Choosing a Pain Management Doctor or Orthopaedic Physician

11th September 2006 at 09:27 BST by Dr.C.A.Jenner MB BS, FRCA. Permalink.

A summary of the most important factors to consider when choosing a pain management doctor or orthopaedic physician and the importance of the multidisciplinary team approach to the management of patients with painful conditions

In the UK, the majority of Consultant Doctors who specialise in pain management have been trained as Anaesthetists and have undergone further specialist training in pain management. After qualification from Medical School, a period of training as a Pre-Registration House Officer (now F1) is undertaken. This is followed by a minimum 7 year training programme in which the Doctor will train in Anaesthesia, Intensive Care Medicine and Pain Management.

For those Doctors who have a special interest in pain management, there are a number of Fellowship positions available both in the UK and abroad and Doctors can gain further experience in general and/or specific aspects of pain management that particularly interest them. For example, advanced pain management procedures or pain management programmes. Most Doctors who are appointed as Pain Management Consultants will do anaesthesia and pain management although there are increasingly many full time Pain Consultants.

The majority of Consultants in Pain Medicine will have an NHS Consultant post and see some private patients independently. There are also a number of Consultants who have a background in General Medicine rather than Anaesthesia. All Consultants in Pain Management undergo a period of training in basic and advanced pain management including the management of acute and chronic pain problems. This encompasses musculo skeletal pain, neuropathic pain and cancer pain.

Often the doctors will develop specific interests and experience for example, advanced pain management or leading pain management programmes. The training includes lectures, courses, practical demonstrations, clinics and hands-on experience. The knowledge is formally tested in both the primary and final FRCA (Fellow of the Royal College of Anaesthetists) post graduate examinations. Consultants in Pain Management have moved away from the biomedical approach to a more bio-psychosocial model and often work in multidisciplinary teams employing a multiplicity of different treatments.

Such units can span the spectrum from psychological input for instance, pain management programmes and pre-implantation screening to the implantation of spinal cord stimulators. Highly trained Consultants in Pain Management will often work as part of a multidisciplinary team in the full knowledge that each member of the team has their own unique experiences and expertise.

The Consultant often acts as the Team Leader and will co-ordinate the various members in the team. Multidisciplinary team meetings are a chance for the different members of the team to come together to discuss complex cases and plan treatments. It allows them to discuss the findings of various treatment strategies in a more joined up manner.