An estimated 100 million Americans live with chronic pain, making it difficult to sleep at night and concentrate during the day, while also affecting your energy level and overall enjoyment of life. If pain is a regular part of your life, a pain management doctor may be able to help.
Pain can contribute to depression and anxiety. Doctors often refer to “degree of pain” as the “fifth vital sign.” That’s because pain can be a clinical barometer for what’s going on with your health.
Acute pain occurs or appears suddenly, usually in a matter of days or weeks. Subacute pain refers to pain that generally lasts between 6 and 12 weeks. Chronic pain is unremitting pain lasting beyond 12 weeks.
What is Pain?
Pain is an unpleasant sensation. However, pain is also a nervous system response that, for the most part, protects the body. For example:
The pain you feel when you hold your hand over a hot stove causes you to pull your hand back, so you don’t get burned.
Musculoskeletal pain leads you to rest an injured ankle to allow it to heal.
Pain can also be the result of surgery or metabolic problems such as diabetes.
Occasionally, pain can even be the problem without an apparent cause, as in nerve (neuropathic) damage. Neuropathic pain does not have a protective purpose, and there is no known benefit. It may be the result of misread signals between the body’s nerves and the brain, or from damage to a nerve. The brain incorrectly interprets these signals from the nerves as pain. Examples of this pain type include:
Pain isn’t always straightforward, like a cut or burn on your hand. A pain in the lower back could be the result of many conditions, for example. It could be musculoskeletal in nature and a result of one’s posture at work. Lower back pain could also be from a herniated disc, spinal stenosis, or sciatica. Or, the pain could be due to a degenerative condition like arthritis or degenerative disc disease.
As the field of medicine learns more about the complexities of pain, it is becoming more important to have physicians who specialize in treating pain.
What Does a Pain Management Physician Do?
A “pain doctor,” also called a “pain specialist,” or “pain management specialist,” is a medical doctor (M.D.) or doctor of osteopathy (D.O.) who specializes in pain medicine.
Pain management doctors have specialized training to evaluate, diagnose, treat, and prevent many different types of pain. These highly-specialized doctors not only diagnose conditions, but coordinate treatment, and provide ongoing care for pain patients. They work most often with chronic pain patients who experience symptoms for three months or longer.
A pain management physician understands the physiology of pain and conducts specialized tests to diagnose complex pain conditions. Pain management specialists prescribe proper medications and therapies to treat pain. Although opioids can treat some types of pain, they should not be the first line of treatment. There are many minimally invasive procedures (nerve blocks and spinal injections), physical therapy, and non-narcotic therapies that allow a return to normal daily activities without the use of opioids.
A pain management specialist develops a treatment plan to relieve, reduce, or manage pain. The pain management doctor helps patients return to everyday activities quickly without surgery or heavy reliance on medication. In many cases, the pain management physician coordinates care with a team of health professionals to meet all the patient’s needs. That team of professionals may include:
In addition, the pain management specialist is watchful for the patient’s ability to function and their overall quality of life. To that end, they treat the whole patient, not just one part of the body.
While a primary care doctor can and should help in some cases, for advanced types of pain, they’ll likely refer their patient to a pain management doctor.
A pain management doctor has gone through an additional one-year fellowship in pain management after their general residency. They’re also board-certified in their specialties.
What Should I Look for In a Pain Management Physician?
The most important consideration in looking for a pain doctor is to find someone who has the training and experience to help treat your pain problem, and with whom you feel a comfortable rapport.
Since many types of chronic pain may require a complex treatment plan, as well as specialized interventional techniques, pain specialists must have more training than in the past.
When a physician is board certified in their primary specialty and has completed an accredited fellowship, they are eligible for subspecialty board certification in pain management by the American Board of Anesthesiology, The American Board of Psychiatry and The American Board of Neurology, or the American Board of Physical Medicine and Rehabilitation. These three are the only board certifications in pain management recognized by the American College of Graduate Medical Education (ACGME).
As a physician specializing in Physical Medicine and Rehabilitation, Dr. Torres is Board Certified in Physical Medicine and Rehabilitation and Pain Medicine through the American Board of Physical Medicine and Rehabilitation. Dr. Torres completed his residency in Physical Medicine and Rehabilitation at the University of Toledo, followed by an ACGME accredited 2-year Pain Medicine Fellowship at the University of South Florida.
How Can I Be Referred to a Pain Management Physician?
The best way to be referred to a pain management specialist is through your primary care doctor. Most pain doctors work closely with their patient’s primary care physician to ensure good communication, which in turn helps provide the optimum treatment for their patients.
Patients are also often referred by specialists who deal with different types of pain problems, such as surgeons, neurologists, cancer doctors, as well as other specialists.
What Should I Expect During My First Visit to a Pain Management Physician?
Understanding the cause of pain is the first step in treating pain. In some cases, the cause of pain may be apparent, such as a spinal fracture. In cases of chronic pain, there may be more than a single cause, making the diagnosis difficult. A pain management doctor relies on the patient’s medical history as well as physical and neurological examinations.
On the first visit, a pain management specialist gets to know the patient and their specific pain problem. This appointment will usually involve a detailed medical history, both past and present. It is essential for the patient to describe the pain in terms that help the pain doctor understand. A stoic person may describe a pain as a “2” on a pain scale, while someone else might describe the same pain as a “6.” This WebMD article may be helpful in describing the pain.
Often the patient is given a questionnaire before the first visit that asks detailed questions about the pain. The patient may also be asked to bring any imaging studies (X-rays, CAT scans, and MRI scans) or other tests that have been performed. Other items to bring on your first visit to a pain doctor include:
A pain journal (if you have one) that details your symptoms, the triggers, and pain intensity.
A list of any medications you are currently taking.
A list of pain relief treatments you’ve tried.
Information about what makes the pain worse and what helps provide relief.
A good pain doctor will listen to your concerns with a compassionate ear and customize a pain management plan.
In addition to a physical examination, the pain doctor may also conduct:
A neurological exam to evaluate the patient’s sensory (feel) and motor (function) capabilities including reflexes, balance, ability to walk, muscle strength, and muscle tone.
An X-Ray or Radiograph to reveal the condition of the body’s bone structures. Results may suggest more testing is necessary.
A CT scan (Computed Tomography) is a 3-dimensional imaging study that also evaluates bone and soft tissue.
An MRI (Magnetic Resonance Imaging) is a powerful imaging tool useful for musculoskeletal evaluation as it provides detail about bones and soft tissues.
A PET scan (Positron Emission Tomography) measures tissue changes at the cellular level. It is a test used when cancer is the suspected cause of pain.
Discography allows the physician to evaluate the intervertebral disc or discs as a possible pain source. The test evaluates the structural integrity of the discs and may be used to replicate back or leg pain.
Electrodiagnostic tools include NCS (Nerve Conduction Study) and EMG (Electromyography). Usually, both tests are performed, although an NCS may be performed without an EMG.
An NCS (Nerve Conduction Study) evaluates the speed of nerve impulses as they travel along a nerve. This test can help determine if there is nerve damage, the extent of damage, and if nerves have been destroyed.
An EMG (Electromyography) uses nerve stimulation to evaluate electrical activity within selected muscle fibers. The test measures muscle response and detects muscle damage and disease. It can help to distinguish between a muscle and nerve disorder.
What Are Signs of Needing Pain Intervention?
Living with chronic pain can be an emotional and physical challenge. There are many types of interventions that can provide relief. It is essential to make an appointment with your primary care physician if you experience the following symptoms related to your pain:
A pain that has not gone away after 2 to 3 weeks.
A pain that contributes to stress, anxiety, or depression.
A pain that makes it impossible to relax.
You are unable to exercise or participate in activities as you once did.
The interventions that previously controlled the pain are no longer effective.
What Should I Avoid?
You should stay away from pain clinics that offer mostly narcotics to treat pain. These medications can be highly addictive. They can also interact with other medicines you may be taking. A quality pain clinic will focus on the patient and their needs, not just the pain.
Novus Spine & Pain Center
Dr. Torres established Novus Spine & Pain Center in Lakeland, Florida with a goal of providing the highest quality pain management care to every patient. Whether pain is the result of an injury or from another condition, Dr. Torres offers many different treatment options.
Novus Spine & Pain Center utilizes a comprehensive approach and cutting-edge therapies to restore normal function and allow patients to regain an active lifestyle while minimizing the need for opiates. As our patient, you are our top priority. Our goal is to help you achieve the best possible quality of life.
Our Mission Statement:To provide the best quality of life to people suffering from pain, by providing state of the art treatments, knowledge and skill, compassion, and respect for all.