How to Find the Pain Care You Need

From the American Pain Foundation, "Finding Help for Your Pain: A Pain Resource Guide"

"Why is finding a healthcare provider who is knowledgeable and skilled in pain management so difficult? Because understanding that chronic pain is a disease in itself — and one that is harmful to the body — is a new way of thinking.

"Until recently, pain was considered only as a symptom of a disease or condition, or just a natural part of aging. So most healthcare providers have been trained in treating diseases, not pain.

"Today we know that pain should never be ignored. It should be assessed thoroughly and treated aggressively, and in some cases managed as a chronic condition."

It is important to ask your healthcare provider if he or she is comfortable helping you manage your pain, and working as your partner in developing a pain management plan.

Make sure your healthcare provider:

• Knows about chronic pain and how to treat it.
• Believes your report of pain.
• Listens carefully to your concerns.
• Asks you questions and performs diagnostic tests to identify the problem.
• Encourages you to ask questions.
• Is comfortable when you disagree.
• Is willing to speak to your family or friends if you are not feeling well.
• Works with you to develop a pain management plan, including risks and benefits of each treatment.
• Tells you when he or she does not know something about your pain problem or treatment.

"Your family healthcare professional is trained to know about a wide range of diseases, but may not have had much training in treating pain. If your current treatment is not working or if your pain is getting worse, it might be time to see a pain specialist."

Finding a Pain Specialist

• Start by asking your provider to refer you to a specialist with expertise in treating your particular problem. A good question to ask is "Who would you go to if you were in pain?"
• If he or she cannot suggest a specialist, the next step would be to check with your health insurance provider to see if there are pain specialists or pain clinics in your plan.

You can also look for pain specialists by:

• Contacting the referral service of the largest hospital in your area.
• Calling state and county medical societies.
• Speaking with people who belong to pain support groups in your area or region. Ask what doctors they like and why. Ask them what they look for in a specialist or pain center. Check with the American Chronic Pain Association: ACPA@pacbell.net, www.theacpa.org, or 800-533-3231.
• Contacting your local chapter of the American Society of Pain Management Nurses (ASPMN), the American Pain Society (APS), and the American Academy of Pain Medicine (AAPM).
• Calling your local hospice. They can be helpful in finding a pain specialist even for non-end-of-life pain care. Also, someone in your State Cancer Pain Initiative may be able to suggest specialists even if your pain is caused by something other than cancer.
• Ask friends, family members, co-workers — particularly those who've had pain or know someone with pain — for suggestions.

If there are no pain specialists in your area:

• Call or write your chamber of commerce and/or contact the board of directors (chairman or members) of your local hospital. Ask about a larger hospital offering outreach clinics or visiting physicians.
• Contact your local legislators about the lack of resources and request their assistance.

Questions to Ask

As a self-advocate, it's up to you or someone helping you to interview [potential physicians] and determine who best suits your needs — that includes selecting someone who not only has the skills to treat you, but someone who makes you feel comfortable as well.

"Begin your interview by telling the doctor about your symptoms and all the medications you're taking. Describe other treatments for pain you've had. This interview will give you insight into the doctor's willingness and ability to communicate with you."
Some questions to ask the doctor:

• Have you treated others with my type of pain?
• What type of treatments do you use to treat my type of pain (medications and other therapies)?
• How would you describe good pain management?
• What is your success rate in treating my type of pain?
• How much relief should I expect from treatments?
• What do you think of complementary and alternative approaches (such as acupuncture, massage, hypnosis, herbal remedies)?

Other questions to ask:

• Are you a member of a pain specialty organization?
• What was the most recent pain conference or seminar you've attended?
• Do you do any teaching?
• Do you participate actively in improving pain management on a local, regional, or national level? If so, how?

Doctors' credentials can be checked out by contacting your state or county medical society, the American Board of Medical Specialties (www.abms.org), and the Specialty Licensing Board (www.abms.org/member.asp). You can also ask the doctor's office to supply his or her credentials concerning schooling and special training.
 
(The American Pain Foundation. Finding Help for Your Pain. 2002. Available at http://www.painfoundation.org)