What is chronic pain?

Chronic pain is pain that lasts three months or longer.  Many things can cause chronic pain, including cancer (the disease itself, or treatments), arthritis, back or neck injury, migraine headaches, nerve pain (neuropathy) and shingles.  Sometimes pain doesn’t go away after surgery, for example, if the nerves were damaged and other times it isn’t clear what’s causing your pain.

What is a pain medicine specialist?

A pain management specialist completes four years of medical school and further training in a speciality, such as anesthesiology, physical medicine and rehabilitation, psychiatry or neurology, followed by an additional year of training to become an expert in the chronic pain.  Specialized training and expertise is essential since the spine and nerves that register pain are delicate and everyone’s anatomy and pain tolerance are different.

How a pain medicine specialist diagnosis your pain.

Asks you – Will ask you to describe your pain in detail, including where it hurts, how long it has been hurting and what makes it feel better or worse.

Reviews tests and records – Your medical records, X-rays and other images as well as tests help the pain medicine specialist determine how to best treat your pain.

Has you fill in a questionnaire – Forms that can guide you in providing very specific information about your pain.

Performs an exam – Complete physical exam can help shed more light on your pain.

Orders tests – Specialist may order additional tests to help provide more insight, even if you have already had tests done.

How can a pain medicine specialist help?

A physician can recommend a treatment plan that might combine multiple techniques to manage your pain, such as medications and physical therapy.  You will also be given guidance on how to prevent and control pain in your daily life.  Some treatments that might be prescribed include:

Injections or nerve blocks – If you are having muscle spasm or nerve pain, injection with local anesthetics or other medications can help short-circuit your pain.

Electrical stimulation – For chronic pain such as in the lower back, you might get relief with a treatment called transcutaneous electrical nerve stimulation (TENS), which stimulates nerve fibers through your skin by sending electrical impulses to the site of the pain.

Spinal cord stimulation – If you have chronic pain in the back, arms or legs, your pain medicine specialist might suggest spinal cord stimulation.  A device is implanted in your back and blocks pain by delivering electric pulses to nerves and the spinal cord.

Physical therapy – Physical therapy may improve your ability to function and decrease your pain.  Whirlpools, ultrasound and deep-muscle massage may help, too.

Acupuncture – A therapy where very think needles are placed at different points to interrupt pain signals.

Surgery – Usually done only after conservative treatments fail, surgery can be performed to correct anatomic abnormalities that are responsible for your pain and in unusual cases, to sever the nerve supplying the painful area.

A pain medicine specialist may also suggest alternative methods that can help you cope with and overcome chronic pain, such as psychological therapy, relaxation techniques and biofeedback.