Pain affects everyone differently. What causes pain for one person may not cause pain for another person. What works on pain for one person may not work on pain for another person. While many people may suffer from a painful condition such as arthritis, there are varying degrees of said conditions.
Today, more than ever before, people are being referred to pain management specialists. While this may seem like a huge surge in people living with chronic pain, consider how quickly the population has grown over the last several decades and how modern medicine has advanced in recent years.
When put into perspective, it only makes sense that more people are being diagnosed with chronic pain issues. There are many solutions to chronic pain and most of them aren’t as bad as one may think.
What Exactly Can A Pain Management Specialist Do?
A pain management specialist is educated in helping their patients relieve pain. They have a variety of ways to relieve this pain including pain medications which may or may not be narcotic in nature, they may also recommend exercise, behavioral therapy, biofeedback and even injections into the area that is in pain.
For the over 50 million Americans today who are struggling with issues of chronic pain, leading a normal life may seem like an elusive dream. Enjoying the things that they once enjoyed may be but a faded memory.
The pain specialist will evaluate the patient’s condition including what led up to the pain condition. They will also ask questions regarding the type of life the person led before they became injured or acquired a chronic pain condition.
The pain specialist will take a modern approach to help the person manage their pain and regain as much of their life as they possibly can.
The specialist is highly trained in understanding the conditions that cause pain, diagnosing any underlying conditions and finding a way for their patients to manage the pain. They deal with a variety of conditions including cancer, chronic regional pain syndrome (CRPS), Reflex Sympathetic Dystrophy (RSD), arthritis and other pain diseases.
Pain conditions may also arise due to an injury, metabolic issues like diabetes or even due to a surgical procedure. Sometimes the pain may not even have an obvious cause. Whatever the reason, these specialists are highly trained to treat said conditions.
As more treatment protocols are refined more doctors are turning to newer forms of treatment for their patients. These doctors are undergoing constant training in new medications, new protocols to treat pain and other forms of treatments.
Doctors will utilize specific testing methods to help diagnose pain and help them to determine the right solution for each individual patient’s pain condition. What works for one person’s pain may not work well for another patient even if the two patients have the same condition.
Since everyone reacts differently to medications and pain it is important for the doctor to fully assess the individual and their reaction to specific medications. For this reason the doctor may have to try out a few different pain treatments before the right pain treatment is discovered.
What Is The Role Of A Pain Clinic?
The pain clinic is a highly specialized clinic that is open to help treat pain in their patients. They may have an entire team of professionals including counseling personnel, doctors, exercise therapists, biofeedback technicians and more.
Individuals who use a pain clinic will have an array of therapists and doctors to assist them in regaining control of their life and of their pain. The ultimate goal will be to help the person cope with said pain and return to as normal lifestyle as they possibly can.
An individualized plan will be agreed upon with the health care team and the patient so that the patient can return to their life.
How Does A Patient Get A Referral To A Pain Management Specialist?
A patient must first see their regular family doctor or primary care physician. The primary care physician will determine whether or not the patient should be referred to a pain management specialist.
If the family physician or primary care physician determines that the patient needs a pain specialist he or she will then give the patient a referral to a pain management specialist.
The referring doctor may go ahead and schedule the appointment, they may have the pain specialist’s clinic call and set an appointment or they may give the patient the pain management specialists name and number and a referral and have the patient call to schedule the appointment.
What Are Some Typical Methods Of Pain Management?
Once the patient is seen by a pain management specialist, the patient will have a variety of options available that the pain specialist will discuss with him or her. The pain specialist will lay out the options and often the patient may select from a few options that the specialist recommends.
These options may include one or more of the following. The patient may have the option of taking a medication such as a non-aspirin pain reliever such as acetaminophen. They may recommend ibuprofen which is an NSAID or non-steroidal medication.
NSAIDS are anti-inflammatory so often can help to reduce inflammation. If there is more severe inflammation the doctor may prescribe a corticosteroid such as cortisone.
There has also been a recent surge in medical marijuana. Many patients suffering from pain are turning to such alternative therapies with mixed results.
For severe pain a doctor may give the patient something more potent such as an opioid medication like morphine. These are usually reserved for patients who are undergoing some form of cancer treatment or other major issues.
Although anti-depressants are used in treating depression, they also have a place in helping to relieve some types of pain and insomnia. By helping the patient to sleep better the body can sometimes heal more quickly and deal with the pain.
If the above methods aren’t working for the patient, there are also injections of local anesthetics that may work for a period of time to help alleviate pain. Depending upon the condition, this may or may not have to be repeated. This may be a cortisone injection at the site of the pain or it may be another form of medication.
Sometimes doctors opt for a nerve block into the ganglion or plexus which can help to block the pain in the region where it is occurring. This also may have to be repeated at intervals depending upon the severity of the condition and the patient’s own personal tolerance to pain.
Physical therapy may help some patients to regain mobility and aquatic therapy may also be a form of therapy that is also utilized for some specific conditions. Often keeping the body in motion may help to alleviate a portion of the pain and thus help the patient to deal with their pain in a positive fashion.
A TENS machine, trans cutaneous electrical nerve stimulator, may help by putting a small electrical charge to specific nerves to which it is attached. Small electrodes will go from the small portable machine on leads to the body area that is in pain.
These electrodes will hook up to patches on the skin that will help to conduct the electric impulse to the nerve. The patient can dial it up higher for more of a jolt of electricity or they can dial it down for a lower dose. These machines run on a battery and can be worn on the belt or simply held in the lap.
Heat and or cold therapy may help some patients to regain their mobility and reduce pain. Many patients will use this as an additional form of treatment for their pain if their condition flares up.
Some pain management specialists will suggest acupuncture where the doctor will insert a very fine needle at a specific site on the body to help ease pain.
There are also many forms of counseling that the doctor may recommend for the patient including psychological counseling or simply counseling in general to help the patient accept life as it now is.
Occasionally surgery is required to reduce pain. The surgeon will relieve the pain or pressure on specific nerves so that the patient can return to a more normal life.
Relaxation is another way to help the patient deal with pain by reducing their stress level and teaching the patient to use biofeedback.
Finding A Good Pain Clinic
Although the primary care physician will refer the patient to the pain clinic, patients may wish to do some research on their own and ask for a specific referral from their primary care physician.
To find this information patients can seek out a local hospital or medical center. They can call the facility and ask them if they can recommend a pain specialist that specializes in a specific condition.
Medical schools often have a referral system that will not only help the pain patient learn to manage their pain, but will also help students who are seeking to work in pain management a way to learn more about pain management.
Larger sized cities may have a pain management group that meets weekly or they may even have advocates for pain patients that can assist patients in locating a good pain management specialist.
It’s important to note that not all facilities will offer the same forms of treatment. If a specific treatment is desired it is best to call ahead and talk to the staffing and find out what sorts of methods are used in the clinic in question. Write out a list of questions before calling to ensure that all of the questions are answered.
Some clinics offer a consultation appointment whereby the patient can ask these questions and get to know the doctors that would be helping them.
This is a good way to meet the doctor and evaluate whether or not it’s a good patient to doctor fit and vice versa. If it’s not a good fit, keep searching. If it is a good fit the patient can schedule the next appointment and begin the journey to becoming pain free.
What To Look For In Pain Management Specialists
Obviously a patient will want a pain management specialist that they feel comfortable working with. They will want a specialist that has the training and know how to understand and help them deal with their pain.
Since there are so many different types of pain conditions, patients may have to do a bit of research to find the right specialist for their specific condition. If the pain condition is known when scheduling the first appointment make sure to mention it so that the doctor will have that information on hand.
The pain specialist should be well versed in dealing not only with the patient, but also the patient’s family as many patients hurt too badly to drive and thus rely upon family to take them to appointments.
Find out where the specialist was trained and how long they’ve been certified. Ask what their philosophy is on medication, do they rely heavily upon it or do they prefer to start out with physical therapy and other methods of treating pain?
Ideally, the pain management specialist will have had some training as a “fellowship”. A fellowship is a yearlong education whereby the doctor will undergo more training in pain management. It can even last longer than one year.
The doctor will learn more techniques and bedside manners and it will greatly enhance their educational experience.
Additionally, patients will want to ask what sorts of treatment the doctor tends to favor for what conditions. Do they offer referrals if the patient needs further care? Is there a number that the patient can call if they are having problems or the pain medications aren’t helping on a holiday or weekend?
Here are some typical things to evaluate when considering a potential pain management specialist:
- How does the staff treat patients? (Observe in the clinic when waiting to be called and note when on the phone how the receptionist treats the patient on the call).
- What is the clinics philosophy on treating pain?
- Does the clinics philosophy line up with the patients philosophy?
- Does the pain management specialist work with the patient on creating a treatment plan?
- Does the pain management specialist give individualized treatments?
- How does the pain management specialist and the other office staff treat family members?
- Will the pain management clinic send copies of their records to the primary care physician (this should always be a yes)?
- Will the clinic communicate with the patient’s family as required?
- How does the clinic monitor progress?
- If a new treatment protocol is being undertaken will someone from the clinic do a follow up in a few days to see if it’s working?
The answers to these questions can go far in helping a patient to determine if this is the right pain management doctor and clinic for them.
If at any time the patient feels uncomfortable or that the doctor or clinic isn’t a good fit they should immediately discuss this with their care providers and find a quick resolution.
Keep in mind that pain can often distort how a patient perceives things so always take this into account when feeling uncomfortable with a care provider.
What Happens During The First Visit To The Pain Specialist?
The first visit to the pain specialist is a time for the patient and the pain specialist to get to know one another. During this visit the pain specialist will do a complete evaluation of the pain condition.
They will usually ask for a detailed history and review any information that has been sent over from the referring doctor. They will focus on the pain issue and ask about anything unusual in the history.
The patient will have plenty of opportunity to ask questions during this visit.
The patient will be asked to fill out a medical questionnaire at the time of the visit or the questionnaire may be mailed to the patient ahead of time to fill out.
The referring doctor will usually send over any X rays, CT scans; MRI scans and so on as well as the results of any tests that have already been run. Occasionally the patient will be the one to take these to the pain specialist. It will depend a lot on the specific policy of the two clinics involved.
When scheduling the appointment find out if any specific testing will be done so that if unable to drive arrangement can be made for a driver.
After this first appointment a plan will be determined and discussed with the specialist and the patient and a treatment protocol will be arranged.
This first appointment is the perfect time to evaluate the pain specialist and the clinic. If it does not seem like the right fit it’s time to ask for a second opinion or call the primary care physician and see if there is another pain management specialist that can be arranged for.
Further reading:
http://www.webmd.com/pain-management/guide/pain-clinics-overview
https://www.asra.com/page/44/the-specialty-of-chronic-pain-management
