Pain management specialists are doctors who focus on the diagnosis and treatment of different types of pain including:
- Acute pain
- Chronic pain
- Cancer pain
This article will explain the education and training that goes into becoming a pain management specialist, his or her role in patient care, the types of treatments offered, and what to expect at the first appointment.
Medical Specialty Areas that Focus on Pain Management
There is no single field of medicine that focuses on pain management. Most pain management specialists are board certified in one of the following areas:
- Physical medicine and rehabilitation. Physical medicine and rehabilitation doctors use a wide variety of nonsurgical treatments to address painful conditions relating to the musculoskeletal and nervous system. Their goal is to improve patients’ quality of life by decreasing pain and increasing function. These doctors may be referred to as physiatrists, physical medicine and rehabilitation physicians, or PM&R physicians.
- Anesthesiology. Anesthesiologists are physicians who administer anesthetics—substances that reduce or eliminate sensitivity to pain. Most anesthesiologists administer anesthetics to patients undergoing surgeries. Some anesthesiologists go through additional training in pain medicine and can diagnose and treat acute and chronic pain.
- Neurology. A neurologist focuses on the diagnosis and treatment of the brain and spinal cord. Spinal cord related injuries and diseases are a common cause of chronic pain.
Emergency and family medicine doctors also provide their patients with conservative pain treatments and refer patients to additional subspecialists to further treat pain conditions.
An interventional radiologist specializes in using medical imaging, such as ultrasound or CT scan, to conduct minimally invasive procedures. These specialists perform procedures to treat pain and may be referred to by a primary pain management physician to perform interventions through injections or small incisions.
Doctors in psychology and behavioral science may be involved in a comprehensive pain management program but are not pain management specialists.
Most patients are referred to pain management specialists by their health care providers and/or surgical specialists.
Education, Training, and Certification
A pain management specialist undergoes extensive education and training to qualify them to work in the field.
Education and training can include:
- Four years of medical or osteopathic school (an osteopath is eligible to become board certified in physical medicine and rehabilitation)
- State licensure exam
- Medical internship
- Completion of an Accreditation Council for Graduate Medical Education (ACGME) residency program
- Fellowship in pain medicine
- Subspecialty certification in pain medicine from the American Board of Medical Specialties (ABMS)
The American Board of Medical Specialties (ABMS) offers subspecialty certification in pain medicine to doctors who are already board certified in one more of the following specialty areas:
- Rehabilitation and physical medicine
- Psychiatry and neurology
- Emergency medicine
- Family medicine
The ABMS sets standards for physician certification in the US. The exam for subspecialty certification in pain medicine is the same regardless of the field in which the doctor is certified.
Certification in pain medicine is also offered by the American Board of Pain Medicine (ABPM); this organization is separate from the American Board of Medical Specialties and its certification is not recognized in all states. This certification can be earned in addition to or instead of the American Board of Medical Specialties subspecialty certification in pain medicine.
An American Board of Pain Medicine certification requires several eligibility requirements:
- The successful completion of an accredited residency training in pain medicine
- A license to practice medicine in a U.S. state or territory
- Registration with the U.S Drug Enforcement Administration to prescribe, administer, and dispense controlled substances
- American Board of Medical Specialties board certification
Researching and understanding a doctor’s background can help patients choose a pain management specialist who is qualified and familiar with their specific condition. Primary specialty of the physician will often determine a broad scope of his/her expertise. Experience in treatment of certain conditions will also enhance his/her ability to understand and manage patient’s problem.