Understanding Pain Management Options

Explor­ing the dif­fer­ences between Pain Med­i­cine and Physiatry

Your pain med­i­cine and physi­a­try doc­tors are sole­ly focused on the eval­u­a­tion, treat­ment and pre­ven­tion of pain in order to help your body get back to a healthy and pain-free state. While both spe­cial­ties aim to iden­ti­fy and treat your pain, there are some impor­tant dif­fer­ences between them. Dr. Paul Man­ganel­li, Pain Med­i­cine, and Dr. Lena Shah­ban­dar, Physi­a­try, out­line key sim­i­lar­i­ties and dif­fer­ences between the two pain spe­cial­ties to assist you in mak­ing informed deci­sions about your care.

What is Pain Medicine?

Pain med­i­cine is a med­ical spe­cial­ty ded­i­cat­ed to the pre­ven­tion, eval­u­a­tion and treat­ment of pain. Pain physi­cians offer a vari­ety of options to treat the full spec­trum of pain dis­or­ders. Your DuPage Med­ical Group pain doc­tor will assist in find­ing the cause or caus­es to your pain and then work with you to for­mu­late a per­son­al­ized treat­ment plan.

When Should I See a Pain Med­i­cine Specialist? 

If you have expe­ri­enced pain for more than three months or your pain has not improved while under the care of your pri­ma­ry or spe­cial­ty physi­cian, you should con­sid­er an eval­u­a­tion by a pain man­age­ment spe­cial­ist. Below are just a few of the con­di­tions that your DMG pain physi­cians assist patients with every day:

  • Acute or chron­ic arm or leg pain
  • Acute pain
  • Arthri­tis
  • Back and neck pain
  • Can­cer pain
  • Chron­ic pain
  • Dia­bet­ic periph­er­al neuropathy
  • Headache/​occipital neuralgia
  • Joint pain both before and after joint replacements
  • Neu­ro­path­ic pain
  • Neu­ropa­thy asso­ci­at­ed with chemotherapy
  • Oral facial pain
  • Pain asso­ci­at­ed with addiction
  • Pain asso­ci­at­ed with spinal com­pres­sion fractures
  • Pelvic pain
  • Per­sis­tent post-op foot and ankle pain
  • Per­sis­tent post-op pain
  • Sacroil­i­ac joint pain
  • Sci­at­i­ca

Treat­ments Pro­vid­ed by a Pain Med­i­cine Physician

Dur­ing your vis­it with your pain med­i­cine physi­cian, you’ll receive an eval­u­a­tion to deter­mine the cause or caus­es of your pain. Eval­u­a­tions will include a review of your health his­to­ry, a phys­i­cal exam and a review of any tests or imag­ing you may have pre­vi­ous­ly com­plet­ed. Based on your eval­u­a­tion, your physi­cian may rec­om­mend one or a com­bi­na­tion of treat­ment options to reduce your pain and improve your func­tion. Depend­ing on the source and sever­i­ty of your pain, pos­si­ble treat­ment options may include:

  • Nerve blocks or nerve abla­tions — med­ica­tion is inject­ed into your body to numb a nerve or group of nerves to reduce pain. Abla­tions can often last for a year or longer.
  • Oral med­ica­tions — med­ica­tions tak­en by mouth to con­trol pain (anti-inflam­ma­to­ry, aceta­minophen, opi­oids, etc.).
  • Top­i­cal med­ica­tions — oint­ment, cream or patch applied to your skin to man­age pain.
  • Steroid injec­tions — shots admin­is­tered (often with ultra­sound or X‑ray guid­ance) direct­ly into joints or next to nerves to treat painful inflam­ma­to­ry con­di­tions. Epidur­al steroid injec­tions are a com­mon example.
  • Spinal cord and periph­er­al nerve stim­u­la­tion — minia­tur­ized elec­trodes are implant­ed to block pain sig­nals, often pro­vid­ing pro­found and long-term pain relief from patients suf­fer­ing from very chal­leng­ing chron­ic pain conditions.
  • Kypho­plas­ty — cement is inject­ed into painful spinal ver­te­bral frac­tures to strength­en the bone and quick­ly reduce or elim­i­nate the pain.
  • Min­i­mal­ly inva­sive spinal decom­pres­sion devices — small implantable devices that may help man­age leg pain asso­ci­at­ed with spinal steno­sis when surgery is not the best option.

The bot­tom line is that with so many ways to treat pain, you should con­sid­er an eval­u­a­tion by a pain med­i­cine spe­cial­ist before resign­ing your­self to liv­ing with chron­ic dis­abling pain.

What is Physiatry?

Physi­a­trists, also known as reha­bil­i­ta­tion physi­cians, spe­cial­ize in non-oper­a­tive phys­i­cal med­i­cine for mus­cu­loskele­tal con­di­tions (mus­cles, bones and asso­ci­at­ed nerves, lig­a­ments, ten­dons and oth­er struc­tures) in order to restore func­tion, mobil­i­ty and qual­i­ty of life. You could think of a physi­a­try as pri­ma­ry care for the mus­cu­loskele­tal and ner­vous system.

The biggest dif­fer­ence between pain med­i­cine and physi­a­try, how­ev­er, is in their approach. Though physi­a­trists can admin­is­ter med­ica­tions or med­ical pro­ce­dures, they look at your over­all health and well being, focus­ing on the big pic­ture to deter­mine caus­es of pain and best course of treat­ment to restore and enhance your func­tion­al abil­i­ty. This can include devel­op­ment of care plans that address your phys­i­cal, emo­tion­al and med­ical needs, and col­lab­o­rate with oth­er spe­cial­ty teams such as phys­i­cal or occu­pa­tion­al therapists.

When Should I See a Physiatrist?

If you are expe­ri­enc­ing chron­ic or acute pain and want to explore non-sur­gi­cal care for your con­di­tion, a physi­a­trist is a great ref­er­ence. Your pri­ma­ry care physi­cian can help you deter­mine if physi­a­try is right for you and your con­di­tion, as well as work close­ly with a physi­a­trist to devel­op a non-sur­gi­cal plan of care.

Physi­a­trists can treat both acute and chron­ic pain asso­ci­at­ed with nerve, mus­cle and bone injuries or ill­ness, including:

  • Acute and chron­ic joint pain
  • Acute and chron­ic back pain
  • Run­ning or oth­er sports-relat­ed injuries
  • Degen­er­a­tive joint conditions
  • Nerve entrap­ments
  • Overuse injuries
  • Tendonitis/​Tendinopathy

Treat­ments Pro­vid­ed by a Physiatrist

In order to devel­op a cus­tomized treat­ment plan for your con­di­tion, a physi­a­trist will con­duct a com­pre­hen­sive eval­u­a­tion to deter­mine a diag­no­sis. Eval­u­a­tions will include a thor­ough review of your per­son­al and fam­i­ly med­ical his­to­ry, as well as a com­plete phys­i­cal exam. Depend­ing on the cause or sever­i­ty of your con­di­tion, fur­ther diag­nos­tic test­ing such as labs, nerve con­duc­tion stud­ies, psy­cho­log­i­cal test­ing or X‑rays and MRI scans, may also be administered.

Physi­a­try takes a mul­ti-faceted approach to treat­ment focus­ing on restor­ing func­tion, reduc­ing pain and improv­ing over­all qual­i­ty of life. Treat­ment options may include one or mul­ti­ple of the following:

  • Exer­cise therapy
  • Phys­i­cal therapy
  • Occu­pa­tion­al therapy
  • Guides to improv­ing over­all health (such as smok­ing ces­sa­tion or weight management)
  • Non-opi­ate ther­a­pies and medications
  • Psy­choso­cial support
  • Min­i­mal­ly inva­sive injec­tions to the joints, nerves or oth­er painful structures
  • Alter­na­tive ther­a­pies, such as acupuncture

You don’t have to live your life with dai­ly pain and dis­com­fort. Our pain med­i­cine and physi­a­try spe­cial­ists are ded­i­cat­ed to find­ing the means nec­es­sary to iden­ti­fy and treat the under­ly­ing cause of your pain so that you can enjoy a bal­anced, healthy lifestyle. So, whether it is through med­ica­tion or a focused phys­i­cal ther­a­py rou­tine, find­ing the treat­ment approach that is right for you and your con­di­tion is the first step in achiev­ing a pain-free life. If you are strug­gling to decide which pain man­age­ment route is best suit­ed for you, con­sult your pri­ma­ry care physi­cian or vis­it our web­site to learn more.

Click here to learn more about pain med­i­cine and physi­a­try or to sched­ule an appoint­ment with one of our spe­cial­ists today.