Pain management can be simple or complex, depending on the cause of the pain. An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down the leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. sometimes, the pain does not go away. This can require a wide variety of skills and techniques to treat the pain to include interventional procedures, medication management, physical therapy or chiropractic therapy, psychological counseling and support, acupuncture and other alternative therapies; and referral to other medical specialists. All of these skills and services are necessary because pain can involve many aspects of a person’s daily life.
The treatment of pain is guided by the history of the pain, its intensity, duration, aggravating and relieving conditions, and structures involved in causing the pain. ln order for a structure to cause pain, it must have a nerve supply, be susceptible to injury, and stimulation of the structure should cause pain. The concept behind most interventional procedures for treating pain is that there is a specific structure in the body with nerves of sensation that is generating the pain. Pain management has a role in identifying the precise source of the problem and isolating the optimal treatment.
An X-ray guided viewing method is Fluoroscopy. Fluoroscopy is often used to assist the doctor in precisely locating the injection so that the medication reaches the appropriate spot and only the appropriate spot. It can help to determine where the pain is coming. Once the pain has been accurately diagnosed, it can be optimally treated. Ultrasound is also used to identify structures and guide injections.
There are many sources of pain. One way of dividing these sources of pain is to divide them into two groups. We have the neuropathic pain and nociceptive pain. How pain is treated depends in large part on what type of pain it is.
Neuropathic pain: Neuropathic pain is pain caused by damage or disease that affects the nervous system. Sometimes there is no obvious source of pain, and this pain can occur spontaneously. Classic examples of this pain are shingles and diabetic peripheral neuropathy. It is pain that can occur after nerves are cut or after a stroke.
Nociceptive pain: Examples of nociceptive pain are a cut or a broken bone. Tissue damage or injury initiates signals that are transferred through peripheral nerves to the brain via the spinal cord. Pain signals are modulated throughout the pathways. This is how we become aware that something is hurting. Most back, leg, and arm pain is nociceptive pain. Nociceptive pain can be divided into two parts, radicular or somatic.
Radicular pain: Radicular pain is pain that stems from irritation of the nerve roots, for example, from a disc herniation. It goes down the leg or arm in the distribution of the nerve that exits from the nerve root at the spinal.l cord. Associated with radicular pain is radiculopathy, which is weakness, numbness, tingling or loss of reflexes in the distribution of the nerve.
Somatic pain: Somatic pain is pain limited to the back or thighs. The problem that doctors and patients face with back pain is that after a patient goes to the doctor and has an appropriate history taken, a physical exam performed, and appropriate imaging studies (for example, X-rays, MRIs or CT scans), the doctor can only make an exact diagnosis a minority of the time. The cause of most back pain is not identified and is classifies as idiopathic. Three structures in the back which frequently cause back pain are the facet joints, the discs, and the sacroiliac joint. The facet joints are small joints in the back of the spine that provide stability and limit how far you can bend back or twist. The discs are the “shock absorbers” that are located between each of the bony building blocks (vertebrae) of the spine. The sacroiliac joint is a joint at the buttock area that serves in normal walking and helps to transfer weight from the upper body onto the legs.
PAIN MANAGEMENT DOCTOR
A pain management doctor is a physician with special training in evaluation, diagnosis, and treatment of all different types of pain. Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these. Pain can also arise for many different reasons such as surgery, injury, nerve damage, and metabolic problems such as diabetes. occasionally, pain can even be the problem all by itself, without any obvious cause at all.
As the field of medicine learns more about the complexities of pain, it has become more important to have physicians with specialized knowledge and skills to treat these conditions. An in-depth knowledge of the physiology of pain, the ability to evaluate patients with complicated pain problems, understanding of specialized tests for diagnosing painful conditions, appropriate prescribing of medications to varying pain problems, and skills to perform procedures (such as nerve blocks, spinal injections, and other interventional techniques) are all. Part of what a pain management specialist uses to treat pain.
ln addition, the broad variety of treatments available to treat pain is growing rapidly and with increasing complexity. With an increasing number of new and complex drugs, techniques, and technologies becoming available every year for the treatment of pain, the pain management physician is uniquely trained to use this new knowledge safely and effectively to help his or her patients. Finally, the pain management doctor plays an important role in coordinating additional care such as physical therapy, psychological therapy, and rehabilitation programs in order to offer patients a comprehensive treatment plan with a multidisciplinary approach to the treatment of their pain.
The most important consideration in looking for a pain management specialist is to find someone who has the training and experience to help you with your particular pain problem and with whom you feel a comfortable rapport. Since many types of chronic pain may require a complex treatment plan as well as specialized interventional techniques, pain doctors today must have more training than in the past, and you should learn about how your pain physician was trained and whether he or she has board certification in pain management.
The widely accepted standard for pain management education today is a fellowship (additional training beyond residency which occurs after graduating from medical school) in pain management. Most fellowship programs are associated with anesthesiology residency training programs. When a physician has become board certified in their primary specialty and has completed an accredited fellowship, they become eligible for subspecialty board certification in pain management by the American Board of Anesthesiology, The American Board of Psychiatry and The American Board of Neurology, or theAmerican Board of Anesthesiology. These three are the only board certifications in pain management recognized by the American College of Graduate Medical Education.
ln addition to learning about your pain physicians training and board certification, you also should ask concerning your doctor whether they have experience with your specific pain condition and what types of treatments they offer. Do they only perform procedures or do they use a multidisciplinary approach to pain management? Who do they refer to for other treatment options such as surgery, psychological support or alternative therapies? How can they be reached if questions or problems arise? what is their overall philosophy of pain management?
The best way to be referred to a pain management specialist is through your primary care physician. Most pain physicians work closely with their patients’ primary care physicians to ensure good communication, which in turn helps provide the optimum treatment for their patients. Patients are also often referred by specialists who deal with different types of pain problems. Back surgeons, neurologists, cancer doctors, as well as other specialists usually work regularly with a pain physician and can refer you to one.
PAIN MANAGEMENT DOCTORS NEAR ME
Finding pain management doctors near you can be an exhausting task. This can be from recommendations from friends to reviews online, there are so many options for finding one. But, once you’ve found a few you like, how can you narrow down the results to find the one that best suits you? More important, how can you find a doctor that can help you relieve your chronic pain? Finding the right primary care doctor can already seem like a chore. Finding one that also specializes in chronic pain management can be even more difficult. The American Society of Regional Anesthesia and Pain Medicine suggests that the most important consideration in looking for a pain management specialist is to find someone who has the training and experience to help you with your particular pain problem and with whom you feel a comfortable rapport. Since many types of chronic pain may require a complex treatment plan as well as specialized interventional techniques, pain specialists today must have more training than in the past, and you should learn about how your pain physician was trained and whether he or she has board certification in pain management. There are a few steps you can take to get started on finding the best pain management doctors near you to include:
- Talk to your insurance
- Ask your primary care doctor
- Talk to friends and family
- Use a search tool online
Do your personal research before settling for a specialist.