FAQ - Pain Management

Q: What is Pain Management?

A: Pain Management is a medical specialty which uses a comprehensive approach for the diagnosis and treatment of multiple diseases that cause pain. Pain Management physicians first diagnose and determine the underlying issues which are causing your pain. Then, the physician develops an individualized treatment plan taking into account the patient’s physical, psychological and social factors which are affecting their pain. Pain treatment may involve procedures, medications, physical therapy, counseling, or a combination of the above. By educating and empowering the patient, a Pain Management physician, in conjunction with the patient’s family and social support network, helps the patient safely and effectively manage their pain. The overall goal of Pain Management treatment is getting the patient back to life-- improving quality of life, improving function, improving ability to work and improving overall outlook. Pain Management may involve the treatment of short-term pain that began recently or chronic pain (typically defined as pain lasting longer than 6 weeks).

Q: What does a Pain Management Physician do?

A: Pain Management physicians treat back pain, joint arthritis, and complex pain syndromes, among other chronically painful conditions. They are trained to recognize when a patient needs something as simple as physical therapy or requires a referral for something more invasive such as spine surgery. Pain Management physicians work with other Physicians to ensure that acute painful syndromes do not become chronically painful.

Q: What type of training do Pain Management Physicians have?

A: There are many physicians who treat pain or label themselves as pain management physicians who are not formally trained in pain management. These may include physicians who completed residencies in specialties such as anesthesiology or physical medicine and rehabilitation (PMR) where there are a few months of pain training included in the residency. Other physicians who are Board Certified in Pain Management have completed a 4-year college degree, a 4-year Medical Degree, a 4-5 year primary residency in Anesthesiology, PMR or Neurology, and also a 1 year sub-specialty fellowship in which they trained exclusively on pain management. It is during this year that Board Certified Pain Physicians become proficient in the injections and procedures they perform. Currently physicians who have not completed an accredited fellowship are not eligible to sit for the Pain Board Exam that one must pass to become certified in Pain Medicine. This makes Board Certification in Pain Management the highest level of academic training one can achieve in the field of Pain.

Q: Will my insurance cover Pain Management?

A: Yes, Pain Management is a recognized specialty that is covered by Medicare and private insurances.

Q: When should I see a Pain Management Doctor?

A: If you have a Chronically painful condition which has not improved despite treatment, a Pain Management Doctor can help you with the diagnosis and management of your pain. Pain from an injury, surgery, or medical condition is called acute pain when it has happened recently. This pain is typically a normal response to tissue injury, and can be managed quickly and will get better quickly if it is adequately treated. However, there are more serious types of pain which may persist, and may become Chronic Pain. Chronic pain is typically defined as pain persisting after 6 weeks (or 3 months, depending on the definition used) with or without the resolution of the offending bodily insult that first caused the pain. If you have this type of pain, a Pain Management Doctor can help you. Some examples of conditions that a Pain Management Physician will treat include: Back or Neck pain that has not improved within six weeks, Pain that continues to worsen after surgery, Pain that persists despite normal healing, Complex pain at multiple sites, Neuropathic pain syndromes, Post-stroke pain, Cancer pain (from chemotherapy, surgery, radiation, tumor involvement or other process), Critical care myelopathy, pain that persists despite conservative treatment. You may benefit from seeing a Pain Management Physician for a workup and diagnosis for Other chronically painful conditions such as: postherpetic neuralgia, migraine headaches, tension headaches, cluster headaches, rebound headaches, occipital neuralgia, trigeminal neuralgia, TMJ dysfunction, atypical facial pain, reflex sympathetic dystrophy or complex regional pain syndrome, cervical facet syndrome, cervical spondylosis, cervical radiculopathy, fibromyalgia, brachial plexopathy, cervical strain, cervical post whiplash syndrome, thoracic outlet syndrome, Pancoast tumor syndrome, shoulder arthritis, acromioclavicular joint arthritis, subdeltoid bursitis, bicipital tendinitis, rotator cuff syndrome or tear, elbow arthritis, tennis elbow, golfer’s elbow, medial epicondylitis, lateral epicondylitis, ulnar nerve entrapment at the elbow, olecranon bursitis, wrist arthritis, carpal tunnel syndrome, De Quervain's tenosynovitis, carpometacarpal joint arthritis, hand arthritis, Trigger finger, trigger thumb, deep uterines contracture, costosternal syndrome, intercostal neuralgia, diabetic neuropathy, Tietze’s syndrome, Rib fractures, post thoracotomy pain syndrome, acute herpes zoster of the thoracic area, thoracic vertebral compression fracture, lumbar vertebral compression fracture, sacral compression fracture, sacral insufficiency fracture, chronic pancreatitis, ilioinguinal neuralgia, genitofemoral neuralgia, lumbar radiculopathy, spinal stenosis, arachnoiditis, sacroiliac joint pain, piriformis syndrome, ischiogluteal bursitis, coccydynia, arthritis of the hip, lateral femoral cutaneous neuralgia, meralgia paresthetica, phantom limb pain, greater trochanteric bursitis, knee arthritis, suprapatellar bursitis, prepatellar bursitis, pes anserine bursitis, Baker’s cyst, knee arthritis, Osteoarthritis of the knee, ankle arthritis, tarsal tunnel syndrome, Achilles tendinitis, Morton’s neuroma, plantar fasciitis.

Q: Why is my pain so bad on some days but not on others?

A: Patients with chronic pain may experience pain which is worse on some days than others. Some common reasons that a patient may experience increased pain include changes in the weather and barometric pressure, such as cold weather with arthritis. Missed dose of medication, such as a long-acting medication which was not taken that day. Increased or new activities and exercise regimens, or a new job. Psychological stress or anxiety provoking conditions. Furthermore, some pain conditions are worse at night or during the day, or worse in the morning. Many chronic pain patients will experience a temporary increase in pain, pain flare. Please ask your doctor if you are experiencing increased pain.

Q: What is a pain flare?

A: Pain flares a temporary increase in the patient’s chronic pain which may be associated with increased activity, a procedure, or other reason. Pain flares are typically treated with ice, heat, rest, anti-inflammatories including topical diclofenac or any other anti-inflammatories, or topical lidocaine. Your doctor may also recommend other treatments for a pain flare. Please ask if you are experiencing an increase in your pain.