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Finding a Good Fit for a Pain Doctor We all have our own notions about how our pain has to be treated, as do the pain experts who treat us. Some of us are open to all types of treatments available, while others are not. Maybe we have participated in costly medicine trials or treatments which didn’t work. Maybe opioids were effective, but our provider is no longer inclined to prescribe them. Maybe there are no alternative treatments available to us. That’s why it’s a must that patient and pain doctor are compatible. Are all pain doctors made equal? Barely. Pain management professionals have diverse clinical backgrounds and pain management board certifications. The American Society of Regional Anesthesia and Pain Medicine says the American College of Graduate Medical Education presently recognizes three pain management board certifications.
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Eligibility for a subspecialty board certification in pain management calls for board certification as well as fellowship as an anesthesiologist, neurologist or physiatrist.
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Anesthesiology – Many pain experts are anesthesiologists. They perform interventional procedures, like epidurals and implantable devices (for example, pain pumps or nerve stimulators), and some do ultrasound-steered trigger point injections. Many prescribe medications for pain too. Neurology – A neurologist may belong to a pain management group and perform the exact procedures an anesthesiologist does, or concentrate on managing nerve pain-causing conditions such as diabetes and chronic migraine. As well, they conduct diagnostic procedures like electromyography (EMG), and provide medication-centered pain management. Physiatry – Based on their training, physiatrists are technically rehabilitation physicians who specialize in the identification of contributing factors; physical and occupational therapy; and movement. Those with a subspecialty in pain management also perform interventional procedures, implant medical devices, and prescribe pain medication as part of chronic pain treatment. Notwithstanding their main specialty, you want a pain doctor who is a good diagnostician and practices an approach that you feel is effective for you. Here are other considerations when searching for a pain expert: Is the doctor in your insurance network? Do you find his bedside manner acceptable? How wide is his experience? Does he perform an extensive physical exam? Does he rush to conduct an interventional procedure on your first meeting? This is a very bad sign. Does he discuss your treatment plan with you, making sure you understand it thoroughly? Does he give you options and discuss them, such as opioid therapy and its risks and benefits; physical therapy; or interventional treatments? Does he use a patient-driven care model and take your ideas seriously when coming up with a plan? Finally, does the provider feel like a good fit for you? Personality matters for sure. If you have poor chemistry with your pain doctor, your confidence in his pain management skills will be diminished. And because pain is considerably subjective, this will also reduce the effectiveness of your treatments.