You have visited your family physician but the prescribed pain medication, physical therapy and Pilates has only delivered limited results in the past twelve months of treatment. Your previously active life of working a physical job during the week, playing social tennis and chasing the grandkids on the weekends has come to a grinding halt. Now each day you are waking in pain after tossing and turning restlessly all night. You are in pain as you drive to work and when you get to work you are now severely limited in what you can do. This is damaging your self-esteem and placing extra pressure on your coworkers. On the weekend when the grand kids come to visit you can no longer chase them around the park and are restricted to watching them from the park bench. Your family has noticed that you’ve lost the zest for life that you’ve always been known for and your partner and friends are becoming increasingly concerned about you.
Come Monday, you are fed after spending another weekend in increasing pain. Your partner and you decide you should visit your family doctor one more time. Upon discussing your concerns about your back pain your doctor senses your dismay and suggests referring you to a pain doctor in the San Antonio area. Your appointment has been booked at the intimidatingly named intervention pain management clinic and you are starting to wonder what you should expect upon your visit.
What is a pain doctor?
A pain doctor or pain specialist (More information see here) is an expert in diagnosing the cause of your pain and then providing treatments to attempt to alleviate your pain. They may be either a medical doctor or doctor of osteopathy. Many specialist doctors may work as pain doctors; these include anesthesiologists, neurologists and neurosurgeons. These doctors typically work at intervention pain management clinics, which focus on the diagnosis and treatment of patients with chronic pain.
What will happen during the first consultation?
Once you arrive at your first consultation the receptionist will ask you to fill in some forms with your general information such as name, address and date of birth. In some cases they may ask questions about your pain but in most cases your doctor will have sent your case history to the pain doctor prior to your arrival. Once the doctor is ready to see you, they will call you through to their office. Once inside their office they will discuss your case history with you and ask questions about your pain. They are likely to enquirer about how long you have had the pain for and what treatments and investigative procedures such as x-rays and MRI’s you have had. After they feel they have enough information they will in most cases conduct an examination. This is likely to involve you completing various functional tests to demonstrate to the pain doctor how you are impeded and allow them to accurately identify the source of your pain.
Upon completing the examination they will usually sit down with you and discuss their proposed course of action. This may involve further diagnostic tests or a specific treatment either in isolation or in combination with another treatment. During this first consultation is also a great time to ask any burning questions, your doctor should be more than happy to address any queries you have. Commonly patients like to know how successful proposed treatments are, the risks involved and of course the cost attached to them. No question is too dumb to ask, your pain doctor is not expecting you to be an expert like they are. In some cases the pain doctor may propose to begin treatment immediately that day, if you are confident with what your doctor proposes that may suit you fine. However, if you would prefer to take some time to think it through or obtain a second opinion that is also ok and your pain doctor should be supportive of your decision.
What kind of treatments do pain doctors prescribe?
Pain doctors can prescribe a number of treatments, what you are prescribed will depend on the nature and origin of your pain. For example those visiting a pain doctor at an intervention pain management clinic with severe back pain may be prescribed a variety of treatments. These treatments may include but are not limited to injections, radio frequency rhizotomy, intrathecal pump implants or electrical stimulation. These treatments may be prescribed alongside less invasive treatments such as oral pain medication or physical therapy.
How successful is treatment administered by a pain doctor?
The success of the treatment you a provided will depend greatly on the type and severity of your pain. Each particular treatment has its own pros, cons and success rate. These issues should be discussed with your pain doctor during your appointment as they are in the best position to give you an educated opinion. However, focusing on severe a back pain as an example, the use of electrical stimulation of the spinal cord has been found to provide up to 50% relief in half of all patients treated using this method. It is important to note that best results are often achieved in conjunction with less invasive therapies such as oral medication and physical therapy.
The take home message
The process of seeing a pain doctor is not too dissimilar to seeing your family physician. However, the role of the pain doctor is very specialized and involves the diagnosis and treatment of your pain. The methods they use can vary from non-invasive techniques such as oral medications to more aggressive treatments such as radio frequency rhizotomy. For many people visiting a pain doctor is a last resort following years of suffering frustrating chronic pain. If you feel you need to see a pain doctor, discuss this with your physician as they will be able to refer you to one in the San Antonio area.