A Physical Medicine and Rehabilitation doctor (pain management doctor), or Physiatrist, is a medical specialist who is trained in assessing, diagnosing, and treating chronic pain and its associated conditions. The training of pain management doctors is extensive. After a medical residency usually in anesthesiology or physical medicine and rehabilitation, candidates can undertake a fellowship, which allows for more specific training in this field.
There is also a board certification offered by the American Board of Anesthesiology, as well as the American Board of Pain Management.
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This specialist treats pain associated with a wide range of medical conditions, including:
A physiatrist will consider a patient’s medical history, evaluate diagnostic testing, and assess a patient’s current condition to formulate an effective treatment plan to ease a patient’s pain. Reducing pain not only immediately benefits the patient, but also enables a patient to more easily tolerate the physical therapy regime that may be necessary to heal.
A pain management doctor can use many different pain management tools. Your doctor will decide which treatment is best for you based on the nature and location of your pain, its intensity, and your physical examination. Some common pain management techniques that may help you start feeling better are listed below.
A trigger point injection represents an option for treating local acute pain caused when a muscle does not relax. Your doctor will search for the specific location of your pain by palpating the area of concern for what feels like a “knot” in the muscle. This location is known as a trigger point.
After locating the painful trigger point, the doctor will inject medication directly into the area with a fine needle. A combination of medication that includes a local anesthetic and corticosteroid offers excellent and immediate pain relief. This is a relatively quick procedure that is performed in the doctor’s office.
An epidural steroid injection is a common surgical treatment option for neck and back pain. Using fluoroscopic guidance, your doctor will inject medication into a specific anatomical space, called the epidural space.
This procedure is intended to reduce pain and inflammation around the symptomatic nerve roots. Once pain and inflammation are reduced, a patient can more readily tolerate the physical therapy necessary to strengthen and increase the range of motion, of the affected body part.
Often preferred for lumbar pain, facet joint injections involve the injection of pain medication directly into the facet joints which are located on the sides of the vertebrae. When pain is chronic, multiple injections may be necessary. Your pain management doctor may use fluoroscopy to guide the procedure and minimize the risk of nerve injury.
Radiofrequency ablation is a minimally-invasive procedure that destroys the nerve responsible for carrying pain signals to the brain. It provides relief for those suffering from chronic and recurrent pain. It is also appropriate for patients who have undergone nerve block injections.
Also known as rhizotomy, it uses heat to prevent pain signals from reaching the brain. The radio frequency waves essentially interrupt the problematic nerve, offering immediate relief and helping a patient avoid further surgical intervention. The patient often experiences improved functioning within a minimal period of time.
Regenerative medicine is new but has proven to be of great help to those who suffer from chronic pain. These injections are commonly used to address musculoskeletal pain. Platelet-rich plasma injections use platelets taken from the patient to accelerate the body’s healing.
Injected activated platelets stimulate the release of growth factors that promote healing. Ultrasound guidance is used to perform this procedure, thereby reducing the risk of complications.
Pain management doctors can also prescribe many different types of medications to manage a patient’s pain. Regardless of the pain management medication prescribed, however, the patient should be monitored at all times for the medication’s effectiveness and potential side effects.