Definition and Overview
Contrary to popular belief, pain is not entirely bad. In fact, it is a normal human reaction to something like an inflammation. However, if it is chronic and debilitating, medical attention must be sought. Chronic pain is one of the most common forms of disabilities around the world that severely limits mobility and significantly decreases a person’s quality of life.
As much as possible, pain should be treated and eliminated completely. However, in cases that this is not possible (like in the case of end-stage cancer), medical professionals find ways to effectively manage it.
Who Should Undergo and Expected Results
Pain management consultation may be necessary when:
An acute pain has transformed into chronic pain – A pain is considered chronic when it is recurrent, frequent and long-term. Chronic pain has the potential of being a lifelong disability. Before it gets worse, the person should learn how to properly cope with it with the help of pain specialists.
A person has gone through a pain-related situation - These include suffering from a physical trauma or surgery (particularly those that uses traditional techniques such as open-heart surgery).
The treatment program no longer works – There are cases wherein patients who are under a pain management program have stopped experiencing pain relief. This could be because the pain has intensified or worsened, or the medication has lost its effectiveness in the body. Either way, the pain specialist will make necessary adjustments to meet the patient’s current needs.
Pain is getting in the way of life – Not all types of pain can lead to prolonged morbidity. There are even some types of chronic pain that are tolerable. However, in many cases, they affect a person’s quality of life. If the patient can no longer pursue regular daily activities like going to work or doing household chores, a consultation with a pain management specialist is in order.
The person has an illness that causes pain – A lot of diseases can cause physical pain with varying intensity and frequency. Usually, the pain itself is a symptom of the illness.
A pain management consultation is beneficial because:
- It equips the patient with techniques to cope and thrive despite the pain.
- It can control symptoms and complement disease treatment.
- It helps establish a good doctor-patient relationship.
How Does the Procedure Work?
Pain management consultation begins through a referral by another specialist. For example, a physical therapist may refer a patient who has a recurrent joint pain to an orthopedic specialist, who is more knowledgeable in conditions affecting and relating to the specific body part.
Prior to the visit to a specialist for a consultation, it is expected that the person who is doing the referral has already forwarded the patient’s medical records to allow the specialist time to go over them and get at least an overview of the patient’s health.
During the actual consultation, the doctor proceeds to determine the concern, specifically the degree, frequency, source and possible cause of the pain. The doctor also obtains a more comprehensive personal and family medical history, as well as history of medications and treatments obtained.
The doctor goes on to locate the pain and conducts a physical exam. If the cause of the pain cannot be determined at this point, the doctor may request for more tests, the results of which are discussed in the succeeding consultations.
A typical pain management consultation lasts for around 30 minutes unless certain treatments are applied during the visit.
Possible Risks and Complications
Pain management consultation requires time and commitment, which are two things not all patients can have. Some may feel the need to skip it once they start to feel better or if they think they have learned to self-medicate. Others may also avoid consultations altogether not only because of lack of time but also because of lack of trust with the doctor, especially if the treatments are not working the way the patient expects them to.
Miaskowski C, Cleary J, Burney R, et al. Guideline for the management of cancer pain in adults and children. Glenview (IL): American Pain Society (APS). 2005; Clinical Practice Guideline: no. 3.
World Health Organization (WHO). WHO's pain relief ladder. World Health Organization: Programmes and projects: Cancer. 2010. Available at: www.who.int/cancer/palliative/painladder/en.