Pain – the first step to treatment is DIAGNOSIS

Pain Management has a primary role in the DIAGNOSOS of the source of the painful condition.  If the source of the pain is spinal, the Pain Management physician can assist in localizing the level of the spine which is the source of the pain (though this may not necessarily be where you feel your pain).  You should consider making an appointment with a Pain Management doctor who is qualified and able to diagnose your condition, and make appropriate referrals as needed to ensure the optimal treatment of your condition. (see below for a definition of a qualified Pain Management physician).

We all experience pain at one time of our lives or another, and pain is probably the primary reason for someone to visit a doctor.

Acute pain can indicate an injury such as a broken bone or a strained muscle, in which case the reason you hurt is obvious.  However most chronic pain symptoms are much more mysterious.  Often chronic pain persists and is manageable by the patient, but then becomes worse so that patients seek medical attention.  The treatment of chronic painful conditions can be simple or complex, depending on the cause of the pain.

An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down a leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. Sometimes, however, the symptoms do not resolve and can require a wide variety of skills and techniques to treat the pain. The skills and techniques may involve managing your pain often a team approach involving several healthcare providers in addition to your Pain Management Specialist.

Depending on your symptoms, you may be referred to see a:

	X-Ray, MRI or CT Scanning facility
	Neurologist
	Surgeon
	Rheumatologist
	Physical therapist
	Psychiatrist or other counselor
	Primary care or family physician (for medication management)

How is pain treatment guided?

The treatment of pain is guided by the history of the pain, its intensity, duration, aggravating and relieving conditions, and structures involved in causing the pain. In order for a structure to cause pain, it must have a nerve supply, be susceptible to injury, and stimulation of the structure should cause pain. The concept behind most interventional procedures for treating pain is that there is a specific structure in the body with nerves of sensation that is generating the pain. Pain Management has a primary role in identifying the precise source of the problem and isolating the optimal treatment.

Who is a Qualified Pain Management Physician?

It is very important that you trust your care to a physician who is trained, qualified and has your recovery and treatment as their prime motivation for seeing you.  Ensure that your chosen Pain Management physician is:

• Boarded by an accredited recognized ACGME entity (Accreditation Council for Graduate Medical Education)
• Has a background in either Anesthesiology, Physical Medicine and Rehabilitation (PM&R) or Neurology
• Is experienced in a wide range of interventional procedures
• Is not focused on medication as a primary means of “pain control”