What Does a Pain Management Doctor Do?

Pain Management Specialists

Just about everyone will experience pain at some point in their lives. It is more or less an inevitable part of being a human being with a body. Pain is simply a sign that something is not right or that your body has some need that is not being fulfilled. For those who are lucky to only experience pain momentarily or sporadically, it can be uncomfortable, but it does not take over your life.

However, there are some injuries or conditions that can happen to anyone that can make pain a bigger part of your everyday life, either for a short time or chronically over a long period of time. This may be treated with medication or chiropractic therapy.

For chronic pains, it is best to listen to pain management doctors. They are medical specialists trained in how to diagnose, treat, and manage pain. They also help organize and educate other members of your medical team to ensure that you receive thorough care that takes into consideration each of your specific needs.

Pain Types

Pain comes in many forms. Sometimes, it lasts only a moment. Sometimes, it can last days, weeks, or years. Some people have conditions that give them chronic pain that persists throughout their life. How a pain management doctor helps you depends on the category of pain that you are experiencing.

Some pain is acute. This refers to the type that flares suddenly but dissipates quickly or only persists so long as the condition or injury that causes it. It can be severe, but it also has a time limit.

Other pain, as mentioned above, is chronic. This refers to pain that gradually worsens or persists for long periods of time. Sometimes, chronic pain can last decades. This is the main category of pain that pain management doctors treat. Experiencing chronic pain means that you may have more complex needs from your medical team or that more basic forms of pain management have not been successful for you. Patients with chronic pain also need pain management doctors to help implement more long-term treatment plans.

Pain Management Training

Doctors who choose to specialize in pain management usually complete several years of training before they are certified to call themselves pain management doctors. Most doctors who are pain management specialists complete not only medical school but also stringent and intensive programs that help them understand the many specifics of what pain management requires. These doctors, if they seek certification, are also required to sit exams for certain organizations and then to be approved by a board of other doctors.

Common Duties of a Pain Management Specialist

Pain management specialists, despite their specialization, still wear many hats and perform many duties in their practice. In addition to the kind of administrative work that all doctors are required to do, your pain management specialist is certified to:

• Make official diagnoses based on your description of pain, other symptoms you may present, and the frequency or average level of pain you choose to report
• Prescribe medication as they see fit
• Deliver information to other members of your medical team, such as your primary care doctor, physical or occupational therapists, and other specialists you may see
• Orchestrate your medical team toward treatment or management of your pain
• Make recommendations for lifestyle changes that can help limit your pain
• Develop a treatment plan based on your individual needs
• Provide certain procedures, such as injections or sometimes surgery

Pain Management Options

Many people, when they picture pain management, may visualize a bottle of pills or a deep massage. This can cause a certain amount of wariness when considering reaching out to a pain management specialist for support, especially as the national opioid abuse epidemic in America worsens. If given the choice, chiropractic care is better than opioids when treating pain. While these can be options for treating and managing any form of pain, prescribing pills and ordering alternative therapies are only a part of what a pain management doctor does. Your treatment plan will be specific to your needs and circumstances, and the doctor will talk you through your options.

The options are varied, but the following are common things that pain management treatment plans may include:

• Recommendations to take over the counter painkillers like non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin
• Prescriptions to stronger medications that help with pain management and cannot be purchased over the counter
• Physical therapy, including recommended exercises and techniques developed with your physical therapist
• Cognitive-behavioral therapy for some forms of psychosomatic pain
• Other forms of treatment from trained therapists for muscle pain, like electrical stimulation therapy or dry needling
• Alternative therapies such as acupuncture or chiropractic therapy
• Minimally invasive injections for pain management, including epidural steroid injections and nerve blocks
• If appropriate, surgical interventions

Pain Management Patients

Just as the circumstances that cause pain are varied, so are the patients who seek help for managing their pain. Many of these patients have little more in common than the fact that they experience debilitating pain that severely limits their quality of life.

Usually, in order to be treated by a pain management doctor, you will first need to discuss your pain and other symptoms with your primary care physician. Your primary care physician will then suggest a few options to work towards pain management, but if the conditions do not improve or worsens, then they will refer you out to a pain management doctor. Your primary care physician may also refer other specialized care, such as that from neurologists, oncologists, or surgeons, depending on the condition and symptoms you are experiencing.

If you are experiencing chronic pain or pain that does not respond to interventions like over-the-counter medications, rest, and heat or ice, you should talk to a primary care physician or another doctor you trust. This will put you on the path toward more specialized care and may provide answers to why you are experiencing the pain in the first place.

Preparing for a Pain Management Doctor

Documentation

There is no central database of medical information available to all doctors, and miscommunication is a common human error that happens not infrequently in the medical field. Therefore, you should not expect that the doctor you are seeing has all of the most relevant information about you, even if you are visiting a pain management specialist due to a referral. If you have any information about your medical records, previous lab results, prescribed medications, or other documents that you think could help you and your doctor make more informed decisions about your treatment, you should bring that information to your appointment.

Prepare Questions

In your busy everyday life, questions about your condition, pain, or treatment may come up. Frequently, these questions may pop into your brains at any other time other than when you are actually visiting your doctor. For this reason, consider a way to keep all of your questions in one place so that when you think of one, you can jot it down and ask your doctor at your next appointment. You could do this in a special notebook or, more conveniently, use an app on your phone where you can keep notes.

Pain Journal

A pain management doctor mainly makes a conclusion about a diagnosis based on your reports of your symptoms. If you cannot explain what your symptoms are, then your doctor will not have the information they need to make a correct diagnosis or to begin building a treatment plan that will actually provide you the relief you seek.

This is where pain journaling comes in. A pain journal is a place to collect information about your pain in your day-to-day life, as well as other information that may help you and your doctor discover patterns that could be causing or alleviating your pain. Your pain journal may be a physical journal, or you could use an app or other digital tool.

While somewhat time-consuming, especially at first, keeping a pain journal is relatively simple:

1. When you experience pain, write it down! You can rate your pain such as on a scale of 0 to 10, or you could use tools that have already been created, such as the Wong-Baker FACES Pain Rating Scale you have likely seen inside a doctor’s office.
2. You can also rate your average level of pain from the day at the end of each day. This will be less specific but may be more manageable for consistent record keeping.
3. Make sure to describe your language with vivid words. It is extremely helpful for your doctor to know whether your pain felt more like a sharp stabbing pain or a constant dull pain. You should also track where in your body you felt the pain.
4. If possible, write down the time of day your pain occurred. This does not need to be specific. For example, you could break your day into blocks such as morning, afternoon, or evening. You should also list the length of the pain.
5. If you can, include information about patterns you notice. Did the pain worsen after exertion? Did it seem to get better on a day when you were careful to drink a lot of water?
6. Note your mood as well. Stress and anxiety can worsen the pain.

What to Expect During Your Pain Management Appointment

During any medical appointment, you will begin with triage. This is when a nurse collects information about your vitals, such as your blood pressure and temperature. These are important markers of what is going on in your body.

Once your doctor joins you in the exam room, they will most likely begin by asking a lot of questions. This is the point at which you can share your pain journal, questions, and documentation. A conversation is the most efficient way for a doctor to make an accurate hypothesis about your condition, so try to be as detailed as possible.

After the initial conversation, your doctor may make a few suggestions or they may decide they need more information. If you need further testing, your doctor may have a nurse complete them that same day, or they may need to refer you to a different specialist before you return to speak with your pain management specialist.

It may take more than one visit for your doctor to give you a diagnosis or make a solid treatment plan. Most pain conditions are complex and involve multiple body systems, and are impacted by a combination of many factors. Every person’s body is different, so doctors must be careful and thorough in their diagnoses.

Common Tests for Pain Management

If your pain management doctor requires more testing, you may be referred for the following kinds of tests:

• Imaging refers to procedures that allow medical professionals to see a better picture of what is going on with your body – literally! Imaging can include x-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scans.
• Lab work is when a doctor or nurse collects tissue from your body, usually blood, to either examine in a lab at the same facility or to send out to a different facility.
• Studies of body systems like your musculoskeletal system or nervous system can measure certain information that can tell doctors more about your pain. For example, the speed with which your body receives messages from your nervous system can tell doctors about how your nerves may be impacting your pain.
• Pain surveys act much like the initial conversations you have with your doctor, except that their purpose is to assign a numerical value to your level of pain
• Neurological exams are frequently ordered in the case of people with chronic migraine and can help doctors identify any potential abnormalities with the physical shape of your brain or the way it sends messages to the rest of your body.

Seeking Pain Management

There are hundreds of conditions or reasons that you may experience pain, and the benefit of a pain management specialist is that they are trained to recognize many of them. Working with a pain management specialist can help improve your quality of life and help you live with less pain day-to-day.