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 to all kinds of treatments, but others are not.
Maybe we have gone through pricey medicine trials or treatments that somehow didn’t work. Perhaps opioids worked well, but our provider is no longer at ease prescribing them. Maybe alternative treatments are inexistent for us. That’s why it’s a must that patient and pain doctor are compatible.
Are pain doctors all the same? Barely. Pain management experts have varying 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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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 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. Several prescribe pain medications as well.
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). As well, they conduct diagnostic procedures like electromyography (EMG), and provide medication-centered pain management.
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.
Notwithstanding their main specialty, you want a pain doctor who is a good diagnostician and practices an approach that you feel is effective for you.
Here are other considerations when searching for a pain expert:
Is the doctor in your insurance network?
Is his bedside manner acceptable to you?
How experiences is he?
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 present and discuss your options, such as interventional treatments; physical therapy; and opioid therapy, including risks and benefits?
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 have poor chemistry with your pain doctor, your confidence in his pain management skills will be diminished. And because pain is considerably subjective, this will also reduce the effectiveness of your treatments.