How to Choose the Right Pain Specialist

With almost one in five American adults experiencing chronic pain, it is hardly surprising that there is so much demand for pain specialists.  That is, at least in part, why there are an increasing number of health care professionals who have assumed the title of “pain specialist.” Many of these pain specialists may have some medical training in the field of pain management, but this training isn’t always sufficient to qualify them as a pain medicine specialist.

The Field of Pain Medicine

The specialty of pain medicine arose relatively recently, but, of course, it has origins that go back to the creation of medicine. Pain medicine as a medical specialty started in the 1960s, followed in the 1970s with an international professional association. In 1991, the American Board of Anesthesiology created a certificate of added qualification in pain management; that same year, the American Board of Pain Medicine was established.  

The discipline of pain medicine is focused on the prevention of pain as well as the diagnosis, treatment and recovery of people in pain. Pain physicians obtain specialized training in pain as a symptom of other health conditions in addition to pain as a disease in itself.

Pain doctors may be the principal treating physician or a consultant to other physicians. Using a multi-disciplinary approach to pain management, pain specialists draw on the fields of anesthesiology, psychiatry, and neurology. Currently, there are no well-defined boundaries to the field of pain medicine that would distinguish it from other medical specialties.

Primary Care Versus Specialty Medicine

When considering the kind of medical professional to treat your chronic pain, the first choice should be between a primary care doctor or a pain specialist. In most cases, you have probably been obtaining care for your pain from your primary care physician since the onset of your pain symptoms, but you may find that a pain specialist is a better option if

  • Pain becomes chronic—the definition of chronic pain is any pain condition like arthritis, back pain or neuropathy that lasts longer than three months. If you reach the three-month mark without any pain relief, you should request a referral to a pain specialist.
  • No underlying cause—if your primary care physician can’t find a health condition that is causing the pain, you may need the advanced diagnostic skills of a pain specialist. It may be that there is a condition that your primary care physician is missing, or that the pain itself is the primary condition; in either case, you are probably more likely to find relief with a specialist.
  • If you are only on opioids—many primary care physicians have a limited understanding of pain and pain management, so they resort to opioid medications as the default treatment for any pain condition. This is a flawed approach, as chronic pain requires a holistic strategy and an opioid-only plan poses serious risks to the patient.
  • Your only option is surgery—if your doctor is recommending a risky procedure without any alternatives, then you should explore your options with a pain specialist.  Because pain specialists have broader knowledge of the latest pain therapies, they may be able to offer you some more palatable options.

Which Pain Specialist Is Right for You?

Once you have arrived at the conclusion that you need a pain specialist, then you need to choose one that best suits your personal needs. You should know that although there are some certifications in pain medicine, there is no one qualification that labels a physician as a pain specialist. Because pain specialists may start their professional careers in a number of medical specialties and eventually migrate to pain medicine, there is no easy way to distinguish a true expert in this field.

As a general rule, you should obtain pain treatment from a clinic that uses a multi-disciplinary approach. Not only does a team of physicians and health professionals working in tandem on your case improve your chances of achieving a breakthrough, but a multi-disciplinary therapy plan covers more aspects of pain conditions. For example, people who have lived with pain for an extended period of time often have secondary issues like depression or sleep deprivation which need to be remediated in an integrated therapy.

If you do decide you want an interdisciplinary program for your chronic pain, you should be prepared to make some difficult decisions. The number of clinics that use a multi-layered approach are dwindling in the U.S. because they are expensive and less likely to be covered by health plans. So, you may have to do some legwork to find such a clinic and book an appointment.

A second consideration is finding a right fit for your specific type of pain. Ask the program administrator not only what kinds of pain patients them most often treat, but also which kinds of patients experience significant improvement in their pain symptoms. 

Another consideration is the kinds of therapies that a pain specialist utilizes. There are a multitude of pain therapies including physical therapy, cognitive retraining, pharmacological compounds, or mind-body therapies. It is often a wise choice to discuss the pain specialist’s personal approach to treating pain and then decide if that approach is what you want. You should keep in mind, however, that not every therapy that sounds outlandish to you should be immediately dismissed.  There are many treatments which need some investment to produce results.

Finally, interview your pain specialist.  Pain medicine is a rapidly evolving field, so you want someone who has a strong grasp of the latest advancements. That usually means someone who regularly goes to pain conferences and researches new techniques in medical journals.  Your pain specialist may rely on more traditional treatment modalities, but they should have a keen understanding of emerging therapies as well—and strong arguments for his or her preferred treatments. You may want to question them about their position on opioid use among pain patients; you probably don’t want someone who sees opioids as a long-term solution, but you also don’t want a physician who undertreats patients.

Article written by: Dr. Robert Moghim – CEO/Founder Colorado Pain Care

M.D. Disclaimer: The views expressed in this article are the personal views of Robert Moghim, M.D. and do not necessarily represent and are not intended to represent the views of the company or its employees.  The information contained in this article does not constitute medical advice, nor does reading or accessing this information create a patient-provider relationship.  Comments that you post will be shared with all visitors to this page. The comment feature is not governed by HIPAA and you should not post any of your private health information. 

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