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Pain management

mike 29mmike 29 Posts: 35
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
I am six months out from a l5 s1 fusion. And now am being sent to a pain management. What goes on at a pain management appointment.


  • I am assuming from the fact that you are being sent to pain management that your pain was not resolved from the surgery. Are you having the same type of pain since prior to surgery or is this new, either in location or type, or intensity?

    Pain management doctors usually come out of two specialties: physiatry, which is a doctor of physical medicine and rehabilitation, and he is called a physiatrist (not to be confused with someone from physical therapy!), or many anesthesiologists go into pain management.

    I'm sure each doctor runs his practice slightly differently, but in general, the first appointment will be an evaluation of where you are and trying to determine why and where you are in pain. I think they usually perform the standard things that a first appointment with a spine specialist does -- testing reflexes, neurologic exam, etc. Some offices make you sign a pain contract before they will treat you. This is a pledge stating you will only be under one doctor's care for pain management, that you will get your medications from said doctor, that you will take them exactly as prescribed, not any more or any less or on your own time schedule, etc. and that a violation of any of these rules will be reason for dismissal.

    They will talk with you to decide if you might benefit from an epidural steroid injection, or something like a nerve block, facet joint injections, etc. They have quite a few options in their bag of tricks.

    Decisions will be reached. You may be prescribed oral medications and will be sent home with a plan of treatment.

    At least this is more or less what happened at my first appointment...I am assuming this is more or less standard practice for this specialty. Hopefully others will chime in with their experiences.

    Is your surgeon switching your care to pain management or will you still see him/her too?

    Good luck. Hope this works out for you.
  • My experience with my pain mgmt doc was exactly as Gwennie has described. I also went into pain mgmt after having and L5/S1 fusion that didn't resolve my pain but instead became worse.
  • gwennie17 my doctor added the pain management, but I still will see him too. Thank you and ming for the info.
  • SpineAZSpineAZ WiscPosts: 1,084
    I have had two pain management doctors, and when I first saw both they did a review of my history, surgeries, had me describe my pain (and I fill out the same form every month so they have a record of the updates or changes). I had to provide them a list of ever medication I was on and had tried recently and also had to sign the pain contract. I have been seeing my same Pain Management doctor for about 15 months now and they are wonderful. There are some PM doctors and practices out there that are not as good as they could be. So if something doesn't make sense, or you are uncomfortable with the process, let us know and maybe we can let you know if it's what we've experienced as well.

    It is common for a surgeon to refer you to pain management after surgery if the surgeon isn't comfortable with continuing to prescribe pain medications. And most PM doctors have a more extensive knowledge of the pain meds and treatments available.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Thanks for the info SpineAZ. And if I have any questions I will message.
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