Pain Management


Chronic pain affects about 100 million American adults, according to the Institute of Medicine. It can take over your life, preventing you from getting good sleep, eating properly, being active and fully enjoying activities and time with your family. Thankfully, help is available.

Doctors who specialize in treating pain, such as physician anesthesiologists, have the expertise to diagnose and treat chronic pain. Pain treatments vary depending on the person and type of pain. Pain treatment is complex and can cause more harm than good if it is not provided by a skilled pain specialist such as a physician anesthesiologist, who has the training and expertise to diagnose and treat each individual patient safely and effectively.

Chronic Pain

Most pain is acute, or temporary. The pain you feel after stubbing your toe or having surgery hurts, but eventually goes away. In some cases, acute pain can become chronic, meaning it lasts three months or more. For example, if surgical pain isn’t treated correctly, the nerves can become hypersensitive causing pain, which can become chronic.

Other common causes of chronic pain are:

  • Arthritis
  • AIDS
  • Back and neck injury
  • Migraine headache
  • Phantom limb pain (experienced by those who have had a leg or other limb amputated)
  • Shingles

Why See a Pain Specialist?

Over-the-counter pain medications such as ibuprofen and acetaminophen can help alleviate headaches and occasional aches and pains. But for ongoing, chronic pain, it’s important to see a pain specialist, such as a physician anesthesiologist, who has received formal, extensive training in pain medicine to diagnose and treat pain.

In addition to completing four years of medical school and four years of training in anesthesiology and pain medicine, physician anesthesiologists who specialize in pain undergo an additional year of training to become an expert in treating chronic pain. This expertise is essential since the spine and nerves that register pain are delicate and everyone’s anatomy and pain tolerance is different. In addition, pain medications are strong and can be harmful if not administered by a physician with appropriate training.

The pain specialist will work with you and any other physicians who are treating you, such as your primary care physician, surgeon or oncologist. While other physicians manage and treat your conditions (such as arthritis or cancer), the pain specialist is in charge of diagnosing and treating your pain.

Here are some things a pain specialist may do to best diagnose and treat your pain:

  • Review your medical records, x-rays and other images
  • Perform a complete physical exam
  • Ask you to describe your pain in detail, explaining where it hurts, how long it has been hurting and what makes the pain feel better or worse
  • Have you fill out a detailed questionnaire to help determine the impact your pain is having on your life, and exactly how it is interfering with your daily activities
  • Order tests

Depending on your pain and other conditions, the pain specialist may prescribe a variety of treatment options.

These may include:

  • Injections or nerve blocks – When the pain is caused by muscle spasm or nerve pain, injection with local anesthetics or other medications can help short-circuit your pain. This type of pain control should always be delivered by a physician anesthesiologist or other physician with specialized training in pain medicine.
  • Electrical stimulation – Some people with chronic pain such as in the lower back find relief with transcutaneous electrical nerve stimulation (TENS), in which an electrode is placed on the painful area and electrical impulses are sent to the site. The impulses decrease your pain by stimulating nerve fibers through the skin.
  • Physical therapy – A physiatrist or physical therapist may be able to create an exercise program that helps you improve your ability to function and decreases your pain. Whirlpools, ultrasound and deep-muscle massage may help, too.
  • Acupuncture – You may find relief from acupuncture, in which very thin needles are placed at different points on the skin to interrupt pain signals.
  • Surgery – Usually a last resort, surgery can be performed to sever the signals to the nerves that are responsible for your pain.

Additionally, there are a number of methods that can help you cope with and overcome chronic pain, such as psychological therapy, relaxation techniques and biofeedback.