We all have our own perceptions about how our pain must be treated, as do the pain specialists who treat us. Some of us are open-minded about all available treatments, others not.
Maybe we have gone through pricey medicine trials or treatments that somehow didn’t work. Maybe opioids were effective, but our provider is no longer inclined to prescribe them. Maybe alternative treatments are inexistent for us. That makes the right fit between patient and pain doctor essential.
Are pain doctors all the same? Hardly. Pain management specialists have unique clinical backgrounds and pain management board certifications. The American Society of Regional Anesthesia and Pain Medicine says there are three pain management board certifications the American College of Graduate Medical Education recognizes.
Eligibility for a subspecialty board certification in pain management calls for board certification as well as fellowship as an anesthesiologist, neurologist or physiatrist.
Anesthesiology – A huge number of pain professionals are anesthesiologists. They count on interventional procedures, including nerve blocks and epidurals among others, and some perform ultrasound-driven trigger point injections. Many prescribe medications for pain too.
Neurology – A neurologist may belong to a pain management group, performing the same procedures as an anesthesiologist, or he may specialize in the management of nerve pain-causing conditions (for example, chronic migraine and diabetes). They also conduct diagnostic tests like electromyography (EMG), and provide pain management through medication.
Physiatry – By training, physiatrists are rehabilitation doctors who focus on movement, physical and occupational therapy, and spotting factors contributory to pain. Those who have a pain management subspecialty also conduct interventional procedures, prescribe pain medication and implant medical devices as part of chronic pain management.
Whatever their core specialty, what you need in a pain doctor are excellent diagnostic skills and a treatment philosophy you feel will be right for you.
The following are other considerations as you look for a pain specialist:
Is the doctor in your insurance network?
Do you find his bedside manner acceptable?
What kind of experience does he have?
Does he conduct a meticulous physical exam?
Is he in a rush to perform an interventional procedure on your initial consultation? This is a red flag.
Does he explain your treatment plan, ensuring you understand it very well?
Does he give you options and discuss them, such as opioid therapy and its risks and benefits; physical therapy; or interventional treatments?
Does he use a patient-centric care model and listen your ideas while devising a plan?
Lastly, does the doctor feel like the right fit for you? Certainly, personality matters. If you don’t have chemistry with your pain doctor, your confidence in his ability to cure or manage your pain will be reduced. And because pain is considerably subjective, this will also reduce the effectiveness of your treatments.
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