Pain medicine

Pain medicine is a specific medical subspecialty within the broader, interdisciplinary field of pain management. Some subspecialty training programs do call themselves pain management.

While this is a subspecialty, its physician practitioners may be in the role of primary physician for a patient whose chief complaint is a chronic pain syndrome. Pain medicine physicians also are the experts in difficult acute, chronic, and end-of-life pain relief through a wide range of modalities.

The field was first defined as a subspecialty of anesthesiology, but it quickly became obvious that a wide range of specialties, including neurology, radiology, surgery, family medicine, pediatrics, internal medicine, and obstetrics and gynecology could be reasonable pathways to the fellowship. Dentistry, especially when the dentist is trained in maxillofacial surgery, is another pathway.

It must be remembered that pain management, like closely related hospice and palliative medicine, is a team discipline, involving nonphysician professionals including nursing, physical therapy, pastoral care, various types of psychotherapists, and clinical pharmacy. A variety of complementary and alternative medicine techniques are not infrequently used, especially visualization and meditation, massage therapy and acupuncture, as well as other disciplines.