Critical Questions to Ask Your Pain Specialist

Critical Questions to Ask Your Pain Specialist

The following questions and answers were provided by John V. Prunskis, MD, FIPP, medical director at the Illinois Pain Institute and the Barrington Pain and Spine Institute.

Q: What kind of training do you have?

A: Successful pain management requires that your physician possess sophisticated medical decision-making abilities and expertise with numerous injections and other medical techniques, which demand rigorous technical training. That training can include an anesthesiology or physiatry (physical medicine and rehabilitation) residency, followed by a pain management fellowship. In many states, a physician is licensed to practice medicine in all of its branches, and the physician may self-declare to be a pain specialist. Make sure your physician has received the advanced training indicated above.

Q: How will you determine the cause of my pain?

A: The diagnosis and treatment of painful conditions principally involves taking a detailed medical history, performing a pertinent physical exam and ordering appropriate tests, which may include: MRI, X-ray, nerve studies, blood work, etc.

Q: Will you be finding the cause of my pain or just mask the symptoms?

A: Today, we are usually able to identify the source of the pain and work to fix the underlying problem. This leads to a reduction or elimination of narcotic opiate and other medication usage and allows patients to work, play and enjoy life without surgery.

Q: Do you use specialized equipment for pain treatments? Where do you perform your treatments?

A: Effective treatments for painful conditions demand precision and safety. Proficiency with image-guided (fluoroscopy, ultrasound, etc.) procedures should be expected of your physician. Also make sure that your pain physician performs procedures in a facility dedicated to pain management that upholds the highest standards.

Q: What is your backup plan if your diagnostic or treatment approaches to the source of my pain do not work?

A: Capable pain physicians will usually be able to diagnose the source of your pain. They will also be able to answer this question with ease because they will have planned for that possibility. Treating pain effectively can be challenging. In complicated cases, several physicians from differing areas of medicine may have to collaborate in their efforts. If needed, this allows for a coordinated multispecialty approach to achieve the best possible outcome.

Q: When should I consult with a qualified interventional pain physician?

A: Usually if your pain has lasted at least two weeks.

Q: Will I become potentially addicted or become dependent on pain medicine?

A: In the overwhelming majority of cases, your dose of potentially addictive pain medicine will decrease as your qualified interventional pain physician structures your treatment. Some patients may develop or already have a psychological addiction or dependence on pain medication, and this has to be closely watched. There are many classes of medications other than opiate narcotics, such as anti-inflammatory drugs and muscle relaxants, that can help alleviate the pain and provide a long-term solution.

Q: What options do I have to help myself in a painful condition?

A: In general, stretching, exercise, weight control, yoga, stopping smoking, relaxation techniques, physical therapy or chiropractic care are things that may be helpful in addition to the procedures performed by your interventional pain physician.

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Originally published in the Fall 2015 print edition.