what can I expect from a pain management doctor - Pain Management Message Board

jacritch · 08-18-2004, 06:42 PM

I have had a foronamotomy in March 2004. Some of the symptoms were helped but I still have pain down the leg and I feel a lot of pressure in my spine. They have aslo said that I hae spinal stenosis. Another problelm I have is throacic outlet syndrome in my neck. I have two lumps at the base of my neck. The muscles in my neck are all bound up and hurt an a daily basis. I go see my pain management doctor on Friday and I was wondering if I should be asking him specific questions. Does anyone that has gone to a pain management specialst have any insight for me as to what I can expect. I also see a Felenkrais person who works with awareness through movenent with me and it does help. I am not on pain meds, because I wanted to deal on my own, but I can't do anything that is at all strenous or my neck looks like hulk hulgan and I favor my left leg.

Judy

Kissa · 08-18-2004, 08:34 PM

Each PM has their own method of management. Some lean more towards injections and non evasive techniques (therapy), some lean more towards meds, some do not med at all and some do a combination of meds and non evasive with injections. So it is difficult to say what exactly your PM will do.

Generally you are going to get a packet mailed to you that is probably several pages long, it asks questions about what hurts, for how long it has hurt and all the treatments you have tried including medications. They may ask you what medications have worked for you in the past and what medications wont. One thing to always keep in mind is that the goal here is to never have 100% relief, if you have severe pain it won't happen without making you non functional at all levels. Shoot for 50% but if you get more you are doing well. You will sign a contract stating you can not get meds from any other doctor (pain meds) and you must keep all appointments, understand that if you loose meds or they are stolen they will not be replaced, you aggree to the techniques they prescribe, you agree to report any new meds that you might of gotten from an ER situation immediately, you will be advised you must advise all your doctors that you are seeing a PM when you discuss pain. There are many other things in the contract itself, read it closely.

Your first appointment will be a mini physical and various questions will be asked, your dr will probably go over your form. From that point you will discuss a plan of action and it could take several routes. They may ask for more medical records or xray reports before doing anything.

If they are an injection dr. they will start scheduling injections for where the pain is a problem. A mild medication or anti-imflamatory might be prescribed.
If they lean more on the pill end of the spectrum they will ask what works and at what intervals and discuss what to prescribe you and you will leave with script in hand and make a new appt in 2 or 4 weeks.
If they are somewhat in the middle they might suggest a pain management class, psychological services, therapy and mild to moderate pain meds depending on your situation.

Follow ups are generally on a monthly basis if you are given medications, most doctors prescribe for 28 days instead of 30 to get you under the "legal limit". Expect that your appointsments to be very short ones, maybe 5 minutes going forward. You will go in, talk about the meds you took, are they working etc. If you had injections you will review those and possibly schedule more. Some doctors will let you come every so many months for an eval but you can pick up your medication monthly.

So as you can see it will vary from doctor to doctor and situation to situation.
Good luck and I hope your Pm is able to help you. Let us know how it goes and if you have any questions feel free to ask!

jacritch · 08-19-2004, 05:00 AM

Kissa,

Thank you so much for taking the time to reply...very helpful. I will keep you posted. My appt. is tomorrow.

Judy

scotty12 · 08-19-2004, 06:53 AM

Kissa hit the nail on the head.most likely this is exactly what you can expect.........scotty

jacritch · 08-20-2004, 07:36 PM

Hi Kissa,

Well, I went for my first appointment today and the pm doctor was wonderful. He is going to check out my exrays and mri's and then decide where to go from there. He gave me a thorough examination and He thinks I may have problem in my facet joints becasue that is where the pain is. He said something about freezing the facet and I don't know much about that but I will do some research to see what it entails. I really liked him.

Judy