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.

  • I appreciate the profound impact pain can have on an individual’s quality of life. When patients enter our clinic they should be very optimistic, as the tools at our disposal are constantly improving. To achieve the best outcomes, I start with the most conservative approach and progress through more advanced interventions as pain and symptoms warrant.

  • I incorporate the best practices in musculoskeletal care in a multidisciplinary practice to empower patients to reclaim their function and improve their health. In my practice, I value the process of listening to the patient and understanding the whole person before formulating a treatment plan that achieves positive results for the patient.