What is pain management and when is it appropriate? Pain management is a specialty of medicine that is often recommended for patients with difficult, chronic pain. It is an important medical specialty that tries to ameliorate human suffering. With the aging of our population, the demand for this specialty will continue to grow. As we age our bodies degenerate and this can cause pain and disability.
The most common type of patient treated by pain physicians are those with neck pain and low back pain, i.e. spinal pain. Common problems treated are herniated discs, degenerated discs, arthritis, spondylosis, spondylolisthesis, sciatica, arm and leg pain.
Common treatments for these problems are epidural steroid injections, selective nerve root blocks, facet injections and radio-frequency lesioning. These treatments are generally considered appropriate, after patients have failed to improve from non-invasive treatments such as physical therapy and chiropractic. Good surgeons generally want patients to try at least one of these treatments before considering surgical treatment.
I often treat patients concurrent with these methods. And I am often grateful to pain physicians who can help me with patients when my methods are insufficient. Conversely, there are occasions when patients proceed to injections before physical therapy or chiropractic treatments, and the injections may prove insufficient. It is best for all three parties concerned, to cooperate in ascertaining what is necessary to get each patient as improved as possible. Sometimes one, or both, treatments are necessary and a professionally cooperative relationship best serves patients, the objective of medicine.
Unfortunately, for patients and specialists alike, many specialty physicians don't have professionally cooperative relationships with other specialists. As a result, they don't really know what others do, nor the relative value of other treatments and they can't learn about them. Keep in mind that it's not enough for one professional to read about another procedure. It is best when doctors can discuss common patients, and have patients share their impressions about various treatments. Over time, physicians who learn of other procedures can become better patient advocates.
I have had the good fortune to work with many physicians in other specialties, and I have learned a great deal. I can triage patients appropriately, and speak authoritatively to patients, at least in a general sense, about surgery and pain management procedures. When I, a non-surgeon, counsel patients, respectfully, about such procedures they find it reassuring and are thankful. They know I am serving their interests, not mine.
On another note, I should like to point out a common fallacy among physicians and patients. That is the notion that patients who have been referred to pain management will not improve from other treatments such as physical therapy or chiropractic. In fact, 30% of the patients that I treat have already had pain management and it did not help or it stopped helping. When I treat these patients, the large majority will improve sufficiently that they will not opt for surgical treatment. The reason that I am able to help most of these patients is that many are not receiving the best available free notion alternative to pain management treatment.
Craig Castanet, D.C. is an Atlanta chiropractor with 24 years experience. For more information on the relief of back and neck pain including video, you can go to physical therapy Atlanta.
