What is the difference?

[Sharka]

What is the difference of a Pain Management Doctor and a Medical Doctor? Thanks

[railroaded]

My orthppedic surgeeon, who I have been seeing due to pain, mainly referred pain from 2 pack surgeries, which resulted in extreme nerve damage and loss of feeling in left LEG, and chronic deep aching pain down my sciatic nerve. The 2nd surgery did nothing but made me able to walk again, which IS success in a way!  My pain has never improved, pain meds dull it, but nothing, epidurals, trigger point injections, steroidss, you name it, they have tried it. A micro-neurosurgeon performed my surgeries, and now the insurance companies have me seeing a "paain management" doctor.  There is NO difference in his knowledge of pain, that I can tell, and I have seen more than 3, than my regular back dr.  In fact LESS, since he doesn't usually see you as regularly, or in my case, for near as long, and they don't seem to take into much account underlying medical issues you may be seeing your family physician or your back dr. for.  They are hired guns by the insurance companies to get you on the cheapest regimen possible.  Yesterday, after seeing a NEW pain management dr., ordered AGAIN by the insurance company to switch me to the dirt cheap methadone, which i again refused, and was then harrassed for hours about, and it's not near over yet, believe me!  Anyway, I saw my regular back dr. who knows of all my underlying conditions, and i told him the insurance drs. plans, and that he had said basically he could make me PAIN-FREE!, well, we both just looked at each other.  my regular dr. attends more pain management conventions than you would believe, and it turns out, he KNEW the Dr. and knew why i was having a problem EGO! Pain management drs. are less informed on issues other than pain, BECAUSE they only focus on the immediate problem, or, as in my case, keeping the insurance company happy and continuing to send patients to convert. I KNOW they aren't more knowledgeable, but boy oh boy, they sure think so!  I was given a 1950's "saddle Block" by mistake, and that is WAY too close to the spinal cord, and way to careless to be comfortable.  The Dr. then denied doing it of course.  I urinated all the way from the pain clin, 100 miles, due to NO feeling!  But NO, I was mistaken!  Drs. put their pants on one leg at a time, and don't EVER forget it.  I am being harrassed and terrified of the ultimate ramifications, but i will stand my ground.  They do hold all the cards, unless you happen to be independantly wealthy like them, with THEIR " Blue Chip Insurance"!  (My pain management drs. very words.)  I want to thank everyone who has replied to me both in the past and in advance.  People who are NOT in chronic aching neuropathic pain will continue to think we are substance abusers, (although never a blip of a high, ever), and continue to think we don't REALLY need it.  So why did they need to formulate it at all?  To try to relieve some of the suffering.  I am so sick and tired of people feeling that if i just either got off it altogether or bit the bullet, i would be fine. Usually they are the kind that would be in tears at an emergency room while we tough it out day AND night.  Thanks for letting me vent!

[Tuckamore]

A Pain Mangement Doctor (PMP) is a medical doctor. The difference is usually the  extended training and education in the treatment of chronic pain. Actually any physician can become a PMP.

States differ. In my state it is not the PMP that prescribes for and follows chronic pain patients. Our PCP (primary care physician) prescribes our narcotics. A PMP will preform procedures such as a complicated steroidal injection that requires more skill and speciality than a PCP may have. They will do nerve block and similar procedures. It is always the PCP responsibility to "monitor" and prescribe narcotics, at least to my knowledge. We have very few PMP because we do not utilize them in the manner that other states do.

My PCP states this is because our state is so rural. I would have to travel an hour and a half to the closest PM Clinic. The next closest one, in the case that my insurance may not cover the first, would be over 3 hours away.

Hope this helps. Best of luck to you.

Take Care,
Tuck

[chasingthehigh3]

A pain management doctor works with people that have chronic pain issues whereas your regular medical/family doctor does not- well, actually some do but a lot of family physicians will, once they have diagnosed you with chronic pain or feel that extensive treatment is needed, pass you on to a PM doctor. A PM doctor is usually an anesthesiologist that can perform a number of different things like injections, etc. Also, a big difference is the amount and length of time prescribing narcotic pain medication. A regular doctor is only able to prescribe so much to a certain amount of patients. A PM doctor can right as many as needed to every single patient if he chooses. Does this make sense? LOL

I'm sure someone else can get on here and describe this better or differently but this is my take on it here in my area of Florida. Hope I helped you understand the difference though ;)