As the medical field has expanded and the complexities of pain have become more well-known, pain management physicians have become more available to patients. Pain management is a specialty that requires additional training and education surrounding pain. Physicians that pursue this route in their medical career play an important role in bringing quality of life to patients who are suffering. Pain management doctors are experts in the following:
- Having an in-depth knowledge of the physiology of pain
- Specialty procedures such as nerve blocks, epidurals, spinal cord stimulation, and other interventional methods
- Ability to evaluate patients with complicated pain problems
- Understanding specialized tests used in diagnosing pain conditions
- Coordination of additional care such as physical or psychological therapy
Doctors are able to practice pain management after obtaining a bachelor’s degree from four years of premedical studies, an MD or DO from four years of study at a certified medical school, and four years of residency in anesthesiology or physical medicine and rehabilitation. Many pain management doctors also complete fellowships; additional training beyond residency. Many fellowship programs are associated with anesthesiology residency programs, however, there are fellowships associated with neurology and physical medicine and rehabilitation residencies as well. Fellowships provide at least one additional year of training in pain management. After residency and fellowship training have been completed physicians are able to obtain board certification in their primary specialty. At this point, physicians are also eligible to obtain sub-specialty board certifications if they choose. These would include certifications from The American Board of Neurology, The American Board of Psychiatry, or The American Board of Physical Medicine and Rehabilitation.
Seeing a Pain Management Specialist
Patients are typically referred to pain management specialists through their primary care physician. It is important to find a pain specialist with the training and experience to help treat the patient’s problems. Pain can come in many forms. Some patients find themselves dealing with acute pain lasting only three months as a result of an injury while other patients may experience things like chronic back pain lasting for years. Underlying conditions such as diabetes, arthritis, or neurological conditions can also cause pain. Finding a doctor with the training and experience that is most relevant to the patient’s current situation is ideal.
After a referral is made, patients will meet with their pain management physician for a consultation-type appointment. The patient and doctor will discuss the problem at hand, go through a detailed account of the patient’s medical history, and ultimately, get to know each other. The information discussed in this first appointment is critical for the pain management physician to accurately analyze, diagnose, and treat the patient properly. There are a wide variety of interventional treatments that pain specialists can offer, from steroid injections done in-office to more advanced surgical procedures.
It is also important for both the patient and the doctor to build rapport and feel comfortable with each other. Patients should feel comfortable asking questions and getting to know the doctor just as much as the doctor is getting to know the patient. Patients should ask about the doctor’s experience with their specific condition, the types of treatments offered, and get to know their overall philosophy regarding pain management. Pain management doctors should also maintain relationships with the patient’s primary care physician and any other doctors they refer out to, such as rehabilitation therapists or clinical psychologists. Pain management is a growing specialty and a critical part of the medical community.
Interventional Pain Management Treatments
Due to the nature of this specialty, there are many treatment options offered to patients of pain management doctors that are not offered in other specialties. Pain management physicians may refer their patients to additional specialists such as physical or occupational therapists, but the treatment received from pain specialists is truly one of a kind. Pain management treatments include:
- Ozone therapy: Also known as chemical acupuncture, ozone therapy uses radioscopic control to insert a needle and inject an oxygen-ozone gas mixture into the intersomatic space. One study of 63,000 patients showed 80% of participants saw a reduction in pain as a result of this treatment.
- Spinal cord stimulation: This procedure has been used by pain physicians since 1960’s with 50%-80% of patients experiencing long-term relief. The permanent implantation includes using fluoroscopy to feed thin wires called electrodes to the epidural space in the spine. These electrodes output electrical impulses that interrupt pain signals and therefore, provide pain relief.
- Deep brain stimulation: This has been used in the field of pain management since the 1970s. Similar to the spinal cord stimulation procedure, deep brain stimulation uses electrodes to control pain. An electrode is placed in the brain that is controlled by a small generator. The generator sends electrical impulses to the electrode to regulate abnormal impulses that cause pain.
- Nerve blocks: Nerve blocks are a minimally invasive way to treat pain. Nerve blocks are administered via injections of numbing substances that numb the patient’s pain. These blocks can be administered in the face, forehead, pelvis, abdomen, back, and jaw.
The specialty of pain management has greatly benefited the medical community. These physicians are experts in their field. From spinal surgeries to in-office injections, this specialty has proven to be successful in bringing patients their quality of life back.