What is a pain management doctor?

In basic terms, a pain management doctor is someone who dedicates there entire practice to treating patients with chronic pain.

The need for a pain management doctor is the result of our recognition of such high numbers of Americans living their lives with chronic, unrelenting and often debilitating pain. Traditionally primary care doctors had born the burden of addressing this need but often were overwhelmed with the management of all of the other chronic diseases that their patients suffered from. They also had few effective tools with which they could try and alleviate pain. Physical therapy, muscle relaxant, anti-inflammatory medications and sometimes narcotic analgesics were employed but when pain persisted, patients had nowhere to turn. They also were frequently viewed as patients with psychological or psychiatric problems and dismissed as crazy. In the worst scenarios, patients became addicted to strong narcotic medications.

In basic terms, a pain management doctor is someone who dedicates there entire practice to treating patients with chronic pain

– Dr. Spencer Bertram, M.D.

With this ever-increasing population of miserable Americans and the growing recognition of a substantial public health concern, doctors began to dedicate their practices to the management of persistent pain. One group of doctors that stepped up to meet this challenge where Anesthesiologists. Because many patients suffered from chronic back pain this seemed to make sense. Anesthesia doctors were already experts in delivering medication via injection to areas of the spine when pregnant mothers were laboring. These injections were called epidurals. So began the field of chronic interventional pain management with the application of epidural steroid injections to alleviate chronic back pain and sciatica.

Interventional pain doctors are not only trained as anesthesiologists but now are required to spend additional years of training to gain expertise in all types of injection treatment besides epidural injections. Commonly pain fellowship training exposes a physician to other techniques such as nerve ablations, joint injections and minimally invasive surgical procedures. They learn to read MRI scans and interpret EMG studies. They often focus on atypical pain syndromes such as chronic regional pain syndrome, central sensitization, peripheral neuropathy, shingles and post-herpetic neuralgia. They also engage other health professionals such as pain psychologists, physical therapists, neurologist and spine surgeons. Every effort is made to develop a team of caring physicians and therapists.

Ultimately, a pain physician is someone who has accumulated multiple tools for the management of chronic pain of many types. They focus on improving the lives of their patients with mild medications, injection therapy, physical therapy, chiropractic care and mental health interventions. Success is measured in terms of a person’s level of function and their ongoing engagement in family, work and recreational activities. Often pain is not curable but with the help of a pain doctor, you can face your pain and know that you are not alone.


Spencer Bertram, M.D. is a Pain Management Doctor practicing at University Pain Clinic of Rochester in Rochester, Michigan


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