When you live with chronic pain, it’s not uncommon to be referred to a pain management specialist – aka, a pain clinic. Depending on where you are sent you may find a helpful clinic with doctors who listen and provide an array of options to treat your pain. Or, you may find a clinic with one set procedure for every issue, run by a doctor you never see, and staffed by nurse practitioners that hand out prescriptions like candy.
Years ago, after experiencing months of uncontrollable pain in my shoulder, I was sent to a pain specialist. No one could figure out what was causing the pain, so, if we can’t find an answer we’ll just treat the symptom. That office (like many from what I understand) is run almost like a factory. You are just a number, one of thousands that they see each day. They don’t know your name, they barely listen to you when they ask how you are.
Over a six month period I visited monthly. I never saw the doctor. Each month, a different nurse practitioner walked into the room, asked me about my pain and then handed me a pre-written prescription.
I did see the doctor once, as I was being wheeled back for an injection into my nerve. I tried to talk to him, to describe the pain I’d been experiencing for months. He told me to stop moving and be quiet.
The injection didn’t work. I continued to go in monthly in hopes that something would change. It didn’t. I kept seeing the NP and the NP kept giving me a pre-written prescription, that I rarely even filled.
During my last visit, I told the NP that I didn’t want the script. That I wasn’t taking the pills anyway. I’d rather deal with the pain than be unable to function. Her response was “Well, will you take this script anyway, it’s already written.” It was too much trouble for her to have to void the script, she’d rather me just take it.
I cancelled the remaining appointments and began the search for someone better. I knew there had to be other options. There are many pain management doctors out there. You don’t have to end up at the factory, being treated like yet another widget with a problem. If you feel that that’s your situation, or if you are just seeking out a pain specialist for the first time, consider these steps, inspired by Leslie Michelson, author of The Patient Playbook.
There are lot of different types of pain management specialists. It’s important that you find one that fits your pain. If it’s chronic migraines you want a neurologist that is certified in pain management. If it’s chronic pain of some other kind, you may want an anesthesiologist, or an orthopedic doctor that is certified in chronic pain. Find out what kind of doctor they are.
There are two primary types of chronic pain management doctors: medical pain management specialists and intervention pain management specialists. Medical pain management specialists use a combination of medications, trigger point injections, prolotherapy, and physical therapy to treat your pain. They may also refer you out for other types of treatments like chiropractic care, and acupuncture.
Intervention pain management specialists are the typical pain management doctors that use epidural injections, nerve blocks, nerve ablations, and pain pumps, as well as other invasive (or surgical) procedures.
You may want to start with a medical pain management specialist, to explore non-invasive pain management before moving on to the intervention pain management specialist.
Reach out to friends, family, and even local support groups for referrals to doctors in your area. Talk to those who have experienced similar issues and see who they’ve found helpful. Use those referrals to help guide you as you research the doctor(s) further.
Talk to the doctor – before you make an appointment if you can. Many good doctors will be more than happy to talk with you over the phone and answer some basic questions about their protocol. Often, you can just ask the office staff and they will be able to give you some valuable information. But, talking with the doctor is ideal. If not over the phone, ask if you can make an appointment just to evaluate the doctor and determine if they are a good fit for you.
Ask what kind of services they offer to help alleviate your pain. Do they offer just one standard service to everyone (injections) or do they taylor the treatment to the patient? You want the latter.
Don’t do what I did and just go wherever you are initially referred without asking questions. Most insurance companies do require that you have a referral to a pain management doctor. If that is the case, and you choose to go to a different doctor than you were originally referred to, don’t be afraid to call the doctor who provided your referral and ask for a new one to the doctor of your choice.
During your initial consult with your doctor, make sure they are listening to you. If your doctor (pain specialist or otherwise) doesn’t listen to you, it’s time to find a new doctor. You deserve a doctor who pays attention and who listens to your experience and treats you like an individual.
Finding a good chronic pain specialist (or any good doctor) will require a little extra work, but it’s worthwhile in the long-run because you are more likely to stay with that doctor longer and see better results.