Ask the Patient Advocate About Pain Management Specialists

By LanaPA Latest Activity February 15, 2013 at 8:45 am Views 4,179 Replies 19 Likes 4

Lana

A pain management doctor can offer options to help you to function if you are living with chronic pain. The goal is to help you to manage your pain so that you can hopefully enjoy a better quality of life. If your daily living has been affected by pain and you are unable to focus on household tasks, work, and leisure, then maybe a pain management specialist can help you.

What questions do you have for me about pain management specialists?

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Replies (19 replies)

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  • redorangedog
    redorangedog September 19 at 10:17 am   

    Introduction to pain management
    Pain management can be simple or complex, depending on the cause of the pain. An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down the leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. Sometimes, however, the pain does not go away. This can require a wide variety of skills and techniques to treat the pain. These skills and techniques include:

    Interventional procedures
    Medication management
    Physical therapy or chiropractic therapy
    Psychological counseling and support
    Acupuncture and other alternative therapies; and
    Referral to other medical specialists
    All of these skills and services are necessary because pain can involve many aspects of a person's daily life.

    How is pain treatment guided?
    Readers Comments 54 Share Your Story
    The treatment of pain is guided by the history of the pain, its intensity, duration, aggravating and relieving conditions, and structures involved in causing the pain. In order for a structure to cause pain, it must have a nerve supply, be susceptible to injury, and stimulation of the structure should cause pain. The concept behind most interventional procedures for treating pain is that there is a specific structure in the body with nerves of sensation that is generating the pain. Pain management has a role in identifying the precise source of the problem and isolating the optimal treatment.

    Fluoroscopy is an X-ray guided viewing method. Fluoroscopy is often used to assist the doctor in precisely locating the injection so that the medication reaches the appropriate spot and only the appropriate spot. Ultrasound is also used to identify structures and guide injections.
    medicinenet.com

  • redorangedog
    redorangedog September 19 at 10:15 am   

    A bag of narcan will never make you want to use narcotics.

  • PandorasPandemonium
    PandorasPandemonium February 16, 2013 at 2:50 pm   

    For my worker's comp injuries, I have been a patient of a "rehabilitation specialist" for the past 14 years.

    My injuries are considered an "accumulative trauma", a result of injuring the same body parts repeatedly. This was caused by lifting things that were too heavy for me. Honestly, I thought that the other emploies probably felt that things were heavy for them too. I never took into consideration that they were all much bigger than I am. Also, you would think that I would have been building muscles from all of the lifting. My injuries pretty much include everything from the waist up.

    After 14 years with this doctor, he has well earned my trust. From the very beginning, he gave me treatment options, we discussed them together and made an informed decision together.

    Last October, I discovered that he also treated Fibromyalgia, and he has been treating me for this issue as well. He immediately put me on Sevella, and it has worked wonders not only for my Fibro, but for my arthritis as well.

    There are two pain specialist in our area, and the only thing that they do is give injections. I did recieve the injections for two years from a pain specialist. Some injections worked for an hour, some a few weeks or months, others, not at all. I was getting up to twenty injections at a time. I stopped getting them because the doctor and I decided together that it wasn't working well enough to continue.

    A new pain center recently opened, and since they never returned any of my phone calls, I went there in person to book an appointment. I was told that they only do injections there also, and they don't take Fibromylagia patients, because the injections don't work on us.

    In my humble opinion, if at a pain managment specialist your only option is injections, you are at the wrong place.

  • Harley_Dog
    Harley_Dog October 15 at 5:04 am   

    Worker's comp 14 years WOW that is one heck of a train ride I am on that now. Sorry to hear you are having to live life like that it is rough! I am fighting mine tooth and nail right now just to get treatment on my left knee it was twisted and popped wound up with torn ligaments. going on 6 months and still no decision in site.

    I can relate with you on the pain management department. I was diagnosed with OA in 2004 and since, have had both hips, right shoulder and right knee replaced. I am waiting on decision for my left knee replacement, after that only one major joint left right shoulder . Pain Management I have been to soo many I have lost count, it seems the only thing they learned how to do is prescribe you a pill, shot which usually I consider a band aid last maybe 6-12 months for me others maybe longer or use a cold/hot pack.

    I honestly would not know how to act if one of them did not prescribe some form of medicine and said hey lets try something that is not going to destroy your body more than it already is. I shake my head any time a doctor speaks pain management and say no thanks

  • redorangedog
    redorangedog February 17, 2013 at 6:25 pm   

    I would have loved to kick that. 'Pain is our friend,' doctor between the legs and asked him 'what are your boys sating to you now.?

  • Kelseymarie
    Kelseymarie February 16, 2013 at 10:27 am   

    This is a great topic to talk about.
    I have always been leary of pain management. I have heard a lot of negitative things about pain managment like they just pass out addictive meds and never address the root of pain or it is a waste of money. I would love to find one that offers alternatives to medication to help cope and lesson pain. I think the idea of pain mang is wonderful but I have not heard a lot of postive stories so I have mixed emotions.

  • Dr James
    Dr James September 3 at 6:18 pm   

    I happen to be one of VERY few Clinical Pharmacists who have been Pharmacy Director at NIDA (National Institute for Drug Abuse). Narcotic medications will become addictive-with abuse potential-IF the patient has an addictive personality. This is much different from Medical "Addiction" side effects of mediation= NO drug seeking behavior.
    For a Pain Management Clinic; use one thru a TEACHING Hospital-they have acupuncture,trigger(sic), trigger point massage, nerve ablation therapy etc. THIS IS BETTER THAN PRIVATE CLINICS BECAUSE THE PROFIT MOTIVE IS ELIMINATED. Some private clinics will (as the Lawyers say) hold the patient hostage due to diagnosis. This means if you -or your regular Doctor/Pharmacist find a drug interaction,or other irregularity, you are UNLOADED QAUICKLY.
    Bottom line Kelsey-if your pain levels compromise activities of daily living there is no reason not to try a trial of narcotic analgesics.

    P.S. Please excuse typos & sp need surgery both hands= Tx Dr James

  • Kelseymarie
    Kelseymarie February 16, 2013 at 10:27 am   

    This is a great topic to talk about.
    I have always been leary of pain management. I have heard a lot of negitative things about pain managment like they just pass out addictive meds and never address the root of pain or it is a waste of money. I would love to find one that offers alternatives to medication to help cope and lesson pain. I think the idea of pain mang is wonderful but I have not heard a lot of postive stories so I have mixed emotions.

  • kittenpurr1
    kittenpurr1 February 15, 2013 at 2:58 pm   
    Edited February 15, 2013 at 3:03 pm by kittenpurr1

    You know what my pharmacy told me- when I told them, "They want me to go to pain management", he said, "You don't need to go there, it's cost too much, they do things that are expensive, you get drugged tested, and you aren't on but 2 controlled substances." So, I said, "Okay!" I canceled the appointment.

  • Lana
    LanaPA February 16, 2013 at 8:16 am   

    I think there is a lot of misconception about what pain management is and what pain management doctors do. A couple years ago, I was in a car accident and my injuries included herniated discs in my neck and back. I tried everything for an entire year and nothing helped so my doctor recommended pain management. After a series of nerve block injections, I found that my pain was nearly gone. Of course, a year later is it is back and I am considering going back. I was never asked what medications or pain meds I was taking and every time I went in, the staff was kind and caring. I went in for a series of four injections, three for my neck and one for my low back. Interestingly, my low back pain is what has come back.

    Sometimes medications alone are not enough to treat chronic pain. Other treatments can be more effective. Pain management doctors offercorticosteroid injections that are injected around nerve roots or into muscles and joints to relieve swelling, irritation and muscle muscles. They also offer nerve block injections which are used to block pain in a specific area. Pain management offers other therapies including physical and occupational therapy, electrical stimulation, acupuncture, relaxation training and surgery as a last resort.

    My insurance picked up most of the cost so I am not really sure about the cost. When I was referred, I was not on any narcotic pain relievers. I was taking an anti-inflammatory and muscle relaxer as needed. I was also going to a chiropractor and physical therapy. I had misconceptions about pain management before I went in but I have changed my tone because nothing else offered me relief.

  • Crazy Jane
    Crazy Jane February 23, 2013 at 8:24 pm   

    How much does Medicare and Anthem cover for pain management? I'm thinking about finding one.

  • Lana
    LanaPA February 23, 2013 at 9:30 pm   

    It should pay all or part of it. Some will not cover outright, they will expect you to exhaust all other options before pain management. Some things that can help you to overcome insurance barriers and to get the coverage you need include:

    • Knowing your insurance plan. Ask your insurance company which medications and pain management therapies are covered under your plan. Find out if you need a referral or other preauthorization before seeing a specialist. Ask questions if you understand aspects of coverage.
    • Make sure all your paperwork is taken care of and don’t assume that other parties are taking care of. Make sure that everyone you see is covered under your pain. Make sure your referring doctors has filed any required paperwork.
    • Keep records of everything. Keep all bills and correspondence from doctors, hospitals and your insurance company. Having detailed records will help if there is a dispute.
    • If you are denied, appeal. Find out your insurance company’s guidelines for appealing and follow up. Every company is required by law to allow you to appeal a denied claim. Your doctor can also help make an argument for pain management.

    If your insurance will not pay, talk to your doctor about other options. Most hospitals offer charity programs and assistance, there may be something you may quality for to pay for pain management. Good luck!

    BTW, I have Anthem BCBS and they have picked up for pain management. It was after I had exhausted other options.

  • Crazy Jane
    Crazy Jane February 24, 2013 at 8:11 am   

    Thank you so much, Lana! I will pursue this option.

  • kittenpurr1
    kittenpurr1 February 16, 2013 at 6:07 pm   

    Thanks, Lana.

  • debraselmore
    debraselmore February 16, 2013 at 6:40 pm   

    Oh gee…this is an ancient topic for me, but I do remember the experimental days. When it comes to pain relief my favorite is a good lots of time to spend in a hot tub. I have never had that option, and ultimately chose physical therapy.

    Here is how it happened:
    I once had a doctor who pumped me full of pain meds. My doctor moved and I went to another doctor who was just looked at me and said, "Pain is our friend. Pain is telling us that we have limitations and we need to learn to listen and appreciate pain." Then he sent me to a physical therapist.
    Physical therapy was confusing and it took me several years and three different physical therapists to understand how it works to relieve pain.
    So here is the secret according to the physical therapy method: Keep the muscles firm and they will support the bones and you will have less pain! It is true, if you can bypass the pain long enough to coax yourself to do your prescribed exercises.

    Medications wear off and then you have pain again! I like my liver and kidneys too much to go the medication route again. I still support the idea of a hot tub, but will probably never have that luxury, so I use an electric blanket often and it works extremely well when you are having pain so bad that you can't sleep. A sleepless night only makes you hurt more, so get lots of sleep. In the summer time a dip in a cold pool of water also works to relieve pain and swelling.

  • Kelseymarie
    Kelseymarie February 19, 2013 at 11:25 am   

    Thank you for sharing this information. What the therapist told you makes sense. Your right in saying the hardest part is pushing past the pain to exercise.

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