Ask Pain Doc (FAQ)

Ask Pain Doc (FAQ)

Ask the Pain Doc is a FAQ on Pain Management for referring Physicians’ to have quick & easy answers to general and specific questions about their patients. You can submit questions that you need answers for by using the form.

“What Five Things should I know about the Pain Physician before I refer a Patient to them?”

  1. What is your primary Board Certification area? Anesthesiology, Physical-Rehab Medicine, Psychologist, Addiction Medicine,Primary care, others.
  2. Do you only do injections or medications or both? A comprehensive pain practice can add function to your patients lifestyle.
  3. How long do you plan to follow the patient? Pain can be managed long term or as needed with periodic follow ups for flair situations.
  4. Will you return the patient to my care with recommendations or follow with me for long term care? A preference for referral based practices.
  5. What do you do if the care plan you have is not able to solve the patients pain problem or bring it under control to increase function?


 “What does ‘Boarded in Pain’ really mean?”

  • It can mean many things to lots of different people. There are several board certifications in pain medicine with the most rigorous being The  Subspecialty Certification in Pain Medicine from the American Board of Anesthesiology as you first have to be Boarded in Anesthesiology. A pain fellowship for 1-2 years is also a good indicator for diligence in care of your referred patients.  A qualified test is also the American Board of Pain Medicine as you have to be boarded in certain specialities of the 24 member ABMS specialties in order to qualify. A good question is if the physician is boarded in two specialties’ and how much of their time is spent in the practice of pain medicine.


“What is the difference between ‘Addiction’  and ‘Dependence’ to medications?”

  • Addiction is the seeking of medications for the effects it can give you. It may also be the avoidance behavior seen in addicts to avoid withdrawal. Withdrawal is the expected physiology or emotional effects of the body demonstrated by lack of agonist attachment to the receptor.  It can be seen in many drug classes such as antidepressants, anti- hypertension meds, and opiates. The most dangerous withdrawal is seen with alcohol and tranquilizers or benzodiazepines. Dependence is the need of the medications to do as expected, such as control pain, control or help with anxiety and even to control the medical condition indicated such as hypertension or diabetes. There can be expected withdrawal in either condition with patients thinking they are addicted when really addiction is rare in the situation of true medical need for treatment.