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When should I go to pain management?

I have a question of sorts and I will be as brief as possible. I have been treated by my family Dr. For long term pain management for. Cervical injury. My neck surgeon has told me that he can't do anything and referred me to pain management. My family Dr. Says that nothing can be done for me, there is no "magic bullet". He says epidural a etc. only provide temporary relief and it's only 50-50 that they may work anyway.
My injury leaves me unable to walk too much or sit like someone who isn't injured.
I am diagnosed as permenantly disabled. If I am already getting all the meds I need from my Dr., what would be the point of going to another doc? I have been going to chiro and taking supplements etc. working hard with my present caregivers.
Would going to another doc help me in any way if they can't correct my injury-only treat pain etc?
I am scared to have anyone put needles etc into my neck or burn my nerves.


  • There are many different modalities to treat pain, not just the use of opiods to manage pain. For some, injections and the Radio frequency ablations work wonders at relieving some of the pain, which in turn leads to better overall pain control.
    Pain management doctors are versed in all of the available and coming up treatments and have the ability to work with different medications that most GP's are not as familiar with.
    In my opinion, just as you are going to a surgeon for a surgical consult, when it comes to managing pain, a pain specialist is the best option for his specialty.
  • dilaurodilauro ConnecticutPosts: 9,842
    edited 02/11/2014 - 8:10 PM
    I have been seeing a physiatrist now for over 6 years. Her role is to completely coordinate my well being. She has total records of all medications that I am taken, prescribed by her or not. She coordinates any diagnostic testing that I may need.
    She will send me to a pain management doctor for specific functions (ie ESI - Epidural Spinal Injection)

    In ways think of a physiatrist is your general contractor. while building or remodeling your house. They need to know what your requirements are and will coordinate with our service provides to make sure you're needs are being addressed.

    Now, back to our conditions. The fact that you are able to put together threads/post indicate that you can function. I do not know what level of disability you have, nor is it my business. But what I do know, is no matter what your condition is, you need someone to take charge.

    Many GPs , Primary Care Physicians and even Surgeons at a point in your situation state there there is nothing more that they can do,. That does not mean that nothing can be done for you. I think it was honorable that your current doctor told you that there is nothing more they can do, but are recommending some one else to take charge. In many ways, consider your self lucky. So many of us do need such a person that can coordinate everything for us.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • is a specialist in spinal cord injury and physical medicine and rehab, so I get the best of both worlds, since she is the one who manages both the rehab stuff for me due to my spinal cord injury, and has so far kept me on my feet..She orders tests that may need doing, my medications, sends me to specialists as we need for me to be seen, and because she is well versed in my case, is my go to person when it comes to changes in symptoms or pain levels.
    She also saw my injections back when I had the first surgery and my second, as well as physical therapy, etc....
    I adore mine.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,730
    If the physiatrist recommends you to see a Pain management Dr. Keep this in mind.
    He has more tools in his tool chest.
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • srwynnessrwynne Posts: 1
    edited 07/25/2015 - 9:59 PM
    I have heard and seen many places, including initially from my spine doctor at Kaiser, that there is only a 50/50 chance an epidural steroid injection will work. What does that mean exactly? Does it mean that simply just that some (50%) people don't respond to the steroid and some (the other 50%) do, or that there's a 50% chance the doctor injecting could miss the right nerve, or injected into the wrong nerve, or something else. I had an ESI back in November 2014. At the time he wrote me "it wasn't the nerve causing the pain and all my symptoms", but didn't offer anything else. I continued to call my pain, tingling, cramping, etc as caused by stenosis or radiculopathy. Recently he said that they had done the ESI to diagnose whether the forminal neural narrowing was causing the pain and since the ESI didn't work, the narrowing thus couldn't be the culprit! That was a better explanation of his earlier statement, but is that always true? If the ESI doesn't work on someone, then their symptoms could not be caused by the stenosis and neural narrowing that showed up on not just one but two separate (a year apart) MRIs?
    Your advice and assistance is appreciated.

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  • From my experiences, ESI injections work in a few situations, if the injury is 3 months old or less, and when there is swelling or irritation/inflammation present. The steroids can reduce pain ,swelling and inflammation, so even if you have an older injury, but there is a recent flare of pain or symptoms, injections can help reduce those symptoms.
    If it what is called an acute injury, injections can also be very helpful then too.
    There are other types of injections and procedures that can also be both diagnostic and relieve symptoms that can be offered as well.
    It is worth at least trying a pain management doctor out, as they have far more to offer than just injections in reducing pain.

  • gfishggfish Pittsburgh PAPosts: 158
    I stated to go to a PM doctor when the pain wouldn't stop. Granted, I did have a 7 level thoracic fusion. But after 8 months, I had enough. I take 12 pills a day plus a butrans patch. I still have pain around 6-7 all day. My PM doctor just seems like a pill doctor. It got depressing when he said that there is no fix for me. If you getting the meds for your doctor now. That's all aPM doctor will do. You should go just for another opinion. What could it hurt?
    Greg fisher
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