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What Do Pain Management Doctors Do?  

Date: August 1, 2022

Pain is an uncomfortable sensation that alerts you to the possibility that something is amiss. There are various ways to describe it, from constant to throbbing to stabbing to aching to pinching.  

Pain can affect us physically, emotionally, and psychologically. This alters the way we live, work, and associate with others.  

Acute pain can lead to chronic pain, and it is therefore important to find solutions to it easily. That is where pain management doctors come in.

Who is a pain management doctor?  

Your general doctor can usually treat any first pain concerns, but through multi-disciplinary treatment, you may be able to get more help. Medical practitioners in several disciplines work together to provide comprehensive care that meets as many patient requirements as feasible in multi-disciplinary care.   

Your general doctor may refer you to a local pain management specialist for step-by-step treatment. No matter how difficult it may be, you can always learn to manage your pain.  

A pain doctor should be able to offer a wide range of treatment alternatives to alleviate the discomfort caused by a sickness or an injury. Expertise in the assessment, diagnosis, and treatment of pain is a specialty of these doctors.  

After completing a general residency, these clinicians do a one-year fellowship in pain management and are subsequently board-certified in a specific field. Pain management practitioners mostly focus on treating patients with chronic pain because their needs can be difficult to diagnose and may necessitate months or years of treatment with a range of treatments.  

Types of pain management doctors  

Anesthesiology has always provided pain management services as anesthesiologists were well-versed in drugs, including local anesthetics, pain management, and other operations for nerves, such as nerve blocks and various spine techniques (epidurals). That is the basic origin of pain management, but currently, there are doctors that specialize in interventional procedures and medical pain management in two distinct groups:  

1. Interventional pain management  

The aim of interventional pain management is to alleviate pain and improve the quality of life for patients by employing pain-blocking procedures. Patients may be treated with surgical procedures including electrostimulation, nerve blocks, spinal injections, or implantable drug delivery systems.  

Anesthesiologists who specialize in pain management finish a five-year residency in anesthesiology and a one-year fellowship in pain management. Pain management fellowships are also available to a group of physicians known as physiatrists, and pain management can also be a specialty for neurologists.   

2. Medical pain management  

Doctors trained in the field of pain management diagnose and treat patients with a wide range of pain conditions. Many types of long-term, chronic pain, such as low back pain, can be treated by a doctor in pain management.  

These specialists specialize in treating patients with long-term medical conditions that necessitate the use of opioids or other long-term drugs. They treat chronic pain, which is a condition that lasts for an extended period of time that might even occur on a regular or irregular basis.   

What do pain management doctors do?  

Chronic pain saps millions of Americans' vitality and health. People don't have to suffer alone because chronic pain sufferers can visit a pain management doctor.   

Pain treatment clinics are designed to satisfy the needs of chronic pain patients. Chronic pain diagnosis and therapy can be specialized or broad, and there are many techniques used to diagnose and treat pain conditions.  

Steps in pain managementMethods used
1. DiagnosisPalpation, Imaging devices, Patient- doctor feedback
2. Treatment Surgery, Medications, Injections, Physiotherapy, Home remedies, Alternative medicine
3. Living pain-freeSelf-management, CBT, Lifestyle changes

1. Diagnose pain  

A pain management specialist specializes in the diagnosis of pain to treat several types of long-term chronic pain, such as low back pain. Patients can be diagnosed on the same day at a pain clinic and go home the same day after their visit.  

The first step in treating pain is always finding the cause of the pain. Pain management practitioners utilize a wide range of pain diagnosis techniques to find the source of pain.  

When you initially meet your pain doctor, they will ask you a variety of questions and check your medications and historical medical data, including diagnoses, tests, and X-rays, are going to be checked. A physical exam can also be conducted to find any other pain sources as well as test the intensity of the pain.  

Palpating areas around the pain source can determine the extent of the pain in cases of physical pain. Your pain doctor may ask you a few questions to diagnose the pain, and they may ask you to indicate the level of pain on a scale of 0-10.  

0 typically means no pain at all, while 10 means that you are in terrible pain. The pain doctor starts with a basic diagnosis such as a physical and questions to the use of other intricate methods such as medical equipment.  

Some of the questions asked may include:  

  • Where do you feel the pain, and exactly how long have you felt it?  
  • Has it happened before, or is this the first time?  
  • How often does the pain come? Does it only happen during certain activities or during certain times of the day?  
  • Are there any medications you have taken or have been taking?  
  • Have you seen a different doctor about this? Or is this the first time?  
  • Is the pain accompanied by other symptoms?   

2. Treat pain  

After pinpointing the source of the pain, the pain specialist can begin treating it using their specific knowledge and the latest research. Patients who don't respond to conventional pain treatments are often the focus of pain management specialists' own study; each patient is unique, and they uniquely respond to different forms of treatment.  

Some of the wide range of conditions treated include arthritis, fibromyalgia, a herniated disc, migraines, sciatica, and more.   

Pain management doctors frequently use non-surgical and interventional treatments, as well as complementary therapies to decrease or eliminate the need for surgery. Some of these treatments include massage, acupuncture, yoga, and meditation, as well as physical therapy, dietary counseling, and chiropractic adjustments.  

They may prescribe NSAIDs and other pain relievers, including muscle relaxants and anti-depressants. Additionally, steroid injections, nerve blocks, joint injections, radiofrequency ablation, and spinal cord stimulation or neuromodulation may be prescribed based on your condition.  

The stages of pain treatment  

Pain management practitioners deal with three basic types of pain one causes a direct injury to the tissue, such as osteoarthritis; the other to the nervous system, such as a stroke; and the third is a mixture of the two, such as leg pain.   

Physical therapy and over-the-counter painkillers can be used by a primary care physician to alleviate pain, but to receive more advanced pain care, you will be sent to a pain management doctor. Doctors that specialize in pain management are taught to treat patients in stages, step by step, till the patient is able to return to a pain-free life.  

The first stage of treatment involves the administration of medications such as anti-inflammatory drugs, muscle relaxants, and anti-depressants and injections intended to relieve pain, such as nerve blocks or spinal injections. TENS (Transcutaneous electrical nerve stimulators—devices that provide low-voltage electrical current to painful regions via skin pads) can also be used as first-stage treatment options.  

An image showing pain medication used to manage pain

The second stage of treatment options includes radiofrequency ablation (RFA) and viscosupplementation, where pain can be eliminated by injuring a nerve with heat or chemical agents during RFA. Viscosupplementation is a method for treating arthritic pain that involves injecting lubricating fluid (hyaluronic acid) into joints.  

At the third stage the spinal cord which is the body's control center for detecting and responding to pain stronger drugs are used to alleviate that pain. An implanted spinal cord stimulator or a pump is used to do this.  

If none of the other methods have helped to alleviate your discomfort, surgery is usually an alternative if it can help treat the pain.   

3. Alternative treatment  

Body massage is a form of non-invasive treatment for pain

The various methods of treating chronic pain can be helpful in the short term, such as pain medication. Most pain management experts prefer to use non-pharmacological methods in the long run to reduce dependency on these treatment options.  

Pain medications such as opioids can cause a dependency since pain can have a huge physical, mental and emotional toll on someone. A patient may need to up the dosage after some time with the advice of the doctor to prevent misuse of the medication.  

Some alternative forms of treatment can be effective in pain management. Some of the forms of treatment that also target the mental and emotional aspects of pain include:  

  • Acupuncture
  • Biofeedback  
  • Diet therapy  
  • Hydrotherapy  
  • Massage  
  • Meditation 
  • Counseling in the form of cognitive-behavioral therapy (CBT)  
  • The practice of chiropractic medicine  

4. Self-management strategies  

What do pain management doctors do? They diagnose and treat people living with pain

People commonly return to self-management to relieve pain as they try to adjust to their usual lives. Severe pain impacts practically every aspect of a person's quality of life, and therapy is typically ineffective and involves a wide range of disciplines and professions.  

Catastrophizing pain happens when someone exaggerates the threat and believes that they have no control over it. Patients operate better when they have some power, aren't immobilized, and don't oppose catastrophizing pain.  

Patients acquire confidence in their abilities to self-manage pain. Self-management of pain refers to both informal efforts made by people with pain, such as following the advice of non-professionals or written or online sources of information, and structured activities guided by a health professional or by an established protocol to improve a person's ability to manage their own pain.  

Self-management programs emphasize patient education and active engagement in therapy to empower patients to manage their own health, treatment, and pain. Short rests, returning to normal activities, strengthening exercises and organized physical activity, administering heat and cold therapy, utilizing over-the-counter drugs and topical ointments and creams, sleep, yoga, and caution when lifting and carrying are examples of back pain self-management.  

A patient's journey to pain management includes a number of follow-up visits to the same or new doctors and advisors, and this can be done in any order. This can be done through:  

  • Self-management- It may be done with the help of family and friends—whose prior experience and expertise, accurate or not, will be important—but with little formal supervision or involvement from a physician.  
  • Primary care- The practitioners may use a variety of pain management strategies, such as prescription medication and advice on physical activity, physical therapy, or weight loss, perhaps after consulting with specialists.  
  • Specialist care- Help from a physician skilled in diagnosing and treating the underlying disease causing the pain that may be done at a pain management center for the treatment of chronic pain, where an interdisciplinary approach may be employed.   

Primary care, specialty care, and pain centers all offer pain management strategies that aim to help patients with their daily routines. Specialized care is required if:  

  • The prescribed dosages of drugs do not alleviate the patient's pain.   
  • The patient has severe side effects from the pain medication, and none of the treatments seem to be helping.  
  • The patient experiences a new kind of pain.  
  • If the pain has an impact on the patient's ability to sleep, do everyday tasks like cleanliness and bathing, consume meals, go to school and work, or engage in social activities such as going out with friends.   

Frequently asked questions  

When should I see a pain management doctor?  

Pain specialists collaborate with other doctors to develop a multi-disciplinary treatment plan for your condition, which may include physical therapy, the use of suitable drugs, injections, or surgery. Spine diseases, such as herniated discs in the lumbar (back) or cervical (neck) spine, are the most prevalent conditions treated by pain specialists.  
Your primary care physician may take X-rays, prescribe anti-inflammatory medicine, or send you to physical therapy. If none of those options prove effective, you'll be referred to a surgeon for a more thorough examination, and non-surgical candidates are sent to a pain expert by the surgeon.  
Your primary care physician may refer you to a pain specialist for pain management.   
They may have been treating your condition for years before referring you directly to a pain specialist when the situation becomes chronic.  
When you experience pain that doesn't go away or always recurs, you should visit a pain management doctor to have it checked out. Most of the time, acute pain becomes chronic if it is not addressed.  

About Dr. Sean Ormond
Dr. Sean Ormond in black medical uniform and black fog background
Dr. Sean Ormond is dual board-certified in Anesthesiology and Interventional Pain Management. He completed his anesthesia residency at Case Western University in Cleveland, Ohio where he served as Chief Resident, followed by an interventional pain management fellowship at Rush University in Chicago, IL. Following fellowship, Dr. Ormond moved to Phoenix and has been practicing in the Valley for a few years before deciding to start his own practice.