If you live with chronic pain or suffer from an incident where you find yourself in pain, chances are, you’ll be referred to a pain management specialist. The International Association for the Study of Pain (IASP) offers one of the most widely accepted descriptions of pain:
“Pain is an unpleasant sensory or emotional experience associated with actual or potential tissue damage or described in terms of such damage.”
From this definition it is evident that pain is not only a purely somatic experience, it also an emotional one. A pain management doctor is a medical doctor (M.D.) or a doctor of osteopathy (D.O.) who specializes in pain medicine. These doctors focus on the evaluation, diagnosis, and treatment of different types of pain, including the prevention of pain. Pain management doctors often consult with other physicians and health care providers to coordinate individualized patient care.
The background of pain management physician is very important and traditionally pain management anesthesiologists are the specialists involved in interventional pain management. It is very important for your physician to have a formal fellowship training in an accredited ACGME fellowship program. Also, very important for your anesthesiologist/pain management physician to have board certification by the American Board of anesthesiology for both his primary specialty as well as his secondary specialty (pain medicine). Double board certification by the American Board of anesthesiology is in our days the goal stander that can guarantee quality of medical services and knowledge of interventional pain management for the patient’s benefit.
Pain doctors use a wide range of techniques and utilize many high-tech options to treat pain. Typically, the treatment style can be categorized into these areas:
These treatments are usually the first step of any pain management program. Treatments include things like physical therapy, biofeedback, joint manipulation, TENS therapy, massage therapy, mindfulness, meditation, and heating/cooling.
With the rise of the opioid epidemic, pain doctors are finding other types of medication to administer that help reduce pain and help their patients live more comfortably with their pain. Some of these medications include over-the-counter pain relievers, Nonsteroidal anti-inflammatory drugs, gabapentin and neuropathic pain medications, muscle relaxants, and topical ointments. From blocking pain signals to healing nerve damage, taking medications can help patients return to a higher quality of life. These medications are not intended for long term use and should be used under the supervision of a physician.
Interventional pain management (IPM) refers to the use of interventional procedures to treat pain. Some of these procedures can be as simple as nerve blocks and epidural steroid injections. By far the most common interventional pain management procedure in the United States is epidural steroid injections of the spine for treatment of painful sciatica, and facet joint injections for treatment of axial back pain. For long-term treatment of axial back pain radiofrequency ablation of the medial branches of the facet joints has been used with great success.
Spinal cord stimulation represents a very successful long-term non pharmacological interventional pain management treatment for patients to have chronic torso and extremity pain usually as a result of failed back post laminectomy syndromes. Another common indication for spinal cord stimulation as well as dorsal column stimulation with DRG is complex regional pain syndromes of the lower extremities. Neuro blockade of the sympathetic plexus in the form of stellate ganglion blocks, lumbar sympathetic blocks, splanchnic nerve blocks, ganglion impar blocks or hypogastric blocks gives great results for sympathetically maintained painful syndromes of the torso and extremities.
No matter what intervention your interventional pain management physician should be someone that has the appropriate training and certification as well as the clinical experience so that he can provide these treatments with safety and be able to give you the best outcomes possible.
Frequently, these types of treatments can be done in-office. Interventional pain management techniques are good solutions for patients seeking long-term relief from pain.