Finding a Good Fit for a Pain Doctor We all have our own ideas about how our pain needs to be treated, as do the pain professionals who treat us. Some of us are open to all kinds of treatments, but others are not. Maybe we have participated in costly medicine trials or treatments which didn’t work. Perhaps opioids worked perfectly, but our provider is no longer happy prescribing them. Maybe we have no alternative treatments to consider. That’s why a good fit between patient and pain doctor is crucial. Are all pain doctors the same? Hardly. Pain management professionals have diverse clinical backgrounds and pain management board certifications. The American Society of Regional Anesthesia and Pain Medicine says the American College of Graduate Medical Education presently recognizes three pain management board certifications.
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Eligibility for a subspecialty board certification in pain management calls for board certification as well as fellowship as an anesthesiologist, neurologist or physiatrist.
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Anesthesiology – A large number of pain doctors are anesthesiologists. They depend on nerve blocks, implantable devices (for instance, nerve stimulators), epidurals and other interventional procedures, and some do ultrasound-maneuvered trigger point injections. Many prescribe medications for pain too. Neurology – A neurologist may belong to a pain management group and perform the exact procedures an anesthesiologist does, or concentrate on managing nerve pain-causing conditions such as diabetes and chronic migraine. 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 with a subspecialty in pain management also perform interventional procedures, implant medical devices, and prescribe pain medication as part of chronic pain treatment. 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. Here are other considerations when searching for a pain expert: Is the doctor in your insurance network? Are you okay with his bedside manner? 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 negative sign. Does he discuss your treatment plan in detail, making sure you understand it completely? 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? Personality matters for sure. If you have poor chemistry with your pain doctor, your confidence in his pain management skills will be diminished. And as pain is substantially subjective, this will also diminish your treatment’s efficacy.