If you are among the 50 million Americans living with chronic pain, a full and active life may seem like an impossible dream. But don't give up. If the pain treatment you have tried doesn't provide relief, a pain clinic may help.
A pain clinic is a health care facility that focuses on the diagnosis and management of chronic pain. Some specialize in specific diagnoses or in pain related to a specific region of the body. Also called pain management clinics, pain clinics often use a multidisciplinary approach to help people take an active role in managing their pain and regaining control of their life. These programs are focused on the total person, not just the pain.
What Does a Pain Clinic Do?
Although pain clinics differ in their focus and offerings, most involve a team of health care providers that can help you with a variety of strategies to manage your pain.
These health care providers are likely to include doctors of different specialties as well as non-physician providers specializing in the diagnosis and management of chronic pain. These providers may include psychologists, physical therapists, and complementary and alternative therapists such as acupuncturists or massage therapists. Together, they will put together a pain management plan for you.
Strategies for Pain Relief and Management
At a pain clinic, your therapy plan will be tailored to your specific needs, circumstances, and preferences. Depending on the cause of your pain, treatments may include one or more of the following:
- Non-aspirin pain relievers. These drugs, such as acetaminophen (Tylenol), relieve minor pain and are sometimes combined with other drugs to provide greater pain relief.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Available over the counter or by prescription, these drugs -- including ibuprofen (Motrin) or naproxen (Aleve, Naprosyn) -- are used to treat pain and inflammation.
- Corticosteroids. Available only by a prescription, these cortisone-like drugs are used for more severe inflammatory conditions.
- Opioid pain medications. These morphine-like drugs are often prescribed short term for acute pain or for cancer pain. Occasionally, doctors prescribe them for chronic, non-cancer pain.
- Antidepressants . Originally designed to treat depression, these drugs can be useful for relieving certain types of pain. Antidepressants may also promote sleep, which can be difficult when you are in pain.
Often, medications alone aren't enough to treat chronic pain. Other treatments may be more effective than medications, and medication may be more effective when combined with other treatments. Other available treatments offered by pain centers may include:
Injections. Local anesthetics, sometimes combined with a corticosteroid, may be injected around nerve roots or into muscles and joints to relieve irritation, swelling, and muscle spasms.
Nerve blocks. If a group of nerves, called a ganglion or plexus, causes pain to a specific organ or body region, injections with local anesthetics may be useful for blocking the pain in that area.
Physical and aquatic therapy. A physiatrist (doctor specializing in rehabilitation medicine) or physical therapist may prescribe a specially tailored exercise program to increase function and decrease pain. Other physical therapy options at pain clinics may include whirlpool therapy, ultrasound, and deep-muscle massage.
Electrical stimulation. The most common form of electrical stimulation used in pain management is transcutaneous electrical nerve stimulation (TENS), a technique that uses a small, battery-operated device to stimulate nerve fibers through the skin. Other implants for pain control use medicine, heat or chemicals.
Acupuncture . This ancient Chinese practice involves inserting very thin needles at specific points on the skin to relieve pain.
Psychological support and counseling. Although pain is a physical sensation, many people in pain suffer emotionally with feelings of anger, sadness, and hopelessness. Dealing with unrelenting pain can affect your ability to hold a job, maintain a home, meet family obligations, and relate to friends and family members. Psychological support, along with medical treatment, can help you manage your condition.
Surgery. Although sometimes surgery is clearly necessary to relieve a problem that is causing pain, it is often a treatment of last resort. If pain has not responded to any other treatment, surgery on certain nerves may offer relief and allow you to resume normal activities.
How to Find a Good Pain Clinic
If you decide you want to try a pain clinic, your doctor should be able to refer you to one that offers services to help your specific pain problem. If your doctor cannot help you, try the following:
Your local hospital. Ask your local hospital or medical center if they have or are affiliated with a pain treatment center. If the hospital does not have one, ask to speak with their department of anesthesiology, which may have doctors on staff who can refer you to a different hospital.
Medical school. Contact your nearest medical school, which is probably affiliated with a private or state university.
Organizations. Organizations that support pain research and/or advocate for pain patients may be able to help. One to try: the American Society of Anesthesiologists (ASA).
Because there are many forms of pain treatment and not all centers offer the same services, it's important to do your homework before you consent to treatment. Find out what types of pain therapies are offered, what the specialists' credentials are, and if they have successfully helped others with your type of pain.
When checking out a pain clinic, schedule an appointment to meet with the team. If you feel comfortable with them, it will be much easier for you to make progress. Asking yourself the following questions can also help you determine if a pain clinic is right for you.
- Does the staff treat me with compassion and respect?
- Does the clinic share my beliefs and goals for treatment?
- Does it develop treatment plans based on individual needs?
- Does it involve me in designing treatment?
- Does it involve my family in treatment goals?
- Will my health care team communicate frequently with one another?
- Will my health care team communicate frequently and effectively with me, my family, and my primary physician?
- Does the clinic monitor my progress?
- Does the clinic have formal follow-up with patients?