Whom Should I See for Chronic Pain?

As there are many types of chronic pain, there are many options for who can evaluate and treat your chronic pain.  There are 2 issues I think are most important:

1.  First, know what body system your pain is in.

Many fields of medicine treat disorders that cause pain.  For example, a rheumatologist would treat arthritis, a cancer specialist would treat cancer, and a neurologist would treat headaches.  You should get a good evaluation, a specific diagnosis, and a plan for treatment from someone who specializes in your particular disease.  This person can follow you over time, or serve as a consultant to your primary care doctor.  The important point is that someone should follow your condition and work with you, in an ongoing way, to monitor how you’re doing and make adjustments to treatment as needed.

2.  Do you need a pain management expert?

There are physicians who specialize in treating chronic pain.  They are in fields such as neurology, anesthesiology, psychiatry, and rehab medicine, but their primary interest and expertise is treating patients with chronic pain.  These practitioners are invaluable in your care, especially if pain is one of your primary symptoms.

If you see your primary care doctor or specialist, and that clears up your pain, that’s wonderful.  But if your pain remains, it’s very worthwhile to see someone who specializes in chronic pain.  Again, this can be a consultation or ongoing treatment.  Chronic pain is often very difficult to treat, so you want to have an expert on your treatment team.

Lastly there are diseases of the pain systems in your body, where pain is not a symptom of something else, but the disease itself is in the systems of your body that control pain.  These are diseases like CRPS (Complex Regional Pain Syndrome, or RSD), central pain, and diseases that cause sensitization of your nervous system.  In these diseases, it’s very important to see someone who specializes in them.

Where do you find a pain management expert?  The best option is to ask your primary care doctor for a recommendation, or to look in an academic health center or in a health system for a pain management center.  Many of the national pain societies also have directories of members where you can look for someone in your area.

Should I See a Pain Management Psychiatrist, Psychologist or Therapist?