pain and is thought to be related to dysfunction of the central nervous system
• Strokes, which affect the brain, can cause around 10% of patients to develop a painful condition called post-stroke pain
• Injuries to the spinal cord can cause long term pain
• Multiple sclerosis is characterized by the degeneration of the spinal cord and can be extremely painful