Did you know that more than 1 in 5 adults in the U.S. have chronic pain? For some, the pain is debilitating enough to interfere with their daily life at home or work.
Whether you are struggling to feel “normal” again after an injury or deal with the symptoms of a health condition like arthritis, chronic pain is a burden no one should have to live with. Pain management specialists can help guide you through a variety of safe options for treating your pain from medications to injections and physical therapy or even surgery.
Thomas Ng, MD, a pain management physician at Summit Health answers frequently asked questions about the specialty and explains how doctors like him can help patients experiencing chronic pain.
Q. What is a pain management specialist and how can they help?
Dr. Ng: A pain management specialist is a medical professional who diagnoses and oversees pain treatment. They are usually doctors with training in Physical Medicine and Rehabilitation or Anesthesiology and fellowship training in the management of pain conditions.
Q. How does chronic pain develop?
Dr. Ng: Acute pain refers to pain that started recently — it tells us that something in our body is not right. Generally, acute pain is treated by a primary care, urgent care or emergency medicine doctor. Once the issue is addressed, the pain usually resolves.
If the acute pain does not improve over several months, it becomes known as chronic pain. When chronic pain is not responsive to conservative treatments such as over-the-counter medications, patients are often referred to a pain management specialist.
Q. Who should consider seeing a pain management specialist?
Dr. Ng: The patients I see are dealing with either acute pain that is very severe or chronic pain. They have been unable to find relief and are looking for other options to control their pain.
Q. What types of pain or conditions would benefit from pain management?
Dr. Ng: Pain management is ideal for patients with all types of chronic pain conditions, such as:
- Back, neck, spine or joint pain
- Muscle aches
- Nerve pain including numbness, tingling and burning sensations (pinched nerves, sciatica, neuropathy and complex regional pain syndrome)
- Sports or work-related injuries
- Patients who need specialist care in fluoroscopic-guided precision spine injections and other joint procedures
- Any pain that has not improved with conservative treatment or surgery
Q. What should I expect at my first appointment?
Dr. Ng: The first appointment is generally a consultation. My goal is to understand the patient's pain, how it has affected their life and what treatments they have tried. I review any diagnostic tests and perform a physical exam. Many patients are surprised to learn that there may be multiple reasons for their pain.
Together, we will discuss a treatment plan. Some types of pain may be treated in the office on the first appointment, while others are less clear-cut and may require additional diagnostic tests such as MRI or EMG testing.
Q. Does pain management always involve medication? Should I be concerned about addiction?
Dr. Ng: I tell my patients who are concerned about chronic pain medications that they are only one of the options we have. While opioid pain medications are effective in treating pain, they may come with significant risks and would never be considered as a first choice. Part of my role in helping the patient is to minimize their risk and exposure to habit-forming medications.
Q. What other types of treatment options are there?
Dr. Ng: Treatment options may include prescription medications, physical therapy and injection therapy. Surgery may also be considered. Many of the patients I see are not candidates for surgery, do not want to consider it or continue to have pain despite having surgery.
Other non-surgical treatments include:
- Facet injections/radiofrequency ablation (rhizotomy) for neck and back arthritis
- Epidural injections for pinched nerves in the neck and back (i.e. sciatica)
- Joint injections for arthritis
- Trigger point injections for muscle pain
- Nerve blocks can be used for knee pain, pelvic pain and certain headaches.
- Spinal cord stimulator trials for post-laminectomy syndrome, complex regional pain syndrome and diabetic neuropathy.
Q. When are surgical options considered or necessary to manage pain?
Dr. Ng: Pain management can help many patients avoid or delay surgery, but there are times when surgery may be necessary. Surgery is often considered when patients fail to respond to less invasive options such as injection therapy, are experiencing pain that prevents them from performing activities of daily living or have a diagnosed ailment that is unlikely to respond to conservative therapy.
Q. Do pain management specialists work closely with other specialties?
Dr. Ng: Yes, managing chronic pain often requires a multispecialty approach. At Summit Health, we have specialists in more than 80 areas of medicine available. Pain management doctors work closely with physical therapists, surgeons, neurologists and psychiatrists.
Q. Do you incorporate integrative and behavioral approaches? If so, what kinds are available?
Dr. Ng: Pain management treatment can take many forms. Many patients ask about complementary and alternative treatments. We support the use of treatments, such as cognitive behavioral therapy, platelet-rich plasma injections and acupuncture therapy, that have shown evidence in the treatment of certain pain conditions.
Q. What misconceptions about pain management do you want patients to understand?
Dr. Ng: Many patients are concerned that pain management only involves the use of opioid-based pain medications. It is important to understand that pain management involves multiple treatment modalities, often not requiring opioids, and that treatment can be tailored to the patient's preferences.
Summit Health can help.
If you are experiencing chronic pain, our pain management specialists are here for you. Together, you can make an individualized treatment plan to get you back to the activities you enjoy. Make an appointment for an evaluation today.