What To Look For In A Pain Care Specialist

December 21, 2020 / Thomas Cohn, MD

Pain isn’t created equal, and either is pain care. As a patient with such a highly individualized issue like chronic pain, you should be treated by someone who is going to do all they can to help you find a solution to your specific issue. Not all pain care providers are built the same, so it’s important that you take the time to find someone who is right for your situation.

But how do you know what you should be looking for in a pain management physician? We explain some traits and abilities you should look for when trying to find the right physician for your chronic pain issue.

Finding The Right Chronic Pain Specialist

When trying to find a specialist to help with your chronic pain issue, it’s important that you don’t just pick the closest physician to your house or the first one you come across in-network. You need to look at some other relevant factors if you want to give yourself the best chance at finding a physician who can treat your pain issue. Here’s what you’ll want to look for.

1. Depth Of Knowledge – Most general practitioners have a wide breadth of knowledge, and that allows them to provide professional care for a number of different issues. However, for a specific condition like chronic pain, you want to find someone with a deep knowledge and years of experience on the subject. Although we’ve noted that pain is highly specific to the individual, drawing on the experiences with past patients can make all the difference in finding a solution to the problem presented by the current patient. Find someone with years of experience in the specialized field of pain management.

2. A Listener – Does your current physician really take the time to listen to your story and apply those facts to your treatment, or do your words seem to be going in one ear and out the other? They say that “doctor knows best,” but that doesn’t mean the patient can’t provide crucial and relevant facts to assist in the treatment process. A great doctor really listens to the patient and uses this information to provide the best level of care. If you feel like you’re being treated as just another patient and the doctor seems to have their mind made up before you even get a chance to talk, consider looking for a different specialist to help with your pain.

3. Willing To Adjust – Another thing that both patient and provider need to be willing to do is adjust to roadblocks that develop, because they always do. If they didn’t, chronic pain would be easy to treat. Your provider needs to be able to look at the changing landscape of your pain condition and make adjustments to account for these potential obstacles to successful treatment. This may involve finding new forms of physical therapy, adjusting if pain injections are no longer as effective as they used to be, or consulting another professional when a problem proves mystifying. If you feel like you’re just trying the same old techniques that haven’t been working, why should you expect anything to ever change?

4. Seeks Long Term Solutions Over Short Term Relief – Any pain physician can write a prescription for painkillers and provide their patient with short term relief. It’s a passive solution that is like putting a band-aid on a bullet hole. Painkillers absolutely can be part of a comprehensive treatment plan, but they shouldn’t be the focal point of your care. You want a pain care provider that pursues active treatment options that will help you find long term relief. If your doctor isn’t working towards long term relief, switch physicians.

If you can find all four of these things in your care provider, odds are you’ll have an increased likelihood of regaining control over your pain condition. Dr. Cohn has done this for countless patients in the past, and he can do the same for you. For more information, or to set up an appointment, reach out to his clinic today.

If You Have Chronic Pain, Don’t Wait In Silence

July 16, 2020 / Thomas Cohn, MD

A recent study commissioned by one of the nation’s largest providers of physical therapy services found that roughly one in four people with a chronic pain condition aren’t seeking professional assistance to treat their pain. Whether they are doing this because they hope the pain will go away on its own or they don’t want to go through the hassle of seeing a physician, this can be problematic for a number of reasons. Below, we explain why you shouldn’t put off a visit with a doctor if you have a chronic pain condition.

Why You Need Professional Help For Chronic Pain

Unlike acute pain, which occurs after a moment of injury, chronic pain isn’t likely to go away on its own. A stubbed toe is an example of acute pain that often resolves after a few hours or days without intervention, but chronic conditions like bulging disc pain, fibromyalgia-related pain or osteoarthritis issues aren’t likely to get miraculously better on their own. That’s why you need to see a specialist, but the data shows that chronic pain sufferers aren’t flocking to physicians in droves.

Some of the data from the recent study found that:

Only 76 percent of chronic pain sufferers have sought professional help for chronic pain.
Roughly 60 percent of patients seek profressional help if they’ve been dealing with chronic pain for at least a week or longer.
51 percent of Americans say pain needs to reach a “7” on a scale of 1-10 before their seek help for chronic back, neck or knee pain.

So while it’s clear that a number of chronic pain patients aren’t getting the professional help they need to manage their pain, the biggest point we want to convey in this blog is why this is so problematic. Delaying treatment and suffering in silence with a chronic pain problem is an issue because:

It’ll Get Worse – As we mentioned above, it’s rare for a chronic pain condition to resolve on its own. In fact, far more often the condition ends up getting worse without intervention, leading to increased pain and discomfort.

Treatment Success Likelihood – While it may not be as severe as a condition like cancer, chronic pain is a lot like the cancer in that the sooner treatment begins, the higher the likelihood it will prove successful. Putting off professional intervention will only reduce your long-term treatment success.

Opioid Reliance – When people are reluctant to head to a doctor for active treatment options, they may fall back on passive short-term fixes, like painkillers. They may provide some short-term relief, but research has shown that along with potential problems like dependence and overdose, over-reliance on pain medications can reduce your body’s ability to manage pain on its own and it can increase a person’s sensitivity to pain.

Solutions Are Closer Than You Think – The final reason and the reason that breaks our heart the most is that many people don’t head to a professional because they think pain is just something that they’ll have to live with for the rest of their life. Even if we can’t cure your pain, we’ll do everything in our power to help reduce your pain and get you to a point where you’re having more good days than bad. Oftentimes treatment is simpler than you may imagine, so don’t cheat yourself out of an improved quality of life because you mistakenly believe your pain not treatable.

For more information, or for help with your pain condition, reach out to Dr. Cohn’s office today.

Does Anyone Understand My Pain?

August 28, 2017 / Thomas Cohn, MD

Most people who have chronic pain, no matter what the source, believe they are alone in the world and that no one has similar problems and no one in medicine can appreciate the problems they suffer. However, as I have often said, about 30 percent of the population in the world has problems of some type with pain. It is the same in the United States as it is in the undeveloped world in Africa or in the industrial world of Europe or Japan. If so many people have pain, a lot of people have similar types of problems and there are likely medical professionals that do understand pain problems. There are many types of medical professionals that see pain patients, including Chiropractors, Physical Therapists and Psychologists, to all kinds of physicians including Physiatrists to surgeons.

Who Should I See For My Pain?

The best person for one to see is someone who may understand whatever problems are causing pain. If the problem is simple, it may not matter who you see because many professionals understand and are trained on that care. The more complex the problem, the harder it becomes to find professionals who care and understand the issues and have the expertise to coordinate management. My personal bias for the complex patient is to find a pain clinic that is led by a specialist in Physical Medicine and Rehabilitation – a Physiatrist. These are the physicians that have been crossed trained across multiple specialties including internal medicine, rheumatology (arthritis), neurology and orthopedics among many disciplines. Most of these doctors are good at coordinating a team effort to help patients. As with any doctor or specialist, 90 percent of them will do a good job and 10 percent will be outstanding.

Finding an outstanding doctor is always difficult. Sometimes it is a gift of a good personality, others listen well, and some just have so much experience that they can help those who want help and are willing to work toward a solution. Every patient has a different need and many patients will define good doctors and professionals in their own ways. Some doctors just understand things better because they have been through the problems personally.

My Personal Experience

To tell the truth, when I was in my medical training, the experience I had treating pain patients was one of my least favorite areas. I always was looking for other things to treat, including pediatrics, spinal cord injuries, electrodiagnostics and inpatient rehabilitation. As I entered private practice 30 years ago, I did inpatient rehabilitation of devastating problems like stroke and spinal cord injury, and outpatient care of every type of medical problem that could cause pain. After about five years I was doing more outpatient than inpatient, and eventually I transitioned to all outpatient practice. Most of my patients had medical problems or injuries that somehow caused pain. Either I needed to get good with diagnosis and treatment or else find something else to do, so I worked at getting good at that special area.

Unfortunately as I became older, I not only became wiser, but also had back pain problems from an injury to my lumbar spine as a medical student when I tried weightlifting. I also saw close people around me have issues with pain, from my wife to all my children at times. Some of the problems have been easy to help manage, some I struggle with daily and are heartbreaking even for me. The most important thing about the overall experience is that it develops a level of empathy and knowledge that it takes a ton of work on both the patient’s part and the treating physician to provide good care and help with a management plan. Furthermore, for many people pain never goes away, but is something that gets managed. It is physical and it is mental, in your brain and it affects the perception of life. It can be time consuming, tiring and often it seems depressing. Despite all the problems, the reward is moving forward and seeing the world change.

If you have pain, you are part of a third of the world population who does have pain. There are many people out in this world that can help guide you through the maze of pain management. Finding the right person for you may take time. There are multiple choices and multiple providers that may help. Yes, some people are better than others, and some will be more helpful, and lastly you may not like some of the people who may actually have the best answers. Life is tough, but it will be a team effort to move forward, and the most important person to move forward is you.

Pacing Yourself With Chronic Pain

April 18, 2016 / Thomas Cohn, MD

If one has chronic pain issues, sometimes life requires compromise. Our bodies change as we age. Just like a car, when we are young, not much maintenance needs to be done. As we get older, the parts become worn and it takes more work to keep us running. We can no longer just add fuel and go, we have to do routine maintenance and do special work to keep the body moving. Going full speed ahead may not be the wisest move, and slowing down might be helpful.

3 Aspects of Health and Wellness

In order to keep going, one of the most important aspects of care is to exercise. There are three components to a good program; stretching, strengthening and aerobic conditioning. Like a three legged stool, all of these components are necessary to prevent one from collapsing. When one is young, doing only one aspect may be okay, but if you have chronic pain, without all three it may not work.

Stretching – Muscle tightness and “spasms” often cause pain, so stretching of these areas significantly reduces muscle tightness and pain. Stretching often needs to be done several times a day, once should be fairly extensive, but short 30-60 seconds of isolated stretches may be extremely helpful throughout the day.

Strengthening – Strengthening is essential to maintain the body’s power and ability to perform activity. To be able perform an activity, one needs to have the muscle strength. Performing strengthening of the muscles by using exercises that push the body against gravity, or using machines, weights or bands are simple ways. Simple exercise routines can be found easily in apps for your smart phone or by searching the internet especially for the neck and low back region.

Aerobic Conditioning – The last leg of the stool is aerobic conditioning. Aerobic exercise ranges from walking, to pool exercises, to workouts on treadmills, ellipticals, or bicycles. Conditioning should be for about 30 minutes and be 4-5 times a week.

If one has chronic pain, the intensity and speed that one went at life prior to injury often needs to be decreased. Going all out at any activity often will cause more problems. Despite doing the appropriate exercise, once injured the body is often not perfect thereafter. Expecting to be able to do everything the same as what one did 20 years ago is unrealistic. Spring cleanup or housework that was once done in a single day may now require splitting up the routine over several days and paced out. It may take just a bit longer, but the job will still get done. It often does not matter what route one takes, as long as one gets to the same endpoint.

Once a new car leaves the dealer, it is always deteriorating unless it is never used. Once we reach adulthood, the body is always slowly growing older. It will never be quite the same as it once was in the past. Maintenance is always needed. Pacing ourselves through life will give us longevity. Getting to the endpoint is what is important. Speeding will garnish a ticket; more pain and will not make the journey especially enjoyable.