Choosing a pain management team
A pain management team is a group of individuals, both health professionals and others with community and education expertise, who will assist in maximizing your quality of life. This help can take the form of physical therapy, prescription of medications, cognitive therapy, education about pain and its management and support to live better with pain. The health team will likely comprise: pain medicine specialists and GPs, physiotherapists, psychologists, nurses, etc and others in your support team could be: pain support group facilitators, Pain Link guides, APMA pain management educators and each will have a different role to play in your care.
Choosing who will best fill each role can be difficult and if you are not comfortable with the way a doctor or therapist communicates with you or treats you, try to discuss this with them, and if you remain unhappy try someone else. Remember that each member of the team should be someone whom you trust and feel comfortable with, and should believe that you are in pain, considers your concerns seriously, and encourages open discussion of your problem.
Each member of the health team should know about the other members of the team, be willing to discuss your case with them, and remain receptive to ideas from other members of the group even if they do not agree with them.
All the members of the team should have experience in dealing with people in chronic pain, should not make you feel rushed or a burden during a consultation or therapy session, and should be willing to speak with your carer or family if you are not well. The health professionals should discuss the risks as well as the benefits of the therapies involved in your care and be prepared to admit when the answer to a question is not known. As their patient, you will get more out of the consultations if you're active in the process and ask questions when you need to and take on board the advice given, giving any trial therapy a real trial. This will be different for the varied treatments so ask your doctor how long this therapy should be trialled for to gain edidence of its effectiveness.
The health team members may include the following people:
1. General practitioner -
Your GP is usually your main health care provider and he/she will be your first point of contact. Your GP will communicate with other members of your health care team and, where appropriate, will refer you to a specialist clinician or surgeon depending on the cause of your pain.
2. Specialist clinicians -
Specialist clinicians involved in the management of chronic pain include Pain Specialists, Neurologists, Rheumatologists and Psychiatrists.
- A Pain specialist is a physician who has specialised training in the diagnosis and management of pain.
- A neurologist is a physician who specialises in diseases of the brain, spinal cord, and the nerves.
- A Rheumatologist is a physician who specialises in diseases of joints and the soft tissues that surround and interact with joints.
- A Psychiatrist is a physician who specialises in diseases which affect emotion and ego.
3. Specialist surgeons - Specialist surgeons involved in the management of chronic pain include Neurosurgeons and Orthopaedic surgeons,
- A neurosurgeon specialises in the surgical treatment of the brain, spine, or spinal cord and nerves.
- An orthopaedic surgeon specialises in the surgical treatment of bone, muscle and joints
4. Other medical specialists - Pain associated with organ disease or cancer may require the skills of physicians and surgeons other than those listed above and may include medical oncologists, radiation oncologists, and surgical oncologists.
5. Allied health professionals - include Physiotherapists, Occupational therapists, Rehabilitation counselors, Psychologists, and Social workers.
- Physiotherapists provide physical therapy in the form of massage and manipulation of joints and muscles. They can advise on posture and exercises which may relieve pain, and may use treatments, heat, ultrasound, and traction to ease stiffness and maintain joint and muscle
- Occupational therapists provide advice to help you adapt your environment and daily activities to reduce pain and allow you to live within the restrictions of the pain.
- Rehabilitation counselors provide assistance with employment and retraining issues. They will act as your advocate when navigating the complex rehabilitation system, and provide advice with redeployment or re-employment where necessary.
- Psychologists will assess your response to your pain and teach you techniques to cope with pain.
6. Nurses - A nurse is a highly skilled practitioner who combines knowledge of caring for the sick with scientific knowledge. A nurse is involved with educating patients about health conditions and their treatment, prevention and health maximisation activities, clinical procedures and surgery and other patient care as advised by the treating doctor.
7. Social workers - can provide support and help with different aspects of your life that may be affected by your pain, such as your family life, income and housing, and other life problems.
Community support staff - APMA has a range of volunteers who provide practical help and support in the community.
Pain Link guides take calls from people wanting information about chronic pain or they are calling about the impacts that chronic pain is having on them or a person close to them.
Pain support group facilitators coordinate the pain support groups and assist participants to improve the information they have, their pain training options and tips from guest speakers and arrange a social outlet for people living with chronic pain who are often isolated by it.
Pain management trainers work with organizations or groups to improve the information and skills needed to best manage chronic pain. The training uses adult learning methodology and the active learning is effective on return to the work of the organization. A number of APMA trainers have undertaken Stanford Chronic Disease Leaders Training.
Enjoy the great feeling of confidence you have with great health practitioners and community support staff working alongside you.