Pain that won’t go away is more than frustrating. It can be harmful to your health. It can keep you from getting a good night’s sleep, eating right and exercising. It can make you grumpy, interfere with your work and keep you from spending time with your friends and family. If you’re one of 100 million Americans with chronic pain — persistent ongoing pain — you know how debilitating and frustrating it can be. Doctors who specialize in pain medicine, such as physician anesthesiologists, can help you. They are experts in diagnosing and managing your pain so you can get back to enjoying life.

What is Chronic Pain?

When you have pain, your body is trying to tell you something, such as stop touching that hot stove, don’t walk on that sprained ankle or get to the hospital and have that baby. This pain is like a warning system to keep you safe and healthy. But when pain lasts three months or longer it’s considered chronic and is no longer helpful.

There are many things that can cause chronic pain, including cancer (the disease itself, or treatments), arthritis, back or neck injury, migraine headaches, nerve pain (called neuropathy) and shingles. Sometimes the pain doesn’t go away after surgery, for example, if nerves were damaged during the procedure or the pain afterward isn’t treated correctly. Other times it isn’t clear what’s causing your pain. All you know is it hurts and you can’t get relief.

What is a Pain Medicine Specialist?

Just as there are doctors who specialize in treating conditions such as cancer, heart disease or allergies, there are specialists in treating pain.

These physicians complete four years of medical school and further training in a specialty, such as anesthesiology, physical medicine and rehabilitation, psychiatry or neurology, followed by an additional year of training to become an expert in chronic pain. Be sure your specialist is certified in a pain medicine subspecialty by a member board of the American Board of Medical Specialties, such as the American Board of Anesthesiology. While you may know that physician anesthesiologists manage pain before, during and after surgery, you may not realize that some specialize in managing chronic pain. In fact, decades of research by physician anesthesiologists have led to the development of more effective treatments for chronic pain.

This specialized training and expertise is essential since the spine and nerves that register pain are delicate and everyone’s anatomy and pain tolerance are different. Pain medicine specialists are also experts in using a wide variety of medications, which can effectively alleviate pain for some patients. The pain medicine specialist will work with you and any other doctors who are treating you, such as your primary care physician, surgeon or oncologist.

How Can a Pain Medicine Specialist Help?

If you have chronic pain, a pain medicine specialist will examine you and consider your health history, review tests and ask you for details about your pain. The physician will then recommend a treatment plan that might combine multiple techniques to manage your pain, such as medications and physical therapy. You will also be given guidance on how to prevent and control pain in your daily life. Some of the treatments the pain medicine specialist might prescribe include:

Injections or nerve blocks
If you are having a muscle spasm or nerve pain, injection with local anesthetics or other medications can help short-circuit your pain.

Electrical stimulation
If you have chronic pain such as in the lower back, you might get relief with a treatment called transcutaneous electrical nerve stimulation (TENS), which stimulates nerve fibers through your skin by sending electrical impulses to the site of the pain.

How a pain medicine specialist diagnoses your pain
Asks you — No one knows your pain better than you do, so a pain medicine specialist will ask you to describe your pain in detail, including where it hurts, how long it has been hurting and what makes it feel better or worse.
Reviews tests and records — Your medical records, X-rays and other images as well as tests help the pain medicine specialist determine how to best treat your pain.
Has you fill out a questionnaire — Special feedback forms can guide you in providing very specific information about your pain.
Performs an exam — A complete physical exam can help shed more light on your pain.
Orders tests — While you may already have had tests, the pain medicine specialist may order more to help provide more insight.

Spinal cord stimulation
If you have chronic pain in the back, arms or legs, your pain medicine specialist might suggest spinal cord stimulation, in which a device is implanted in your back and blocks pain by delivering electric pulses to nerves and the spinal cord.

Physical therapy
You may be able to improve your ability to function and decrease your pain through physical therapy. Whirlpools, ultrasound and deep-muscle massage may help, too.

You may find relief from acupuncture, in which very thin needles are placed at different points to interrupt pain signals.

Usually done after conservative treatments fail, surgery can be performed to correct the anatomic abnormalities that are responsible for your pain and in unusual cases, to sever the nerves supplying the painful area.

The pain medicine specialist also may suggest alternative methods that can help you cope with and overcome chronic pain, such as psychological therapy, relaxation techniques and biofeedback.

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