acute pain

How to Choose a Good Pain Doctor

/ Thomas Cohn, MD

pain doctorChoosing a good doctor is always a challenge. There are many options to consider, including:

  • Insurance Requirements
  • Where you Live
  • The Degree of Specialization of the Physician you’re looking for

The best pain doctors will be those who have a broad range of experience, and a broad range of ability to evaluate and treat a variety of problems.

The Definition of Pain

The International Association for the Study of Pain defines pain as: “An unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”  Pain is how the body interprets certain sensory signals in the nervous system, which includes how the brain processes the signals and determines how to react to them.  Pain sounds simple, but becomes extremely complex due to many causes and interactions.

Qualities of a Great Pain Doctor

A good pain doctor needs to have many qualities in order to successfully manage what can be an extremely complex problem.  Pain often comes from multiple sensory sources, and finding each sensory source is a challenge.  The start to finding the source is listening to the patient, the story, and where and what is happening.  The story is often critical, and a good doctor will be able to recognize what story matches various internal problems.  An experienced doctor can match a story very quickly to the pain problem.

In addition to listening to the patient’s story, a doctor may also need to perform other tests in order to grasp the full scope of your pain, such as:

  • Analysis of a patient’s movements
  • Checking motion in various body parts
  • Examining the neurologic and musculoskeletal system
  • Scans and X-rays

The best doctors have done this many times, and can put complex information together rapidly to determine a treatment plan.

Finally, all the good pain doctors should at least be fully licensed, and have subspecialty boards in Pain Medicine.  Backgrounds in Physical Medicine and Rehabilitation are also a huge plus.  Expect a good physician to be familiar with your history and examination, and have a comprehensive treatment plan, and be willing to address a number of complex issues contributing to your unique problem.

Acute Pain vs. Chronic Pain: Definitions & Differences

/ Thomas Cohn, MD

neck painThere are many definitions of pain. Because pain is often subjective, everyone will define and describe it in their own personal terms.

Dictionary vs. Medical Definition of Pain

The dictionary describes pain as physical suffering or discomfort caused by illness or injury. Medicine becomes very technical in its description of pain, often concentrating on the physical aspects, structures involved, and trying to determine if it is “real.” The International Association for the Study of Pain (IASP) defines pain as:

“An unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

Pain has both physical and emotional correlates. If someone has pain, there is usually a physical cause in the body that needs to be found. Pain may also have significant emotional correlates in the brain. The processing centers in the brain for many pain signals sit next to the areas that control emotional stability. Therefore, if people have significant amounts of pain, spread of pain signals to emotional areas of the brain can easily occur, affecting mood and depression.

Pain is always subjective. It is a learned experience, and it is very individualized. A person learns what pain is through experiences related to injuries as a child and as they grow up.

Acute vs. Chronic Pain

In medicine, pain is the interpretation of certain sensory signals, generated from a variety of receptors in the body. When the sensory signals are ongoing, most people interpret these as pain, and seek treatment to relieve them. There are two primary types of pain:

  • Acute pain is from definite tissue injury and will fade after the cause is identified and treated. A common example is cutting a finger – it hurts, it heals, and the pain is gone.
  • Chronic pain occurs when damage causes ongoing sensory signals for long periods of time, and in some degree becomes independent of the actual tissue damage. This type of pain is difficult to stop, and often the best treatment is working on systems to manage the pain.

Understanding the complexities of pain, the body, the sensory nervous system, and the overall interactions in the body are some of the important aspects for a medical doctor who treats patients with pain. A good pain physician understands people and medicine and how all these interact, allowing them to find the causes and improve the quality of your life.