Category: Health

What to expect from your pain management specialist

What pain specialists treat

Pain management specialists are doctors who can diagnose and treat chronic pain. This is pain that you may have for more than three months that isn’t getting better. Although you may try some self-care at home or see your primary care doctor for pain when it first develops, you usually would see a pain management physician for pain that doesn’t go away.

Here are a few examples of the types of pain managed by pain management specialists:

• Back pain.
• Neck pain.
• Headaches/migraines.
• Arm or leg pain.
• Abdominal pain.
• Pelvic pain.
• Nonspecific joint pain.
• Pain related to a failed surgery.
• Pain related to cancer.

Before Your Appointment

If you are seeking help for chronic pain, the following will be helpful to you as you prepare to meet with a pain management specialist for the first time.

Plan to bring the following items with you to your appointment:

• All your medications – either the bottles or a list with current doses
• Contact information for your other physicians
• Your pharmacy’s contact information
• Your medical records, surgical records and imaging results

During Your Appointment

Arrive early so you can fill out forms. When you’re with the pain management specialist, share as much information as possible. This will help him or her make an accurate diagnosis and an effective treatment plan. Also be prepared to take notes.

Don’t hesitate to ask any questions or get clarification if there’s something you don’t understand. Some questions you’ll want to ask are:

• What are reasonable goals for treatment?
• Are there medications I should take or avoid?
• How can I keep myself free of further pain-related issues?

After Your Appointment

Take time to review everything you learned. If there’s anything you don’t understand or remember, be sure to call your doctor’s office.

During follow-up appointments, share how things are going. If you’re not seeing the results you expected, your doctor may adjust your treatment plan.

Types of pain treated by a pain management doctor

The types of pain treated by a pain management doctor fall into three main groups. The first is pain due to direct tissue injury, such as arthritis. The second type of pain is due to nerve injury or a nervous system disease, such as a stroke. The third type of pain is a mix of tissue and nerve injury, such as back pain.

Disorders that cause pain due to tissue injury

• Osteoarthritis (wear and tear arthritis in the large joints: knees, hips)
• Rheumatoid arthritis (arthritis due to an autoimmune reaction – felt in small joints like fingers, wrists)

Nerve or nervous system disorders that cause pain

• Stroke (post-stroke pain)
• Multiple sclerosis
• Spinal cord injury
• Neuropathy (nerve pain due to shingles, HIV, diabetes)

Mixed pain disorders

• Neck pain
• Back pain
• Cancer

Adjusting your plan of care with follow-ups

Most likely, your doctor will schedule your follow-up appointment one month after your initial evaluation to check on your progress in your plan of care.

Your physician will want to follow up with the effectiveness and potential side effects of any medications prescribed, and touch base about any of your questions after your procedure.

During the follow-up, you and your physician are tracking your plan of care’s success based on the following functional measures:

• Activity level: Has your activity level and function improved? How far can you walk before pain?
• Daily activities and self-care: Can you more effectively do your basic self-care and daily activities? 
• Pain score: Has your pain score dropped since your initial evaluation?
• Goals: Have you met any of your goals since your initial evaluation?

If both of you conclude that not you’re not achieving enough progress due to side effects or a lack of efficacy, then your physician will adjust as needed.

Follow-ups are also used to assess and determine:

• Different medications and refills
• Last-minute procedures due to flare-ups
• Intrathecal pump refills

Typically, we find that chronic pain patients will consistently follow up with their physicians every month to keep track of and manage their pain effectively. On the other hand, we find that acute pain patients can have as few as three total visits before they find relief and are ready to be discharged.  

Pain Clinic

A pain clinic is a location where multiple doctors and provide procedures to reduce pain. These clinics provide assistance through medication as well as other treatments that include managing pain through physical, behavioral, and psychological methods. Your treatment team may recommend changes in everyday routines and offer advice on retaining additional alternative medicine treatments. These alternative treatments range from acupuncture and meditation, to biofeedback.

What is a Pediatric Orthopedic Surgeon?

If your child has musculoskeletal (bone) problems, a pediatric orthopedic surgeon has the experience and qualifications to treat your child.

What Kind of Training Do Pediatric Orthopedic Surgeons Have?

Pediatric orthopedic surgeons are medical doctors who have

• Graduated from an approved medical school
• Graduated from an approved orthopedic surgery residency program
• Completed additional subspecialty training in pediatric orthopedics

Pediatric orthopedic surgeons treat children from the newborn stage through the teenage years. They choose to make pediatric care the core of their medical practice, and the unique nature of medical and surgical care of children is learned from advanced training and experience in practice.

Unique Aspects of Orthopedic Care for Kids

Sometimes kids thought of as small adults. When it comes to bones, that is definitely not the case, and there are special considerations that need to be taken into consideration when treating orthopedic issues in children.

Children are growing, often very quickly, and the areas where bone is growing most quickly, called the growth plate, can be susceptible to injury. A child’s bone is also more elastic (it can bend, without breaking all the way through) and has a capacity to remodel over time.

While healing of a growth plate injury often occurs very quickly because of the rapid growth occurring at that site, a doctor will need to ensure the growth plate was not damaged or if special treatment of that growth plate is needed.

Unrecognized injuries to a growth plate can lead to growth abnormalities such as early closure of the growth plate, or abnormal growth of the bone.

It’s also important that any age-specific lifestyle concerns or long-term issues related to a pediatric orthopedic condition are considered, especially when weighing treatment options. For example:

• Does the child need to restrict her activities? If so, how so and for how long
• Should she avoid specific sports, running, or jumping?
• Will the condition affect further growth and development?
• Is the condition likely to lead to long-term problems or require further treatment?
• Could this lead to any future limitations?

What Kind Of Problems Do Pediatric Orthopedists Treat?

Pediatric orthopedists diagnose, treat, and manage children’s musculoskeletal problems. A child’s musculoskeletal problems are different from those of an adult since their bodies are still growing. A child’s response to injury, infection, or deformity can be different than what is often seen in adults.

Some of the problems pediatric orthopedists treat include:

• Limb and spine deformities
• Gait abnormalities
• Broken bones
• Bone or joint infections or tumors

When should I take my child to a Pediatric Orthopaedic Surgeon?

Pediatric orthopaedic surgeons diagnose and treat a variety of problems with the arms, legs and spine. Problems walking, crooked limbs, legs of different lengths, curves in the spine, broken bones, bone/joint infections or tumors, and birth defects of the hands or feet are just some examples of the conditions that may require a pediatric orthopaedic surgeon.Children with complex pediatric problems such as developmental delay, skeletal dysplasias, or other syndromes are usually best managed by a multidisciplinary, medical-surgical team.

Why does my child need a specialist?

Children are not just small adults. Their growing bones pose different challenges than those of adults. Sometimes, what looks like a problem in a child is just a variation that the child will outgrow over time. Some common pediatric problems don’t even occur in adults. Pediatric orthopedic surgeons, their offices, and supporting staff are all equipped to deal with kids and families to create a comfortable, patient-focused and family-friendly environment.

Helping Kids Feel Well

One of the most important things parents and other family and friends can do for kids with an orthopedic ailment is learn how to support their child. Injuries, illnesses, and medical conditions can cause anxiety and depression in kids, and knowing how to support children is an important role for parents to take.

Do not be afraid to ask for help from your child’s orthopedic specialist or their pediatrician. These individuals have vast experience working with kids who have faced similar problems and should be able to help you navigate what is likely new territory for you.

In the same light, don’t hesitate to tell medical professionals how you think your child can be helped. You know your child better than anyone else—their fears, their anxieties, their comforts—and sharing this with their medical team can help them take better care of your child.

Some simple tips to help with a child facing an orthopedic treatment:

• Encourage your child to ask questions and address those questions seriously
• Reinforce brave behaviors with praise
• Don’t say “it won’t hurt” unless it truly won’t
• Be supportive, comforting, and encouraging—a hug and a smile go a long way