Pain management doctors focus on helping a person find relief from pain due to underlying conditions or as long-term consequences of surgical procedures.

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Pain management typically involves a multidisciplinary approach to care. A team of doctors and specialists may include:

  • pain management physicians
  • physical therapists
  • occupational therapists
  • other specialists who focus on specific conditions

This article reviews what pain management doctors are, the types of pain these doctors help treat, treatment approaches, and more.

Pain management doctors work with a variety of underlying conditions and causes. Their goal is to reduce the pain a person experiences. They will prescribe medications and offer treatments for the cause of the pain.

Pain management doctors require additional training beyond their initial medical training to become a doctor. Though training times may vary, some programs require 12 months and ongoing training to maintain a doctor’s certification to treat pain.

A person may require additional treatment for several different types of pain. Though a person’s needs can vary, the National Institute on Aging (NIA) recommends that anyone who feels their pain needs more care than a primary care doctor can provide should ask for a referral to a pain management doctor.

Acute pain

Acute pain develops quickly over a short period. It is often the result of the following:

Acute pain tends to be sharp. It typically goes away within a short period, ranging from a few days to months. It usually resolves when a person addresses the underlying condition. However, if left untreated, the condition can lead to chronic pain.

In people with severe cases, a doctor may recommend they see a pain management doctor to help address their acute pain. A person may need stronger medications or injections to help alleviate their pain.

Chronic pain

Chronic pain lasts for at least several months. Many experts define it as pain lasting at least 3–6 months.

Chronic pain can be a dull ache or severe enough to be debilitating. People with chronic pain often spend more on healthcare and may have a reduced quality of life.

Pain management doctors often work with people with chronic pain to address their symptoms. They can help manage a person’s treatment and recommend additional therapies to help them find relief.

Neuropathic pain

A variety of illnesses and injuries can cause neuropathic pain, such as:

Neuropathic pain occurs due to nerve damage. According to a 2018 review, this type of pain affects about 7–8% of adults.

Pain management doctors may recommend tricyclic antidepressants or serotonin and noradrenaline reuptake inhibitors (SNRIs) as the first line of treatment. They may then follow these medications with pregabalin or gabapentin.

The author of the 2018 review recommends that doctors consider tramadol or topical lidocaine (lignocaine) as the second line of treatment. Doctors may use stronger opioids as the third line of therapy, depending on whether symptoms resolve with the other therapies.

Nociceptive pain

Nociceptive pain occurs due to tissue damage. Several underlying conditions can cause this type of pain, such as:

  • burns or cuts
  • bone fractures
  • muscle pain caused by repetitive actions or overuse
  • pain caused by joint damage, such as arthritis or sprains

The pain can feel sharp, throbbing, or aching and can be either chronic or acute.

Nociceptors are the nerve endings that initially sense harm or pain. Nociceptive pain occurs when they sense physical damage to various areas, including:

  • connective tissue
  • bones
  • muscles
  • skin

Pain management for nociceptive pain can include a variety of therapies, including:

  • physical therapy
  • over-the-counter (OTC) medications
  • prescription medications, such as opioids and antidepressants
  • surgery
  • alternative therapies, such as acupuncture
  • medical procedures
  • topical agents, such as a lidocaine patch or ointment

Functional pain

Functional pain occurs when there is no obvious injury or damage to the body. A person may experience pain, associated symptoms, and disability due to the pain.

Some potential causes of functional pain include:

In addition, evidence suggests that people undergoing psychological distress, such as from stress or traumatic life events, may experience functional pain.

A pain management doctor may help people with an underlying condition, such as fibromyalgia or IBS, reduce pain and improve their quality of life.

Pain management doctors often form part of an interdisciplinary team. Different pain management members on a team provide different therapeutic approaches to pain management.

A person with acute, chronic, or other types of pain may use one or more of the following treatment approaches.

Medical management

Medical management for pain can encompass a wide range of approaches based on a person’s preferences, a doctor’s expertise, and other factors, such as the location of the pain and underlying condition.

Medical management often includes a pain management doctor, who may suggest prescription medications or injections.

Prescription medications may include:

  • opioids
  • steroids
  • antidepressants
  • other pain medications

Injections may include steroids.

Pain management doctors are typically knowledgeable about the use of opioids. These powerful pain medications can have many side effects and be habit-forming, leading to misuse. For this reason, a person should work with and follow a pain management doctor’s advice on how much and when to take the medications.

Behavioral therapy

Behavior therapy may help with pain management. Doctors may suggest this in conjunction with pain medication and other therapies to help relieve pain.

Cognitive behavioral therapy (CBT) is the most common psychological intervention for chronic pain. CBT focuses on helping a person understand the connection between their thoughts, feelings or emotions, and behaviors.

CBT for pain helps a person focus on a problem-solving, active approach to facing the challenges associated with living with chronic and other types of pain.

Physical therapy

A physical therapist works with a person experiencing pain for various reasons. Physical therapy can provide effective, long-term pain management.

Physical therapy can help improve a person’s strength, flexibility, and mobility, which may help them find pain relief. When done effectively, it may help a person avoid taking excessive pain medication or further complications that require surgical intervention.

Alternative therapies

Alternative therapies include a variety of nonmedical interventions to help with pain management. Like other treatment types, it may not work well for everyone.

Some examples of alternative therapy that a person may find helpful for pain include:

Evidence from the National Center for Complementary and Integrative Health suggests that these therapies may help with pain due to various causes.

A pain management doctor can help a person determine which alternative therapies, if any, may be beneficial for their pain management in addition to medical management.

A person may need a referral to a pain management doctor from a regular family physician.

The NIA suggests a person go to a doctor prepared to discuss their pain. To help a person describe it, they recommend the following questions:

  • Where is the pain?
  • When did the pain start?
  • Are there other symptoms involved?
  • What does it feel like, such as:
    • sharp
    • dull
    • achy
    • burning
    • tingling
    • or other descriptive words
  • Do certain activities make the pain worse?
  • Does the pain get worse or better throughout the day?
  • What medications is the person currently taking?
  • Has the person tried other therapies? If so, which ones?

A doctor will likely perform a physical examination, discuss a person’s medical history and pain, and may order additional testing.

For example, a doctor will typically order testing before starting opioid medications and other treatments. Screenings can help determine if the person is at risk for misusing the medication and help guide how frequently they need monitoring.

The following sections provide some answers to frequently asked questions about pain management doctors.

What qualifications do pain doctors need?

A doctor will need continuing education past their initial training to receive certification as a pain management doctor. Though courses may vary, it can take up to 1 year of additional training, and they will need ongoing training to maintain the certification.

What are the benefits of pain management doctors?

A pain management doctor can help provide stronger medications for long periods. They can optimize treatment plans to help improve a person’s pain while reducing the side effects of medications.

They can also coordinate with other therapists to help provide complete care for the person with pain.

Are there any pain support groups?

Pain support groups may help a person connect with others who experience chronic pain. A person can search for support groups using this nationwide search engine.

Pain management doctors work with a person to help provide relief to pain. They help manage what medications a person takes as part of a larger pain management therapy plan.

Pain management typically involves several approaches and therapies. They can include medications, a medical approach, physical therapy, alternative therapies, and behavioral therapy.

With effective management, a person may find some relief from their pain.