Pain Medicine Physicians
What is a Pain Medicine Physician?
Fellowship Degrees in Pain Medicine were first awarded in 1999 and the Health Insurance Commission (Medicare) recognised Pain Medicine as its own separate medical specialty in 2006. Pain Medicine Physicians are recognised by the post-nominal FFPMANZCA and usually hold a specialty in another related field of medicine such as anaesthesia, surgery, psychiatry or rehabilitation. Pain Medicine Physicians have usually undergone two years specialised training in multidisciplinary pain management clinics and examination to be awarded FFPMANZCA.
Pain Medicine Physicians have an intimate knowledge of the physiology, psychology, pharmacology and pathology of pain coupled with an operational knowledge of hospitals and other healthcare facilities. They usually are the clinical leaders in Multidisciplinary Pain Management Programmes.
Pain Medicine Physicians are aware of diagnostic procedures, surgical techniques, postoperative care and general medical issues. They have an ability to critically analyse conflicting data and opinions relating to these areas.
Pain Medicine Physicians may perform interventional and diagnostic procedures for pain such as facet joint injections, radiofrequency neurotomy and epidural blocks and can advise on patient selection for these procedures.
They are expert in the patient selection, screening and implantation of invasive and advanced forms of pain relief such as neuromodulation (spinal cord stimulation, peripheral nerve stimulation) and Intrathecal Drug Pumps.
When Should A Pain Medicine Physician Provide Expert Opinion?
Many cases do not conform to a straightforward medical model of disease especially when conditions become chronic and complicated by the development of psychological sequelae such as anxiety, depression and secondary deconditioning. A Pain Medicine Physician is well positioned to provide an excellent overall perspective of more complex cases where pain is a major feature especially the less common conditions such as Complex Regional Pain Syndrome (CRPS), neuropathic pain, non-organic pain and drug dependency.
Pain Medicine Physicians are able to:
- Accurately diagnose Pain related conditions
- Give prognosis on Pain related conditions
- Assess causality of Pain and Dysfunction
- Assess quantum of Pain and Impairment
- Determine Maximal Medical Improvement
- Determine adequacy of treatment
- Predict future treatment requirements and costs
- Give consideration to an individuals past Medical and Psychological History
- Explain conflicting medical opinion in relation to Pain Diagnoses
Whenever Pain is a major symptom Pain Medicine Physicians are able to:
- Advise on further treatment and specialist consultations.
- Advise on further investigations
- Determine causation
- Assess contributions of organic and non organic factors
- Assess effects of Pain on Employment
Pain Medicine Physicians Treat
Chronic Non Malignant Painful Conditions e.g. Complex Regional Pain Syndrome, Painful Neuropathies, Neuropathic Pain and Nerve Entrapment Syndromes using a combination of drug and interventional treatments.
Spinal Pain not amenable to surgery such as Failed Back Surgery Syndrome, Arachnoiditis, and Degenerative Spinal conditions using a number of treatment modalities including drug treatments, injection techniques, radiofrequency nerve ablation and “advanced” pain therapies such as Spinal Cord Stimulation and Intrathecal Drug Therapy
Pain Syndromes in which an individuals pain is disproportionate to their physical condition by determining the contribution of physical (organic) and psychological (non organic) components of their pain.
Multidisciplinary Pain Management teams of allied health professionals in Pain Management Programmes in which Cognitive and Behavioural Therapy is used to treat individual’s with pain better self manage their condition
Common Examples of Conditions Assessed by Pain Management Physicians
- Complex Regional Pain Syndrome (CRPS)
- Reflex Sympathetic Dystrophy (RSD)
- Sympathetic Dystrophy / Causalgia
- Phantom Pain
- Phantom Limb Pain
- Chest Pain from Mesothelioma
- Neuropathic Pain e.g. Diabetic Neuropathy, Shingles
- Nerve Damage Pain
- Spinal Pain Sciatica, Whiplash
- Referred Pain Syndromes
- Arthritic Pain
- Fear Avoidance and Abnormal Illness Behaviours
- Drug therapy for Pain
- Organic and Non-Organic Pain
What is an Anaesthetist?
An Anaesthetist is a medical specialist who has undergone advanced training in the pharmacology, physiology, monitoring and care of the unconscious and critically ill patient. Anaesthetists are skilled in the care of the critically ill and are clinical leaders in High Dependency and Intensive Care Units.
Anaesthetists are often referred to as “perioperative physicians” because of they can determining fitness for surgery, perioperative risk, managing medical conditions in the preoperative period and because of their knowledge of pain relieving, anti nausea medications, fluid management and resuscitation.
Anaesthetists conduct anaesthesia using a variety of techniques that include General Anaesthesia, Sedation (twilight, neurolept), or Regional Anaesthesia.
Anaesthetists possess specific skills in airway management, intravenous access, epidurals and neural blockade.
Anaesthetist Areas of Expertise
Anaesthesia for adult and paediatric surgical specialties including:
- Day Case Anaesthesia
- Airway Management
- Spinal and Epidural Anaesthesia
- Regional Anaesthesia
- Nerve Blocks
- Post-Operative Pain
- Fitness for surgery
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