Pain Doctor Education & Training
A pain doctor, also called a pain specialist or pain management specialist, is a medical doctor (M.D.) or doctor of osteopathy (D.O.) who specializes in pain medicine. Pain medicine is a medical specialty that focuses on the evaluation, treatment, and prevention of pain.
Pain doctors specialize in the management of pain as a symptom of disease (eudynia) and primary pain disorders (maldynia). They treat patients who experience pain related to a specific cause (e.g., cancer pain, injury, postoperative pain) and patients who suffer pain as a primary condition (e.g., frequent headaches, neuropathic pain).
Pain management specialists often serve as consultants to other physicians and health care providers (e.g., physical therapists) and coordinate patient care. They diagnose conditions, provide treatment (e.g., prescribe medication and rehabilitation services, perform procedures to relieve pain), and counsel patients and their families. Pain doctors work in a variety of settings, such as private practices, hospitals, and pain clinics.
In some cases, pain associated with certain diseases, conditions, and injuries can be treated by a physician who does not have specific pain management credentials. Although these physicians have not received extensive training in pain medicine, they may be highly skilled in one or more pain treatment methods.
Primary care physicians often are the first to treat patients who experience pain. These doctors (e.g., family practitioners, internists, pediatricians) play an important role in pain management, and often work with pain management specialists as part of a medical team.
Pain Doctor Certification
Pain doctors are required to complete four years of premedical education in a college or university and four years of medical school, resulting in a M.D. (doctor of medicine) or D.O. (doctor of osteopathy) degree. After obtaining a medical degree, physicians in the United States must apply for and receive a state license to practice medicine within a specific state.
Pain specialists can practice within a number of medical specialties. They can be certified in pain management by another specialty board (e.g., American Board of Physical Medicine & Rehabilitation, American Board of Psychiatry and Neurology, American Board of Anesthesiology), or can be board certified in pain medicine by the American Board of Pain Medicine.
To subspecialize in pain medicine, specialists (e.g., anesthesiologists, neurologists, orthopedists, physiatrists) undergo examination and receive certification from their original specialty board.
Physicians who are board certified in pain medicine, called diplomates of the American Board of Pain Medicine (ABPM), are highly trained to diagnose and manage pain and have passed ABPM examination.
Pain doctors may specialize in one of the following areas:
- Back and neck pain
- Cancer pain
- Chronic pain
- Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD)
- Neuropathic pain
- Orofacial pain
- Palliative care
- Pelvic pain
Many pain doctors belong to physician groups that focus on the study of pain, including the American Academy of Pain Medicine, the American Academy of Pain Management, the American Pain Society, and many others.
Pain management specialists use a number of techniques to diagnose and treat pain disorders. Pain evaluations often include taking a personal and family medical history, assessing the patient's lifestyle (e.g., activity level), reviewing prior tests (e.g., blood tests, imaging tests, electrodiagnostic studies), and performing a physical examination.
Treatment for pain varies, depending on the cause. Some treatments are designed to reduce pain, and some are designed to help patients manage pain. Methods used to relieve pain include the following:
- Implantable devices (e.g., pumps, stimulators)
- Injections (e.g., corticosteroids)
- Nerve blocks
- Physical therapy (also occupational therapy and recreational therapy)
- Surgery (e.g., joint replacement, spinal surgery, peripheral nerve surgery)
- Trigger point injections
In some cases, pain management specialists use complementary methods (e.g., biofeedback, relaxation, hypnosis, meditation, acupuncture, cognitive behavioral therapy) to help patients manage symptoms.