Primary care physicians often are the first to treat patients who experience pain. These doctors (e.g., family practitioners, internists, pediatricians) play an important role in pain management. Pain doctors (also called pain management specialists) usually coordinate patient care as part of a pain management team. Good communication with each member of the health care team can help ensure that the patient’s needs are met.
Pain management specialists use a number of techniques to diagnose and treat pain disorders. Pain evaluations often include taking a personal and family medical history, assessing the patient’s lifestyle (e.g., activity level), reviewing prior tests (e.g., blood tests, imaging tests, electrodiagnostic studies), and performing a physical examination.
Treatment for pain varies, depending on the cause. Some treatments are designed to reduce pain, and some are designed to help patients manage pain. Methods used to relieve pain include the following:
It is important to provide the following information to your pain management team before you begin treatment:
How long have you been experiencing pain?
Answers to the following questions may be helpful before beginning pain treatment:
Pain management is the systematic study of clinical and basic science and its application for the reduction of pain and suffering. This discipline emphasizes an interdisciplinary approach to treatment, blending tools, techniques and principles taken from a variety of the healing arts to create a holistic paradigm for the reduction of pain and suffering.
Acute pain, for the most part, results from disease, inflammation, or injury to tissues. This type of pain generally comes on suddenly, for example, after trauma or surgery, and may be accompanied by anxiety or emotional distress. The cause of acute pain can usually be diagnosed and treated, and the pain is self-limiting, that is, it is confined to a given period of time and severity. In some rare instances, it can become chronic.
Chronic pain is widely believed to represent disease itself. It can be made much worse by environmental and psychological factors. Chronic pain persists over a longer period of time than acute pain and is resistant to most medical treatments. It can—and often does—cause severe problems for patients. A person may have two or more co-existing chronic pain conditions.
Addiction is a primary, chronic, neurobiological disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
Physical dependence is a state of adaptation that is manifested by a drug class-specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood levels of the drug, and/or administration of an antagonist.
Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.