Pain management combines techniques that help patients reduce or better tolerate pain. Today, expert physicians known as pain specialists have many options to help patients ease pain.

Pain results from the interaction between three components of the nervous system: the peripheral nerves, spinal cord and brain. Nociceptive pain occurs when nerve receptors that sense tissue damage are stimulated by an unpleasant sensation. Neuropathic pain is caused by damage to the peripheral nervous system or central nervous system.

There are two major types of pain:

• Acute pain. Short-term pain that is often related to recent disease, inflammation, trauma or surgery. It usually passes quickly once a patient recovers from injury and often requires little treatment. Sources of acute pain include bruises, cuts, strains, sprains and fractures.
  
  
• Chronic pain. Persistent and long-term pain due to disease, degeneration or an injury that did not completely heal. In some cases, chronic pain can occur despite a lack of an apparent cause. Common causes of chronic pain include:
  
  
• Arthritis
• Back pain
• Neck pain
• Other joint pains
• Recurrent migraines
• Fibromyalgia
• Myofascial pain syndrome
• Chronic fatigue syndrome
• Systemic lupus erythematosus
• Complex regional pain syndrome
• Sickle cell anemia
• Cancer pain
• AIDS pain
• Neuropathic pain
• Cranial neuralgias
• Post-shingles pain (postherpetic neuralgia)

People who develop significant pain often find that it overwhelms many aspects of their lives. Their personal relationships and work productivity may suffer, and their appetite may be reduced. Pain limits the mobility of some patients and prevents them from performing daily tasks. In many cases, pain also takes an emotional and psychological toll, fostering irritability, depression and feelings of hopelessness or even suicide. Experts in pain management refer to the presence of three symptoms related to pain – suffering, sleeplessness and sadness – as the “terrible triad.”

Untreated or undertreated pain can create an extreme rise in pain levels and patient anxiety. Pain management is best achieved by regular administration of pain medicine, or other treatments, to control the pain. When pain is under control, the patient’s quality of life is greater and the vicious cycle of ever-increasing pain can be alleviated. Patients whose pain is under control find they are less stressed physically and emotionally and are better able to sleep, focus on work and enjoy social activities and relationships with loved ones.

The best way to treat painful symptoms is to seek medical care to help alleviate the pain and diagnose the cause. Patients usually will see their primary care physician first to get a diagnosis and receive initial treatment. Some disorders will require consultation with a specialist to determine a cause. However, severe acute pain and chronic pain are often best treated by a pain specialist. These physicians are experts in all aspects of pain, including its causes, how the body reacts to pain signals and how medications or other treatments can dull or eliminate pain.

Many physicians who specialize in treating pain are anesthesiologists. These are the medical professionals who make sure that patients do not experience pain during and after surgery or other procedures, such as childbirth. In addition, many neurologists are skilled in pain management, especially for neuropathy, neuralgia and migraines and other headaches.

Physicians specializing in pain management usually have advanced training in the field of pain medicine (e.g., pain fellowship training), as well as certifications from a variety of boards, such as the American Board of Anesthesiology or the American Board of Pain Medicine.  

In some cases, the anesthesiologist will lead a team of medical professionals dedicated to managing a patient’s pain. These may include physicians such as neurologists, orthopedists, oncologists and psychiatrists. It may also include other medical personnel such as nurses, physical therapists, occupational therapists and psychologists. This kind of treatment is known as multi-disciplinary approach to pain and has been seen to be most effective for various chronic pain conditions.

Other specialists who treat pain conditions include:

• Rheumatologists, who specialize in rheumatic conditions such as arthritis and lupus
  
  
• Physiatrists and sports medicine physicians, who specialize in musculoskeletal conditions such as tennis elbow and shin splints