We all have our own notions about how our pain has to be treated, as do the pain experts who treat us. Some of us are open-minded about all available treatments, others not.
Perhaps we have undergone pricey medicine trials or treatments that were ineffective. Perhaps opioids worked perfectly, but our provider is no longer happy prescribing them. Maybe alternative treatments are inexistent for us. That’s why a good fit between patient and pain doctor is crucial.
Are pain doctors all the same? Barely. Pain management professionals have diverse clinical backgrounds and pain management board certifications. According to the American Society of Regional Anesthesia and Pain Medicine, three pain management board certifications are currently recognized by the American College of Graduate Medical Education.
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Requirements for eligibility for a subspecialty board certification in pain management include board certification and fellowship as an anesthesiologist, neurologist or physiatrist.
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Anesthesiology – A large number of pain doctors are anesthesiologists. They perform interventional procedures, like epidurals and implantable devices (for example, pain pumps or nerve stimulators), and some do ultrasound-steered trigger point injections. Several prescribe pain medications as well.
Neurology – A neurologist can practice in a pain management group and perform the same procedures an anesthesiologist does, or focus on managing diabetes, chronic migraine or other conditions leading to nerve pain. They also perform diagnostics procedures such as electromyography (EMG), and offer pain control via medication.
Physiatry -Physiatrists, by training, are rehabilitation physicians focusing on physical and occupational therapy, movement, and determining contributory factors to pain. Those with a subspecialty in pain management also perform interventional procedures, implant medical devices, and prescribe pain medication as part of chronic pain treatment.
No matter their major specialty, what you want in a pain doctor are good diagnostic skills and a total approach that you feel will be effective for you.
Below are other considerations when you look for a pain professional:
Is the physician within your insurance network?
Are you okay with his bedside manner?
How wide is his experience?
Does he perform an extensive physical exam?
Does he rush to perform an interventional procedure the first time you meet? 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?
Finally, do you feel that the provider is a good fit for you? Certainly, personality matters. Poor chemistry with your pain doctor diminishes your confidence in his ability to treat your pain. And because pain is considerably subjective, this will also reduce the effectiveness of your treatments.