Pain Management Doctor,  Do You Need One?

Finding a doctor that specializes in pain management is the key to success for many chronic pain patients. 

Once you have not only broken your pain cycle, but start feeling like your old self again, you will realize that you are out of PAIN PRISON and can now focus on becoming active again!

What is a Pain Management Doc?

NEED TO EDIT!!!!!!!!!!

The specialty of Pain Medicine is concerned with the prevention, evaluation, diagnosis, treatment, and rehabilitation of painful disorders. Such disorders may have pain and associated symptoms arising from a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be syndromes in which pain constitutes the primary problem, such as neuropathic pains or headaches. The diagnosis of painful syndromes relies on interpretation of historical data; review of previous laboratory, imaging, and electrodiagnostic studies; behavioral, social, occupational and avocational assessment; interview and examination by the pain specialist; and may require specialized diagnostic procedures, including central and peripheral neural blockade or monitored drug infusions. The special needs of the pediatric and geriatric populations are considered when formulating a comprehensive treatment plan for these patients..

The pain physician serves as a consultant to other physicians but is often the principal treating physician and may provide care at various levels, such as direct treatment, prescribing medication, prescribing rehabilitative services, performing pain relieving procedures, counseling of patients and families, direction of a multidisciplinary team, coordination of care with other healthcare providers and consultative services to public and private agencies pursuant to optimal healthcare delivery to the patient suffering from a painful disorder. The pain physician may work in a variety of settings and is competent to treat the entire range of painful disorders encountered in delivery of quality health care.

The pain physician serves as a consultant to other physicians but is often the principal treating physician and may provide care at various levels, such as direct treatment, prescribing medication, prescribing rehabilitative services, performing pain relieving procedures, counseling of patients and families, direction of a multidisciplinary team, coordination of care with other healthcare providers and consultative services to public and private agencies pursuant to optimal healthcare delivery to the patient suffering from a painful disorder. The pain physician may work in a variety of settings and is competent to treat the entire range of painful disorders encountered in delivery of quality health care.

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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.

Answer: 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 doctor may refer you to pain management if she or he determines that your pain has become out of control.

Pain Management Specialists: What They Do, How to Find One
Doctors 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 physicians: a coordinating physician, 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 physician 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 health care provider should 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 doctors at the pain management clinic you are considering are board certified by going to the American Board of Medical Specialties web site.

Goals of Pain Management
While some types of pain come from primary sources such as headaches, and others from secondary sources 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. And while many patients, especially those in chronic pain, see a psychiatrist or therapist as part of the experience, learning to cope with pain is less and less the focus of treatment.

"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," says Yonan.

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 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 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, says Yonan, 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. 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," Yonan says.

Sources:
Manchikanti, L. MD, Mark V. Boswell, M. MD, PhD., James Giordano, J. PhD Pain Physician 2007; 10:329-356
Personal Interview. Dr. Sameh Yonan, MD, Pain Management Specialist at Hillcrest, Willoughby and South Pointe Pain Centers at Cleveland Clinic Health System
James N. Dillard, MD., DC. CAc. The Chronic Pain Solution: Your Personal Path to Pain Relief Bantam Dell a division of Random House New York 2003