The Difference Between a Pain Doctor and a Pill Pusher

You're not alone

Unfortunately, many patients with real pain are never offered treatment options outside of oral opioids. This has led many patients to associate the term pain doctor with someone who prescribes medications, or a pill pusher. In my experience, most patients are looking for alternatives to opioid medications due to negative side-effects such as addiction, constipation, mental fatigue, and nausea. The majority of patients understand the risk of becoming physically dependent on a substance after prolonged use. These risks are real, and it's our job as physicians to educate patients on alternative options to manage pain.

Medical Insight

"Over 400,000 people have died from opioid-related overdoses. It is through this steep rise in opioid use that the true role of a pain specialist has been obscured and distorted."

What is a Pain Doctor?

When I refer to a pain doctor, I'm referring to a medical doctor who is trained in a specialized field of medicine called pain management. Pain management specialists treat pain through a multidisciplinary approach where multiple treatment strategies are combined into a single, unified pain management plan. For example, a pain management specialist may use a combination of minimally invasive injections, active isolated stretching, medication management, and regenerative therapy like platelet rich plasma to heal pain.

Do Pain Management Doctors Prescribe Medications?

Pain management doctors are extensively trained in medication management and will prescribe medications in the appropriate setting. However, in the vast majority of cases, a combination of non-opioid strategies eliminates the need for oral pain medications.

Here are 3 non-opioid alternatives for pain management

Spinal Cord Stimulation

A spinal cord stimulator is used to mask pain signals before reaching the brain. A small device, similar to a pacemaker, delivers electrical pulses to the spinal cord.

Spinal cord stimulation is best for patients with:

1. Persistent pain after back surgery
2. Chronic radiculopathy (sciatica)
3. Medical conditions that prohibit back surgery

Image: Radiofrequency electrode inhibiting pain signals in a facet joint

Radiofrequency Nerve Ablation

Radiofrequency ablation uses small electrical currents to eliminate a nerve's ability to transmit pain signals.

Radiofrequency ablation is best for patients with:

1. Chronic pain related to degeneration of the spine
2. Chronic pain related to arthritis of the knees
3. Chronic pain related to sacroiliitis

Image: Anesthetic and steroid injected on inflammed spinal nerves

Epidural Steroid Injection

An epidural steroid injection, also called an ESI, is an image guided injection in the neck or back that deposits anti-inflammatory steroid and anesthetic directly onto inflamed spinal nerve roots.

Epidural steroid injection is best for patients with:

1. Spinal stenosis
2. Spondylolisthesis
3. Herniated disc
4. Degenerative disc
5. Sciatica

With Crisis Comes Awareness

Pain management doctors are more important than ever with the growing concerns surrounding oral opioids. If you're living with pain and feel like you have no options, be assured that you do. It's important to find a pain specialist who's trained in all forms of pain management which can be difficult. Helped was founded to help patients understand what's causing their pain and to link them with the best pain specialists in their local area. If you're interested in non-opioid alternatives to pain management, get a free Helped Consultation today.