The Role of the Pain Management Specialist

So many of us with Spinal Cord Injury will know better than most how life changing and debilitating severe pain can be. I can remember going weeks at one time without being able to lie down or sleep because of the pain. I know truly what severe pain is. 
I also know how difficult it is to find effective management for pain. When i was suffering at my worst, i was on morphine and tramadol and still i was in unbearable pain.

At this point i really should have been referred to a Pain Management Specialist or Pain Management Clinic. If you feel your doctor is not providing effective pain relief for you then you need to ask for a referral to a pain specialist or clinic.

The role of this specialist is to help you manage your pain so that you can return to daily activities and enjoy a quality of life where you can at least return to daily activities.
To achieve this, the specialist may need to work with a multi disciplinary team, together they can work a plan of management for you:

Practitioners may include:
Physiatrists

Anesthesiologists

Internists

Oncologists

Surgical specialists

Psychiatrists

Psychologists

Nurses

Occupational Therapists

Physical Therapists

Massage Therapists

Acupuncture Specialists

You should expect to be evaluated and treated in general and not just the specific part of your body. We know too well that pain has effects on so many other areas such as: emotions, mentally, relationships .....

The Pain Specialist will need to know and understand the cause of your pain so will need to know your medical history. It will be fair to presume that your doctor will have included relevant information in respect of this but i would still go armed with the facts.
Take a list of your medication with you also.

What can i possibly expect at the appointment?
This will vary from one place to another and one country but i would expect it to begin with an assessment and and examination.

Physical and Neurological Examination
A physical examination assesses the patient's vital signs; pulse, respiration, heart beat, blood pressure, and so on. A neurological exam evaluates the patient's sensory (feel) and motor (function) capabilities including reflexes, balance, ability to walk, muscle strength and muscle tone.

Strategies for Pain Relief and Management

At a pain clinic, your therapy plan will be tailored to your specific needs, circumstances, and preferences. Depending on the cause of your pain, treatments may include one or more of the following:

Medications. In many cases, patients are prescribed treatment before receiving other forms of therapy. Medications for pain may include:

Non-aspirin pain relievers. These drugs, such as acetaminophen (Tylenol), relieve minor pain and are sometimes combined with other drugs to provide greater pain relief.

Non steroidal anti-inflammatory drugs (NSAIDs). Available over the counter or by prescription, these drugs -- including ibuprofen (Motrin) or naproxen (Aleve, Naprosyn) -- are used to treat pain and inflammation.

Corticosteroids. Available only by a prescription, these cortisone-like drugs are used for more severe inflammatory conditions.

Opioid pain medications. These morphine-like drugs are often prescribed short term for acute pain or for cancer pain. Occasionally, doctors prescribe them for chronic, non-cancer pain.

Antidepressants. Originally designed to treat depression, these drugs can be useful for relieving certain types of pain. Antidepressants may also promote sleep, which can be difficult when you are in pain.


Often, medications alone aren't enough to treat chronic pain. Other treatments may be more effective than medications, and medication may be more effective when combined with other treatments. Other available treatments may need to be explored and offered (we will look at these more closely on further threads)
But some may include:

Physical and aquatic therapy. A physiatrist (doctor specializing in rehabilitation medicine) or physical therapist may prescribe a specially tailored exercise program to increase function and decrease pain. Other physical therapy options at pain clinics may include whirlpool therapy, ultrasound, and deep-muscle massage.



Electrical stimulation. The most common form of electrical stimulation used in pain management is transcutaneous electrical nerve stimulation (TENS), a technique that uses a small, battery-operated device to stimulate nerve fibers through the skin.



Acupuncture. This ancient Chinese practice involves inserting very thin needles at specific points on the skin to relieve pain.





Psychological support and counseling. Although pain is a physical sensation, many people in pain suffer emotionally with feelings of anger, sadness, and hopelessness. Dealing with unrelenting pain can affect your ability to hold a job, maintain a home, meet family obligations, and relate to friends and family members. Psychological support, along with medical treatment, can help you manage your condition.



Relaxation techniques. In addition to counseling, mental health professionals can teach you self-help techniques such as relaxation training or biofeedback to reduce stress and relieve pain

Be sure that you get the very best from your appointment and ask your pain management plan and about follow up appointments. Let the physician know that you want to play and active role in decisions on your pain management and be well informed and advised on treatments you are offered and side affects that you may experience from the medication.
Be informed!  

You may find this thread interesting on Nerve Pain and Management


source