What do you do if you’ve tweaked your back? Whether your answer is having a lie-down or putting some ice on it, the second thing you should always do is call your doctor. A pop in the back can mean anything from a strained muscle to something more serious.
Thankfully, most back pain goes away quickly, even with conservative treatment methods. But what if the pain doesn’t go away? What if it sticks around for weeks, then months? Then travels from the back to the legs or the arms? What do you do if you’ve been struggling with the pain, and nothing you do or try on your own seems to be making it go away?
That’s when you go see a pain management doctor or a pain specialist. In contrast to a family doctor or general practitioner, a pain specialist is someone who works specifically with patients afflicted with conditions wherein the primary symptom is pain, or conditions with symptoms of chronic pain.
Like other specialties, pain specialists operate within their own field of medicine.
However, unlike many other specialty clinics or hospital departments, a pain management clinic is exceptionally versatile, and will usually staff physicians and specialists with different backgrounds in medicine, from psychiatrists to dietitians, orthopedic surgeons, neurologists, and more.
What is Pain Management?
Some people get referred to a pain specialist when their primary physician can no longer help them manage or identify the cause of their pain. But that doesn’t mean they’re being referred to as “pill-pusher”.
Pain management is a complex field of medicine that encompasses a multimodal approach to pain, tackling the physical, social, and mental factors that contribute to it, and exploring different methods of pain reduction, ranging from conservative treatments and long-term lifestyle changes to surgical interventions, non-invasive treatment methods, and targeted short-term pain relief.
Part of the reason a typical pain management clinic is staffed with doctors from many different medical specialties is because pain management requires a holistic outlook on patient health.
Personal stress levels, hereditary mental health issues, family matters, and work-related stressors can be important contributors to a patient’s pain levels, as are their physical health and lifestyle, their neurological condition, their diet, and current medications. The last thing pain management doctors want to do is push their patients to take painkillers and leave.
More Than Medication
The history of pain management begins with the field of anesthesiology, where the application of anesthetics and analgesics was commonplace, both to reduce pain before, during, and after certain procedures. The management of post-surgical pain became especially important over time.
Yet as concerns around the long-term effects of opioid prescription finally peaked and turned into the opioid crisis following the 1990s, pain management had to expand past pharmacological solutions.
No longer the singular field of anesthesiology, research into pain and pain management yielded interesting and effective results from multiple fields of medicine, including psychology, orthopedics, neurology, endocrinology, immunology, and diagnostic medicine.
Today, pain management clinics and their resident pain specialists employ a multimodal approach to pain, considering a patient’s history and medication, family history, lifestyle, and more.
Common pain management methods in addition to pharmacology include nerve stimulation, nerve blocks, epidural injections, non-invasive surgeries to reduce or eliminate pain symptoms, plasma therapy, compression devices, radiofrequency ablation, and viscosupplementation.
In certain cases, surgery may become a viable option for long-term pain relief, by removing the offending nerve or chronically inflamed tissue, for example.
These modalities each serve a different approach to providing pain relief, whether through reducing swelling and promoting recovery or temporarily shutting down pain signals.
Long-Term Pain Management
Just like other physicians, pain management doctors concern themselves not only with the immediate well-being of their patients but with their long-term health as well. Achieving a relatively pain-free status is every pain patient’s desire. But staying pain-free is just as important.
Long-term pain management goes beyond individual procedures aimed at reducing pain symptoms or addressing pain itself through nerve stimulation et al. and aims to help patients develop better habits to reduce pain episodes, improve pain thresholds, and gain access to a deep pool of resources for further pain management needs, later down the line. Like chronic pain management, the goal of long-term pain management is to create a treatment plan that reduces risk.
Opioid medication, for example, is not always the answer for chronic pain. Short-term treatment with opioid medicine may drastically reduce pain, but long-term opioid medication can lead to physical dependence and growing tolerance, reducing the painkilling effectiveness of the medication over time.
Other medications may be more effective at improving sleep and recovery, reducing pain through antidepressive effects, or combating inflammation. Dietary changes may also reduce pain flareups in certain chronic conditions, and other lifestyle changes can help reduce the impact of pain as a secondary symptom in chronic metabolic conditions.
The roles of physical therapy and long-term exercise are not to be underestimated either. Certain cases of chronic pain respond well to physical therapy as a means of reducing pain by strengthening the muscles around an injury site.
A chronically inflamed knee may benefit from stronger knee flexors and hamstrings, reducing the load on the knee with each step, reducing the likelihood of a recurring injury, and reducing pain through improved blood flow and a regular release of endorphins.
A weakened spine can be strengthened through carefully managed load-bearing exercises, which can improve the fortitude of spinal discs, increase bone density, and reduce the likelihood of herniation.
Complex pain diseases such as chronic fatigue syndrome may respond well to low-impact exercise as one of many important long-term pain management modalities, reducing fatigue and pain.
The Biopsychosocial Model of Pain
The role of a pain management doctor is best described by holding a mirror to the complex nature of pain itself. While it serves as a simple warning system on the surface, pain as both a subjective and objective force is something we do not fully understand.
What we do know is that there are biological, psychological, and social factors at play in any given case of chronic or intractable pain, and whenever the services of a pain specialist are required. They draw from a large repertoire of knowledge and medical research to identify and address these relevant factors. Treating pain means taking an all-encompassing, holistic approach to every patient’s case.
Contact PMIR today to find a Pain Management Doctor that help you find relief!