Department

Pain management is a branch of medicine that applies science to the reduction of pain. It covers a wide spectrum of conditions, including neuropathic pain, sciatica, postoperative pain, and more. Pain management is a rapidly growing medical specialty that takes a multi-disciplinary approach to treating all kinds of pain. Dr. Sameh Yonan, a pain management specialist at the Cleveland Clinic, says: "We evaluate, rehabilitate and treat people in pain." Your healthcare provider may refer you to pain management if your pain is ongoing or significant.

Pain Management Specialists

Healthcare providers who specialize in pain management recognize the complex nature of pain, and a pain doctor "approaches the problem from all directions," Yonan said. Ideally, treatment at a pain clinic is patient-centric, but in reality, this may depend on the available resources of the institution. Currently, there are no established standards for the types of disciplines that must be included, and this is another reason why treatment offerings will vary from clinic to clinic.

But at the very least, experts say that a facility should offer to patients three types of healthcare providers: a coordinating practitioner who is specialized in pain management, who provides consultation to specialists on your behalf; a physical rehabilitation specialist; and a psychiatrist, to help you deal with any accompanying depression or anxiety, especially if you have chronic pain.

Other medical specialties represented in pain management are anesthesiology, neurosurgery, and internal medicine. Your coordinating healthcare provider may also refer you for services from occupational medicine specialists, social workers and/or alternative and complementary medicine practitioners.

To qualify as a pain management specialist in the eyes of the American Board of Medical Specialties, a healthcare provider should have completed additional training and credentialing in pain medicine and be an MD with board certification in at least one of the following specialties:

Anesthesiology

Physical rehabilitation

Psychiatry and neurology.

Dr. James Dillard, an assistant professor of medicine at Columbia University College of Physicians and Surgeons, says that the pain management physician should also have her or his practice limited to that specialty in which they hold the certification. You can check to see if the healthcare providers at the pain management clinic you are considering are board-certified by going to the American Board of Medical Specialties website.3

Goals of Pain Management

While some types of pain can be chronic, such as headaches, and others acute, such as from surgery, the field of pain management treats all of it as a disease. This allows for the application of science, and the latest advances in medicine to relieve your pain.

"We now have many modalities, including medication, interventional pain management techniques (nerve blocks, spinal cord stimulators, and similar treatments), along with physical therapy and alternative medicine to help reduce the pain.

The goal of pain management is to minimize pain, rather than eliminate it. This is because quite often it is not possible to completely do away with it. Two other goals are to improve function and increase the quality of life. These three goals go hand-in-hand.

As a first-time patient in a pain management clinic, you might experience the following:

Evaluation.

Diagnostic tests, if necessary, as determined in the evaluation.

Referral to a surgeon, if indicated by the tests and evaluation.

Interventional treatment, such as injections or spinal cord stimulation.

Physical therapy to increase range of motion and strength, and to prepare you to go back to work.

Psychiatry to deal with depression, anxiety, and/or other issues that may accompany your chronic pain.

Alternative medicine to provide a complement to your other treatments.

Back and neck pain sufferers who do best with a pain management program are those who have had multiple back surgeries, including failed surgeries, and are still in pain, those with neuropathy, and those for whom it has been determined that surgery would not benefit their condition.

"People who have become addicted to pain medication actually need more sophisticated help than what a pain management program can offer them. A chronic pain rehab program is a better choice for these people," he says.

According to Pain Physician, results from research studies on pain management are not always applicable to the problems patients come in with to the clinics on a day-to-day basis.5 Unfortunately, this has a negative effect on insurance reimbursement and other payment arrangements, as well as standardization of this medical specialty.

"Better understanding of pain syndromes by communities and insurance companies and more studies on pain will help increase insurance coverage for pain management treatments. In the future, the use of technology will help improve the outcomes of interventional pain management techniques.