What do Pain Management Doctors Do?

By Daniella Johnson

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What Do Pain Management Doctors Do?

Pain management doctors specialize in the evaluation, diagnosis, and treatment of pain. They have advanced training to qualify as your best source of treatment. They help in providing relief if you are experiencing any type of pain due to illness or injury.

Pain is complex. There are many treatment options such as medications, therapies, and mind-body techniques. Pain management may be simple or complex depending on the cause of the pain. A wide variety of skills and techniques to treat pain include:


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  • Interventional procedures

  • Medication management

  • Physical therapy or chiropractic therapy

  • Psychological counseling and support

  • Acupuncture and other alternative therapies; or

  • Referral to other medical specialists

Pain management specialists focus on functional ability and your quality of life. Chronic or complicated pain due to underlying medical conditions need pain specialists. Physiatrists are trained in managing pain. They specialize in physical medicine and rehabilitation. They have a special interest in musculoskeletal conditions. Some of the physiatrists have advanced training in Interventional Pain Management (IPM). IPM is devoted to the diagnosis and treatment of pain related disorders.

A pain management specialist has experience in developing a treatment plan. This is beneficial to relieve, reduce, or manage pain. This is beneficial for everyday activities without surgery or reliance on medication. The physiatrist ensures your needs are fulfilled. They would coordinate with an interdisciplinary team of health professionals including:

  • Anesthesiologists

  • Internists

  • Oncologists

  • Surgical specialists

  • Psychiatrists

  • Psychologists

  • Nurses

  • Occupational Therapists

  • Physical Therapists



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The main concern of pain management specialists is your quality of life. They would treat you completely and not one part of the body.

Education and Training of Pain Management Specialists

The doctor would enter a residency program after graduating medical school and completing a one-year internship. The residency program is usually done in anesthesiology or physical medicine, but could include other fields such as neurology and psychiatry. Upon completion of a residency program of around three years, the doctor further completes a one-year fellowship for advanced training in pain medicine.


Work of Pain Management Specialist

The pain management specialist would diagnose the specific cause of your pain and the underlying conditions causing the pain. Pain could be caused by numerous conditions ranging from lifestyle problems to medical conditions.

The pain management doctor diagnoses the cause of your pain. On the basis of the cause, they would devise a treatment plan that works best for you based on their specialized training and the latest research.

Pain doctors often use a wide range of non-surgical, interventional treatments in conjunction with complementary therapies. They focus on reducing the amount of medication you require or to avoid the need for surgery. They would include massage, a weight loss regimen, acupuncture, exercise, yoga, meditation, physical therapy, dietary changes, or chiropractic care in the treatment regime.


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Types of Pain Treated

The pain treated by the pain management specialist is divided in three main groups such as:

  • Pain due to direct tissue injury including Osteoarthritis and Rheumatoid Arthritis.

  • Pain due to nerve injury or a nervous system disease including a stroke, multiple sclerosis, spinal cord injury and neuropathy such as nerve pain due to shingles, HIV, diabetes.

  • Pain that is a mix of tissue and nerve injury including back pain, neck pain and cancer.


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Diverse Approach to Pain Management

Initiation of pain treatment is usually under the care of a primary doctor. They focus on including basic pain medications and physical therapy. But, in case of progressive pain treatment, a pain management doctor would treat pain in a stepwise manner including:

  • First line treatment: This involves medications such as anti-inflammatories, muscle relaxants, antidepressants and injections that numb pain such as nerve blocks or spinal injections. TENS units that use skin pads to provide low-voltage electrical current in the painful areas to reduce pain may also be effective.

  • Second line treatment: This involves advanced procedures like radiofrequency ablation (RFA) or visco supplementation. Heat or chemical agents are applied directly to a nerve to stop pain signals. These are useful to provide relief from chronic pain problems like arthritis of the spine. Another treatment for arthritis is using Visco supplementation injection that injects lubricating fluid into joints. Stronger medications are prescribed to tackle pain at this stage.

  • Third line treatment: This involves an implant connected with a pain pump or a spinal cord stimulator. These help in relieving pain at the level of the spinal cord that controls the center for sensing pain. Regenerative stem cell treatment is also recommended in this stage.

Communication between the pain specialist and the patient is crucial for a good doctor-patient relationship. Important qualities of a pain management doctor are medical experience and compassion.


Some of the other desirable qualities in a pain doctor include:

  • Comprehensive knowledge of pain disorders

  • Ability to evaluate your difficulty pain disorders

  • Appropriate medications prescribed for pain problems

  • Use of different diagnostic tests to find exact cause of pain

  • Skill with procedures such as nerve blocks, spinal injections, pain pumps

  • Connection with specialized providers for physical therapy, psychological support or surgical evaluation

  • Treatment in line with your wishes and belief system

  • Latest equipment

  • Helpful office staff


Pain management specialists would understand your concerns and customize a pain management plan depending on your needs.


Along with physical examination, the pain management doctor may also conduct:

  • Neurological examination- Evaluating the sensory (feel) and motor (function) capabilities including reflexes, balance, ability to walk, muscle strength and muscle tone.

  • X-Ray or Radiography - Revealing the bone structures to check for any damages

  • CT scan (Computed Tomography) - It is a 3-dimensional imaging to evaluate bone and soft tissue.

  • MRI (Magnetic Resonance Imaging) - It is useful for musculoskeletal evaluation to provide detail about bones and soft tissues.

  • PET scan (Positron Emission Tomography) - It measures tissue changes at the cellular level and is useful to evaluate cancer.

  • Discography - It evaluates the intervertebral disc and/or the structural integrity of the discs to check for back or leg pain.

  • Electrodiagnostic tools - These would include NCS (Nerve Conduction Study) and EMG (Electromyography). These tools help check the speed of nerve impulses travelling through nerves, nerve damage and the extent of damage.

  • An EMG (Electromyography) - It uses nerve stimulation to diagnose electrical activity within selected muscle fibers to check for muscle response, disease and muscle damage.


The aim of pain management is to manage acute or chronic pain. They are helpful in reducing pain frequency and intensity. Apart from addressing pain issues, a multidisciplinary pain management program is beneficial in the functional goals for activities of daily living. Largely, a pain management doctor aims to provide you with a feeling of well-being, increase your level of activity (including return to work), and reduce or end your reliance on medication.


Takeaway

Pain management specialists coordinate your treatment plan between many doctors and healthcare professionals. Additionally, pain management specialists would integrate the ongoing care related to your physical or mental concerns. The specialist would be dedicated to relieving your symptoms along with the treatment of underlying medical conditions.


If you or anyone you know is suffering from pain related problems, our expert providers at Crescent Regional Hospital will take care of your health and help you recover.

Call us on (469) 297-5321 to book an appointment with our specialists.


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