Pain Management

Chronic pain affects at least 100 million Americans and more than 1.5 billion people worldwide.

Americans with it say it makes it difficult for them to sleep well at night and concentrate during the day. 

In addition, they say it affects their energy levels as well as their quality of life.

A pain clinic may be able to help you if pain is a regular part of your life.

What Is a Pain Clinic?

Pain management clinics are health care facilities that diagnose and treat chronic pain. 

There are two types of pain management clinics. 

The first focuses on treating a specific type of pain, such as back and neck pain.

Other clinics, sometimes called interdisciplinary clinics, take a holistic approach to healing.

It is common for your team to include the following:

  • Physical therapists
  • Psychologists
  • Occupational and vocational therapists
  • Nutritionists and dietitians
  • Nurses and doctors

As well as medication, these clinics offer physical, behavioral, and psychological therapies to help you manage pain.

They may also educate you about your pain, coach you on lifestyle changes, or provide you with complementary or alternative medicine.

Alternative and complementary medicines can include:


During acupuncture, thin needles are inserted through the skin at strategic points on your body. 

As a key part of traditional Chinese medicine, acupuncture is most commonly used for treating pain. 

A growing number of people are using it for overall wellness, including stress management.

In traditional Chinese medicine, acupuncture is defined as a technique that balances the flow of energy or life force – known as chi or qi (chee) – believed to travel through pathways (meridians) in the body. 

Through the insertion of needles into these meridians, acupuncture practitioners believe that your energy flow will be rebalanced.

Western practitioners, on the other hand, view acupuncture points as places to stimulate nerves, muscles, and connective tissues. 

This stimulation is thought to boost your body’s natural painkillers.


You control your actions when you raise your hand to say hi to a friend or lift your knee to walk up the stairs. 

Other body functions, such as heart rate, skin temperature, and blood pressure, are controlled involuntarily by your nervous system. 

For instance, you don’t think about making your heart beat faster. 

You do it in response to your surroundings, like when you are nervous, excited, or exercising.

There is one technique that can help you gain more control over these normally involuntary functions. 

The technique is called biofeedback, and it’s used to treat migraine headaches, chronic pain, incontinence, and high blood pressure.

Biofeedback is based on the idea that your awareness of your body and the power of your mind will enable you to better manage your health.

Cognitive Behavioral Therapy

A form of psychological treatment called cognitive behavioral therapy (CBT) has been shown to be effective for a range of issues, including depression, anxiety disorders, alcoholism and drug abuse, marital difficulties, eating disorders, and severe mental illnesses. 

Research studies suggest that CBT significantly improves functioning and quality of life. 

CBT has been demonstrated to be as effective as, or even more effective than, other forms of psychological treatment or psychiatric medications in a number of studies.

Water Therapy

Physiotherapy that takes place in a pool or other aquatic environment is known as aquatic therapy. 

Various names for aquatic therapy include water therapy, aquatic rehabilitation, aquatherapy, pool therapy, therapeutic aquatic exercise, or hydrotherapy.

A typical aqua therapy program aims to accomplish the following:

  • Enhancing aerobic capacity
  • Assisting with gait and locomotion
  • Reducing stress and promoting relaxation
  • Improving flexibility
  • Building muscle strength and endurance
  • Improving balance and coordination

Aquatic therapy differs from aquatic exercise or aquatic fitness in that it is a specialty of physical medicine and rehabilitation that requires a trained professional and is covered by many insurance providers due to its personalized nature. 

Exercise in the water does not need to be supervised by a professional. 

Additionally, it is not covered by insurance, and it is usually done in a group setting with multiple people with varying levels of fitness.

Adaptive aquatics should not be confused with aquatic therapy. 

Adaptive aquatics is the process of teaching people with disabilities how to swim safely. 

The focus of aquatic therapy is not on teaching clients how to swim.

Hospitals, sports medicine clinics, and outpatient rehabilitation centers usually offer water therapy services. 

As a way to encourage their residents to stay active, balanced, and strong, seniors living centers may also provide aquatic therapy services.


A trained, certified medical professional (massage therapist) manipulates the soft tissues of your body – muscles, connective tissue, tendons, ligaments, and skin. 

Different levels of pressure and movement are used.

Massages are often considered part of integrative medicine. 

Medical centers are increasingly offering it as a treatment alongside standard treatment. 

It can be used for a wide range of medical conditions.

According to studies of massage benefits, massage can:

  • Increase relaxation
  • Improve immune function
  • Lessen pain and muscle tension
  • Help reduce stress

Massage therapy is sometimes recommended by pain management physicians to help people cope with the pain and stress of various conditions, such as cancer, heart disease, stomach problems, or fibromyalgia.


The practice of meditation dates back thousands of years. 

It was originally intended to deepen understanding of the sacred and mystical forces of life. 

Meditation is now commonly used for relaxation and stress reduction.

Meditation is considered a form of mind-body complementary medicine. 

It can induce deep relaxation and tranquility in the mind.

Meditation helps you focus your attention and eliminate the stream of jumbled thoughts that may be causing stress. 

As a result, you may feel better physically and emotionally.

By meditating you can feel calm, peaceful, and balanced, which can improve both your emotional well-being and your overall health.

Meditation benefits don’t end when your session is over. 

Meditating may help you manage symptoms of certain conditions and carry you through your day with more calm.

Meditation can help you clear the information overload that builds up every day and contributes to your stress.

Meditation can provide emotional benefits such as:

  • Increasing self-awareness
  • Focusing on the present
  • Gaining a new perspective on stressful situations
  • Reducing negative emotions
  • Building skills to manage your stress
  • Increasing patience and tolerance
  • Increasing imagination and creativity

You might also find meditation useful if you have a medical condition, especially one that is aggravated by stress.

Some researchers believe it is still too early to draw conclusions about meditation’s potential health benefits, despite a growing body of scientific research supporting the benefits of meditation.

According to some research, meditation may help people manage symptoms of conditions such as:

  • Asthma
  • Anxiety
  • Chronic pain
  • Cancer
  • Heart disease
  • Depression
  • Irritable bowel syndrome
  • High blood pressure
  • Tension headaches
  • Sleep problems

If you suffer from any of these conditions or other health issues, you should speak to your doctor about the pros and cons of using meditation.

Meditation can sometimes worsen symptoms associated with certain mental and physical health conditions.

Meditation is not a substitute for traditional medical treatment. 

It may, however, complement your other treatments.

Interventional Pain Management

In this group, physicians are trained in advanced pain management procedures, including nerve blocks, spinal injections, and spinal implants. 

Interventional pain management specialists usually complete a five-year anesthesia residency followed by a one-year fellowship in pain management.

Also, there are physicians who specialize in pain management called PMNRs (physicians). 

Neurologists may also specialize in pain management.

Medical Pain Management

These doctors treat patients who have chronic conditions that require long-term medications like opioids, as their name suggests. 

Medical pain management specialists can be anyone from family medicine doctors to internal medicine doctors to psychiatrists. 

As an example, a patient on methadone for chronic pain would be seen by a medical pain management specialist, not an interventional pain management specialist.

It is especially useful to hire a medical pain management specialist to navigate the many new pain medication regulations and laws. 

Your doctor will ensure you are taking the right dose for the right amount of time to help offset the risk of dependence or addiction.

When To See A Pain Specialist

It’s not always necessary to get a referral to see a pain specialist, but these appointments typically take place after seeing your primary care physician (PCP) and another specialist, such as a neurosurgeon or orthopedic surgeon.

In some cases, your doctor may order X-rays, prescribe anti-inflammatory medication, or refer you to physical therapy. 

If those treatments don’t work, they’ll refer you to a surgeon for further evaluation. 

The surgeon will refer you to a pain specialist if you’re deemed a non-surgical candidate. 

PCPs may treat an ailment with conservative treatment for years, then refer you directly to a pain specialist when the situation becomes chronic.

Pain specialists treat a variety of conditions, but the most common are spine disorders, including herniated discs in the lumbar (back) or cervical (neck) spine. 

Also, a neurologist may refer you to a pain specialist for nerve blocks after an operation to repair a hernia, or a pain specialist may perform nerve blocks for chronic headaches.

A pain specialist will work with your other physicians to provide you with a multidisciplinary plan, whether it involves physical therapy, medications, injections or surgery.

Chronic pain specialists treat a variety of conditions, including but not limited to:

Back Pain

Symptoms of back pain can range from muscle aches to shooting, burning, or stabbing sensations. 

Additionally, the pain may radiate down your leg or worsen with bending, twisting, lifting, standing, or walking.

With home treatment and self-care, most back pain gradually improves within a few weeks. 

Talk to your doctor if the pain:

  • Is accompanied by unexplained weight loss
  • Persists past a few weeks
  • Is severe and doesn’t improve with rest
  • Causes weakness, numbness or tingling in one or both legs
  • Spreads down one or both legs, especially if the pain extends below the knee

Joint And Muscular-Skeletal Pain

Musculoskeletal pain affects bones, joints, ligaments, tendons, and muscles. 

For example, a fracture may cause sudden, severe pain. 

Pain may also be caused by chronic conditions such as arthritis. 

Speak with your healthcare provider if musculoskeletal pain interferes with your daily activities. 

Getting the right treatment can help relieve the pain.

Abdominal And Pelvic Pain

Pelvic pain typically occurs in the lower abdomen. 

The pain might be steady, or it might be intermittent. 

The pain can be sharp and stabbing in one spot or dull and spread out. 

Your daily activities might be hindered by severe pain.

You might experience pain during your period if you’re a woman. 

It might also happen when you have sex. 

Pelvic pain can be a sign that there is a problem with your pelvic organs, such as the uterus, ovaries, fallopian tubes, cervix, or vagina. 

If you are a man, you may have a problem with your prostate. 

Both men and women may experience this symptom due to an infection, or because of issues with the urinary tract, lower intestines, rectum, muscles, or bones. 

It is possible for women to suffer from more than one cause of pelvic pain at the same time.

A lab, imaging, or other medical test may be needed to determine the cause of your pain. 

The treatment will depend on the cause, the severity of the pain, and how often it occurs.


The most common form of pain is headache. 

Most people miss work, school, or go to the doctor because of it. 

Tension headaches are the most common type. 

Muscle tension in your shoulders, neck, scalp, and jaw causes tension headaches. 

These headaches are often related to stress, depression, or anxiety.


Fibromyalgia is characterized by widespread pain, sleep problems, fatigue, and often emotional and mental distress. 

Fibromyalgia sufferers may be more sensitive to pain than those without fibromyalgia.

Chronic Pain Syndrome

Whenever your body suffers from an injury or an illness, you feel pain as a warning that something is wrong. 

You usually stop hurting once your body heals.

In many cases, however, pain continues long after its cause has passed. 

Pain that lasts for three to six months or more is called chronic pain. 

Day after day of pain can take its toll on your emotional and physical health.

About 25% of people with chronic pain will develop chronic pain syndrome (CPS). 

People with these symptoms have symptoms beyond pain alone, such as depression and anxiety, which interfere with their daily lives.

It can be difficult to treat CPS, but it isn’t impossible. 

Counseling, physical therapy, and relaxation techniques can help relieve your pain and other symptoms.

Neuropathic Pain

Neuropathic pain is a chronic pain condition. 

Generally, it is a result of chronic, progressive nerve disease, but it can also be caused by injury or infection.

If you have chronic neuropathic pain, it can flare up at any time without an obvious cause. 

While rare, acute neuropathic pain can also occur.

Most non-neuropathic pain (nociceptive pain) is caused by an injury or illness. 

You feel pain immediately after you drop a heavy book on your foot, for example.

Typically, neuropathic pain is not triggered by an event or injury. 

Instead, your body simply sends pain signals to your brain without your permission.

A person with this condition may experience shooting, burning pain. 

It may occur continuously or intermittently. 

There is also a feeling of numbness or loss of sensation.

Over time, neuropathic pain tends to get worse.

Refractory Cancer-Related Pain

Refractory cancer-related pain is any pain related to cancer or the treatment of cancer that becomes chronic (lasts more than three months). 

Treatments can range from pain medication such as opioids to alternative medicine like acupuncture.

Pain Management Frequently Asked Questions (FAQ)

A number of techniques can be used to prevent, reduce, or stop the sensation of pain. 

Among them are medications and psychological techniques.

Acetaminophen is usually prescribed as a first line treatment for mild to moderate pain, such as from a skin injury, headache, or musculoskeletal condition. 

Osteoarthritis and back pain are often treated with acetaminophen. 

It can also be combined with opioids to reduce the need for opioids.

Pain management is a medical approach that combines both science and alternative healing methods in order to study the prevention, diagnosis and treatment of pain.

Pain clinics are primarily focused on helping patients function as fully as possible within their medical and psychosocial limitations by reducing narcotics, reducing pain, increasing physical activity, and modifying pain-reinforcing behavior.

Alternative medicine refers to medical treatments that differ from conventional (mainstream) treatments. 

The term may also be referred to as “integrative” or “complementary” medicine. 

In the United States, more than half of adults use alternative medicine.