What is Pain Management?

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Pain management, or pain medicine, is a growing medical specialty dedicated to treating acute, sub-acute, and chronic pain.  The goal of pain medicine is to improve quality of life and help patients return to everyday activities, ideally without surgery.
 
A pain management physician is part of a team of medical professionals, such as the patient’s referring physician, physical and occupational therapists, oncologist, and psychiatrist, or psychologist.

Acute, Sub-acute and Chronic Pain

Pain is generally classified as being acute or chronic:
 

• Acute pain begins quickly or suddenly and may be severe. However, acute pain lasts a short time (always under three to six months, sometimes just a few days or hours) and then goes away on its own.
• Sub-acute pain is defined as being between acute and chronic. 
• Chronic pain may be mild or severe and is characterized by its persistence.  It is defined as pain lasting longer than six months.

It is possible for acute pain to transition into chronic pain.

Patient Pain Evaluation

The evaluation begins with a comprehensive medical history and physical and neurological examination to determine the source of the pain. The pain specialist asks if pain developed as a result of a specific event, accident, injury, and how has it changed over time.  Pain can be described in terms of intensity, duration, associated symptoms (such as nausea or weakness), and what reduces or worsens pain. Pain patients are encouraged to record pain symptoms and activities or events in a pain diary.  The patient's written record is helpful to diagnose and management pain.

Pain is rated on a scale from zero to 10; zero being no pain and 10 being the worse pain imaginable. A pain drawing helps the patient to indicate pain locate, intensity, and type.

Pediatric patients use a similar pain rating scale.  However, pictures of facial changes (i.e., smile, frown) help children describe their pain.

Diagnostic tests confirm the physician's diagnosis.  Imaging tests include computed tomography (CT), magnetic resonance imaging (MRI), and diagnostic injections. Spinal injections offer diagnostic value by providing information about the pain source (i.e., Facet Joint and Medial Branch Block).

Treatment Options

Pain specialists develop the treatment program to meet an individual patient's needs.  The physician considers:

• Type and nature of the pain
• Pain history
• Patient’s general health, existing conditions (i.e., diabetes)
• Mental health
• History of substance abuse
• Family situation
• Patient’s preferences

Many pain specialists combine therapies. Sometimes a patient is surprised to learn that a treatment that failed to provide relief before is effective when combined with another therapy.

Pain specialists counsel patients to manage their expectations. In some cases, complete pain relief is not possible. Treatments may only provide partial relief.

Treatment may include:

• Medications
• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Muscle relaxants
• Anti-depressants
• Anti-seizure drugs (these have been found effective in treating certain types of neuropathic pain)
• Narcotics (opioids)
• Injection therapies
• Radiofrequency Ablation (RF Rhizotomy)
• Spinal Cord Stimulation  
• Spinal Pump (Intrathecal Pump)

Pain Management Improves Quality of Life

Pain medicine advances help thousands of patients every day.  There are many ways to control pain and improve your quality of life.