Pain management specialists are medical physicians with advanced training in reducing, relieving, or helping manage chronic pain. Chronic pain often persists for more than three months and requires special treatment. Hence, pain management experts collaborate with numerous specialists to reduce dependence on painkillers and teach techniques for performing daily tasks with minimal discomfort.
One must visit a specialist if the pain has been consistent for longer than three weeks and is restricting regular activities like — exercising, sleeping, or unwinding. Additionally, if the pain persists after trying over-the-counter medications or other pain relief remedies, visiting the expert may help get a proper diagnosis.
Education and training of pain management specialists
To become a pain management specialist, one must obtain a 4-year undergraduate degree and complete four years of medical school. While there are no residency programs for pain management, aspirants can pursue a medical residency program in a related discipline, such as anesthesiology or physical medicine and rehabilitation.
After completing their residency, aspirants must finish a 1-year fellowship in pain management. Finally, they must pass a board certification exam in pain management to start practicing. This exam can be administered either by the American Board of Physical Medicine and Rehabilitation or the American Osteopathic Board of Physical Medicine and Rehabilitation. After obtaining board certification, pain management specialists can pursue further education in sports medicine, traumatic injuries, and other related fields.
A long-term sickness, such as cancer or arthritis, can be the most frequent cause of chronic pain. Several injuries, such as whiplash, a broken bone, or a sprain, can also result in chronic pain even after the wound has healed. Patients with Crohn's disease, fibromyalgia, and shingles may also suffer from this pain after a successful recovery.
Some people with no signs of illness or trauma may also complain about chronic pain, commonly referred to as — psychosomatic or psychogenic pain. Anxiety, stress, and sadness are the causes of this pain, with no outward physical symptoms.
Long-lasting pain patients may experience sensations such as shooting, hurting, stinging, burning, throbbing, squeezing, or stiffness. Additionally, they may complain of chronic anxiety, fatigue, mood swings, and trouble sleeping. Hence, to treat such conditions, specialists may utilize various diagnostic techniques to identify the pain and treatment methods.
What are pain scales and their types?
A pain scale is a tool that specialists utilize to evaluate the intensity of pain experienced by patients. Physicians can gauge the pain type, intensity, and duration among patients of all age groups. Furthermore, it assists doctors in diagnosing the condition, creating a treatment plan, and measuring the effectiveness of the treatment.
Pain scales are of two types — unidimensional and multidimensional. Unidimensional pain scales measure pain levels using numbers, images, words, or descriptions. Some common ones are numeric rating scales (NRS), visual analog scales (VAS), and categorical scales.
Numeric rating scales use numbers ranging from 0 to 5 or 0 to 10, wherein 0 stands for 'no pain' and 5 or 10 stands for 'maximum pain.' Visual analog scales employ a 10-cm line with stops at each end to evaluate the patient's pain intensity. The leftmost point indicates 'no pain,' and the rightmost point means 'maximum pain.' Categorical scales use words or pictures to depict pain intensity, and the patients must choose the one that describes their pain.
On the other hand, multidimensional tools include an initial pain assessment tool, a brief pain inventory (BPI) that contains a series of questions, and a McGill pain questionnaire (MPQ).
An initial pain assessment tool also contains a paper diagram of the body, allowing patients to mark the location of the pain and rate the intensity on the scale provided.
Tests that help identify the cause of chronic pain
Listed below are a few tests that can help with initial pain assessment:
- CT scan - Computed tomography (CT) scans produce cross-sectional images of the body employing X-rays and computer imaging. During the scan, you must lie still on a table, which will pass through a semi-circular scanning device. Your doctor might inject a solution into your vein before the scan, making it easier to get a clearer image.
- MRI - Magnetic resonance imaging (MRI) uses radio waves and a magnet to produce images of the insides of your body. An MRI can take 15 minutes to an hour. This test is not recommended for people with pacemakers, as those devices can negatively react when they come in contact with magnets.
- Nerve block - For this test, your doctor will inject anesthetics into different nerves to help numb the pain. How you react to the nerve block helps your doctor identify the pain's root cause and where it originated.
- Discography - This test is best suited for people experiencing severe back pain. It helps your doctor decide if you need surgery. To conduct this test, your doctor will inject a dye into the spinal disc where you are experiencing pain. The dye helps outline the affected areas on X-rays, which can be used to gain information about spinal pain.
What are the other types of pain?
Apart from acute and chronic pain, medical professionals classify pain into the following types:
- Functional pain: Functional pain occurs when your body has no noticeable damage or injury. Its potential causes include irritable bowel syndrome (IBS), chronic cardiac chest pain, fibromyalgia, temporomandibular dysfunction, stress, and trauma. A pain management specialist can identify the root cause of your pain, help manage your symptoms, and improve your quality of life.
- Neuropathic pain: Various injuries and illnesses, such as multiple sclerosis, diabetic neuropathy, spinal cord injuries, and stroke, that cause nerve damage can lead to neuropathic pain. Doctors usually treat this condition using prescription medications like tricyclic antidepressants.
- Nociceptive pain: Nociceptors are the nerve endings that sense pain signals. Tissue damage resulting from underlying conditions like cuts, burns, fractures, muscle pain, and sprains causes nociceptive pain. This pain can be chronic or acute and can feel sharp and throbbing. Depending on how severe your pain is, its treatment can involve physical therapy, prescription medications, topical agents, surgery, etc.
When treating chronic pain, pain management specialists use a combination of methods that fall under one of two categories: non-interventional and interventional pain.
Interventional pain is when the skin is pierced or cut with an injection or surgery. In contrast, non-interventional methods have various combinations of non-surgical approaches. The former treatment is only adopted when the latter fails to cure the problem.
Pharmacological therapy, which includes over-the-counter and prescription medicine, is typically the first line of non-interventional treatment. Specialists employ this with other non-invasive techniques, such as acupuncture, cold and hot packs, biofeedback, chiropractic, massage, music therapy, and dietary changes. Other methods include physical and occupational therapy, yoga, and exercise specifically designed to target the cause of pain.
The idea behind interventional pain treatment approaches is to either stop pain signals from reaching the brain or administer medication right to the site of the pain. Commonly used interventional techniques include:
- Steroid injections: Steroid injections contain corticosteroids, a drug that can help reduce pain and inflammation. There are various types of corticosteroids, including cortisone, prednisone, and methylprednisolone. Doctors typically administer this injection directly into the affected body part, such as the hands, knees, feet, hips, shoulders, or spine. In case they choose to use an IV steroid injection, the injection site will likely be a vein in your arm.
- Pain pumps: Intrathecal pumps, also known as pain pumps, are surgically implanted devices that allow direct delivery of medicine to the nerves and spinal cord. Doctors might use them to deliver opioid pain medications, drugs for treating muscle contractions, and pain medicines like ziconotide and clonidine.
- Nerve block: Nerve blocks are injections containing medications that relieve temporary pain. Based on which nerve the injection is targeting, nerve blocks can be of various types, including occipital, epidural, genicular, pudendal, and intercostal. Doctors can also use these injections to diagnose the source of your pain.
- Radiofrequency ablation: Doctors suggest radiofrequency ablation for conditions like arthritis, spondylitis, peripheral nerve pain, and heart rhythm problems. This procedure helps reduce or stop pain, improve physical function, and avoid or delay surgery.
- Diskectomy: A diskectomy is a surgical procedure used to remove all or part of one of your intervertebral disks, which are flat, round cushions located between your spinal bones. Doctors usually recommend this surgery if you have a herniated disc (especially if you also experience sciatica, limb pain or numbness, or severe muscle weakness in your buttocks, arms, or lower legs) or cauda equina syndrome.
What medicines do pain management specialists prescribe?
The exact medicine your doctor would prescribe depends on the nature and severity of your condition. A few commonly prescribed pain medications are as follows:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Doctors usually prescribe NSAIDs for mild to moderate pain. Examples of this drug include ibuprofen, aspirin, and naproxen. While you cannot get addicted to NSAIDs, they might interfere with blood clotting and can cause vomiting, nausea, and stomach problems.
- Acetaminophen: Acetaminophen also helps treat mild to moderate pain. Unlike NSAIDs, it does not cause stomach issues. However, it might react with other prescription drugs and cause severe health complications, such as liver damage. If your doctor prescribes acetaminophen, discuss with them beforehand whether it can adversely react when taken simultaneously with any other medications you are on.
- Opioids: Drugs like morphine, codeine, and oxycodone are examples of opioids. Doctors prescribe these for acute pain. Although these medicines are safe for short periods, you might develop an opioid addiction if you rely on them for a long time. Other side effects of these drugs include dizziness, constipation, and rashes.
Tips to make life better for patients with chronic pain
Although pain management professionals can assist with chronic pain, lifestyle changes are necessary to achieve long-term comfort. Dietary changes are the first step in fighting chronic pain. A nutritious diet keeps your weight in check, eases digestion, improves heart health, and controls blood sugar levels. Giving up smoking and drinking alcohol enhances blood flow and sleep. Combining these with a regular exercise regimen strengthens your muscles.
Relaxation techniques help reduce stress, which aggravates chronic pain. Some commonly recommended relaxation techniques include meditation, deep breathing, biofeedback, and massage therapy. Being part of a support group introduces you to others dealing with similar problems and helps you manage your symptoms.
Finding the right pain management specialist near you in Fort Lauderdale, Florida
Chronic pain can be physically as well as emotionally challenging. Therefore, the first practical step in treating chronic pain is choosing the right pain management professional who can suggest a personalized treatment for your specific issues.
Zocdoc's database is comprehensive and easily accessible, which helps you find the best specialists practicing in Fort Lauderdale, Florida. Once you visit the Zocdoc website, fill in a few details, such as your symptoms, condition, or the doctor's specialty you wish to consult. Furthermore, you can narrow down doctors based on gender, language, availability, hospital affiliations, and whether or not they treat children.
Zocdoc will then filter and present you with a list of doctors best suited for your needs. Each pain management specialist near you on the Zocdoc website has a unique doctor profile. These profiles contain detailed information about their medical training and experience, specialization, certifications, accreditations, recognitions, etc. You can also read verified reviews and ratings from other patients to make an informed choice about your healthcare.
An insurance plan is essential in chronic pain treatment as it is always long-term and requires several follow-ups. By clicking on the drop-down menu on Zocdoc or using Zocdoc's insurance detector, you can view the various types of medical insurance. Once you choose your policy, Zocdoc will tell you which pain management specialists are within your network and who will accept your insurance. Adding your insurance information to your Zocdoc account can help you find a doctor who accepts your plan. Many doctors' offices require you to bring your insurance card despite you adding your details online. So, remember to carry it to your in-person appointments. For other insurance-related queries, check Zocdoc's patient help center.
After locating the best pain management specialist near you, you can book an in-person or virtual appointment with them. All bookings on Zocdoc are fast, free, and secure!
Statistics related to pain management in Fort Lauderdale, Florida
As per a 2015 Centers for Disease Control and Prevention report, about 21.5% of adults were diagnosed with arthritis. Florida was one of the states in the US with the lowest prevalence rate. Among the 21.5% of adults, the prevalence rate was around 24.75% among women and nearly 18.01% among men. Approximately 38% of the adults diagnosed with arthritis complained of severe joint pain.
The city of Fort Lauderdale comes under Broward County. As per the same report, in 2015, Broward County had a 22.6% crude prevalence rate of arthritis. Based on another 2021 America's Health Rankings report, nearly 10.3% of adults reported having physical distress for more than 14 days. Similarly, about 24% of Florida adults in 2020 had arthritis. The age group 65 years and older had the highest prevalence (about 40%), followed by ages 45-64 (nearly 27.8%) and 18-44 years (around 7.4%).
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