When Should You Make a Referral to a Pain Specialist?

Thursday, February 6, 2014

Do you wait too long to refer?

Almost all physicians and other healthcare professionals daily meet patients in pain. Often, the cause of the pain is obvious, the cure simple and the timeframe limited. Frequently, dealing with the pain symptom is an inherent part of the treatment, as in the case of the rheumatologist who treats the pain of rheumatoid arthritis with one of the time-tested or newer medications in an effort to treat both the joint disease and the pain simultaneously.

So what characterizes the patient who needs a pain specialist?

  1. The pain has become the disease. The potential or real threat of tissue damage has passed and the pain serves no useful purpose. Conditions such as complex regional pain syndrome, fibromyalgia and phantom limb syndrome represent situations in which there is no apparent continuing cause for the pain. While other specialties may be involved, the pain management specialist can play a key role.
  2. Many of these patients present in situations where the cause of the pain is known — such as pancreatic or other forms of cancer, the pain of radiculitis or radiculopathy, or focal nerve pain — and there is a clear-cut intervention, such as celiac plexus block or ablation, epidural or transforaminal blockage with or without steroids, or nerve stimulation, that may help.
  3. Many patients with special needs or challenges require specialist care, such as the chronic benign patient who requires chronic opioids or other controlled substances which mandate special monitoring techniques such as urine drug screening. Addicted patients suffering with pain who may require methadone or Suboxone will also require the training and expertise of a specialist.
  4. The patient whose symptomotology is one of pain but who, after appropriate referrals and consultations, remains undiagnosed will require the services of a pain specialist.

For more understanding of situations that suggest pain management as well as continuing medical education (CME), visit www.dannemiller.com. This CME activity is brought to you by Dannemiller. For 30 years, Dannemiller has been an independent provider accredited by the Accreditation Council for Continuing Medical Education and holds the highest level of accreditation. Dannemiller provides continuing education online, in printed publications and in live courses. With a significant history in pain management, Dannemiller continues to provide the industry with live and online pain review courses, compose pain reports, and develop educational abstracts and learning modules.