The Management of Acute, Chronic and Cancer Pain

For thousands of years, doctors have been helping to relieve their patients’ pain with a variety of medications and treatments. Like other areas of medicine, a new subset of doctors have become specialists in treating pain. They are focused on managing all types of pain - studying what causes it, how the body reacts to it, how different medications dull or eliminate the pain, and how other treatments can be used to relieve many painful conditions.

DOCTORS WHO SPECIALIZE IN TREATING PAIN

Doctors who manage pain are frequently anesthesiologists. Anesthesiologists are doctors of medicine (M.D.) or osteopathy (D.O.) who make sure that you are safe, pain-free and comfortable during and following surgery. They also provide their services in other areas of the hospital - especially in the labor and delivery area - or in doctors’ offices where painful medical tests or procedures are performed.

But not everyone realizes that decades of research and work done by anesthesiologists have led to the development of newer, more effective treatments for patients who have pain unrelated to surgery. Many techniques used to make surgery and childbirth virtually painless are now being used to relieve other types of pain. In fact, the work pioneered by anesthesiologists that led to these new medications and treatments also has created a new category of medicine called pain medicine.

Frequently the anesthesiologist heads a team of other specialists and doctors who work together to help you manage your pain. The anesthesiologist or other pain medicine doctors (such as neurologists, oncologists, orthopedists, physiatrists and psychiatrists) and nonphysician specialists (such as nurses, nurse practitioners, physician assistants, physical or rehabilitation therapists and psychologists) all work together to evaluate your condition. Then this “team” of specialists will develop a treatment plan designed just for you.

What type of training does a pain medicine doctor have?
Like other physicians, anesthesiologists earned a college degree and then completed four years of medical school. They spent four more years learning the medical specialty of anesthesiology and pain medicine during residency training. Many anesthesiologists who specialize in pain medicine receive an additional year of fellowship training to become a “subspecialist,” or an expert in treating pain. Some also have done research, and many have special certification in pain medicine through the American Board of Anesthesiology (ABA). The ABA is the only organization recognized by the American Board of Medical Specialties to offer special credentials in pain medicine.

When would I need to see a pain medicine doctor?
People develop pain for many reasons. Pain from a recent surgery, injury or medical illness is called acute pain. In many cases, this pain can be managed immediately and will usually get better in just a short time. For more serious pain, however, your primary care doctor may ask a pain medicine doctor to help manage your pain while you are healing.

If your pain persists after the healing process should be over, you might have what is called chronic pain. If the current treatment you are receiving stops working or your pain begins to get worse over time, your primary care doctor may suggest that you see a pain medicine doctor.

Cancer pain is another condition that can be managed by a pain medicine doctor while the patient continues to receive treatment for various types of cancer. The pain can be due to cancer surgery or treatment procedures, including radiation therapy and chemotherapy, or the tumor itself.

What does a pain medicine doctor do? Can these doctors find out why I hurt?
Pain medicine doctors are experts at diagnosing why you are having pain as well as treating the pain itself. Some of the more common pain problems they manage include: arthritis, back and neck pain, cancer pain, nerve pain, migraine headaches, shingles, phantom limb pain for amputees and pain caused by AIDS.

They also manage acute pain caused by surgery, a debilitating illness or a serious injury. Examples include: pain after a knee-joint replacement, pain during recovery from a car accident, pain following stomach or chest surgery, or pain associated with sickle cell disease. You may be treated in the hospital or in an outpatient clinic.

 
• The pain medicine doctor will work closely with your primary care doctor.  
• Pain medicine doctors will review your medical records and X-rays as needed.  
• They will ask you to describe your pain in detail, such as where it hurts, for how long, what makes the pain worse or what makes it feel better.  
• They may ask you to fill out a detailed questionnaire that helps them to assess the impact that your pain is having on your lifestyle and if it is interfering with your daily activities.  
• They also will do a complete physical examination on you.  
• They may need to order other tests and will then review all of their findings to determine what is causing your pain and how the problem can be corrected.