Chronic Pain
Introduction to Chronic Pain
Management: Pain management is a subspecialty of neurology (and of a few
other specialties as well, such as anesthesiology, psychiatry and physiatry). There is a subspecialty
board certification for pain management (you can verify board
certification through the web). Pain management is a
complex field and one that changes rapidly. Until very recently,
there was little research into pain and pain was believed to be
something people needed to accept. Today, we understand that pain is
a medical condition that requires appropriate medical treatment.
Please read this page or jump to any of the following sections:
Because of new research, the various medications and
interventions for chronic pain are evolving rapidly. It is important
to make the diagnosis and institute treatment, but it is also
important to review news and continually revise the diagnosis as
more information becomes available.
Pain management is a unique medical specialty because of the
unique risks. In fact, pain
management has risks greater than those in other fields of medicine.
For example, many pain medications have been linked to liver disease
or heart disease and other medications may be habit forming or fatal
in overdose. Some interventions may cause rapid opioid tolerance and
are no longer as common as they once were; other interventions
seemed to make the pain worse down the line. Still others have been
shown to help. (more below)
Of course, the legal issues of pain medicine are problematic: a
quick review of news on the web shows that law enforcement
personnel, physicians, attorneys, the public and others all have
differing views as to the appropriateness of various pain
treatments. There is no clear national standard of care in pain
medicine, which is one of the problems, but the standard of care is
being developed rapidly. Dr. Anderson participates in Standard of
Care committees and participates in guideline review to help
establish the standard of care.
Although we have made great strides in treating pain, we have a
long way to go.
One of the most significant changes recently is that society now
recognizes pain as a legitimate medical problem, one that deserves
treatment.
There are several types of pain and the words used to describe
them are often confusing; treatments likewise can be confusing. Therefore, we offer more written information,
including a detailed informed consent, than physicians in other
specialties may offer. Most patients are used to signing a long
informed consent before having a major surgery, and because pain
management is just as serious and because pain patients have a right
to understand their treatments, a similar informed consent is
provided in this practice. As discussed elsewhere, the information
focuses on the negative. After all, the good news is obvious: the
treatments are supposed to help. What patients often are not told is
the negative. By providing the negative information, patients can
then have information needed so that they can be a team member in
the pain treatment.
We are adding more information about pain management rapidly.
Please keep checking! In the meantime, we do have some of the
medication information sheets available in the
download area. Also, please
check out our links to pain societies
and other pain information. (more below)
