Pain management

Pain management is the medical discipline concerned with the relief of pain.


Types of pain

Acute pain is such a pain that results from trauma.Usually it has a reversible cause and to overcome it only transient measures and correction of the underlying problem is needed. Besides it, chronic pain is another pain that difficult to diagnose and treat which may take a long time to recover.Some examples include cancer, neuropathy, and referred pain. Sometimes, pain pathways (nociceptors) are made that continue to transmit the sensation of pain even though the injury that originally caused pain has been healed. In such situations, the pain itself is frequently managed separately from the cause of that symptom.In other words the goal of treatment is to manage the pain with no treatment of any underlying condition (e.g. if the underlying condition has resolved or if no identifiable source of the pain can be found).

Trauma:Physical trauma refers to a physical injury. A trauma patient is someone who has suffered serious and life-threatening physical injury resulting in secondary complications such as shock, respiratory failure and death.



Methods

Pain management generally benefits from a multidisciplinary approach that includes pharmacologic measures (analgesics such as narcotics and pain modifiers such as tricyclic antidepressants or anticonvulsants), non-pharmacologic measures (such as interventional procedures, physical therapy and physical exercise, application of ice and heat), and psychological measures (such as biofeedback and cognitive therapy). The World Health Organization (WHO) introduced a pain ladder for managing analgesia which was first described for usage in cancer pain, but can be used by medical professionals as a general principle when dealing with analgesia for any type of pain.


Medical specialties

Pain management experts come from all fields of medicine.Mostly, pain management physicians are anesthesiologists, neurologists, physiatrists or psychiatrists.Some experts are more preferable for the pharmacologic management of the patient, while others prefer the interventional management of pain.Interventional procedures - typically used for chronic back pain - include: epidural steroid injections, facet joint injections, neurolytic blocks, Spinal Cord Stimulators and intrathecal drug delivery system implants, etc.The number of interventional procedures done for pain has grown to a very large number since several years.

Unfortunately, many of these experts are not board certified or are certified by unrecognized boards. Patients should look for practitioners that have completed an ACGME approved fellowship and are board certified by either the ABA, ABPMR or the ABPN.