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    Pain Management
    An_250227 posted:
    What kinda place is Pain Management, and why can't my Primary Care Dr. treat me?
    _swank_ responded:
    Depending on what state you live in there are a lot of rules and sometimes certifications that go along with treating chronic pain. Most primary care physicians don't want to deal with it.
    lorigibs40734 responded:
    A PM office is where your PCP sends you if you have Chronic pain, pain lasting longer than 3 months. Usually they have you sign a bunch of papers, one of them saying that you will never take narcotics from another doctor, hospital, or other PM clinic.

    Depending on where you live, or how the doctor wants to prescribe your meds, visits are usually monthly, or every three months. Urine tests are given every visit (where I go anyway).

    Now that I am back with my old PM doctor (YAY) I go every month. Everyone I know that goes to a PM doctor goes every month, but I live in Kentucky, so it may be different where you are.

    Your PCP might not want to treat you for many different reasons. The meds you're taking could be one of them.

    Hope this helps and good luck!

    ldycountry replied to lorigibs40734's response:
    The law has got it were you have to go to PM now if you have chronic pain for longer than 3 months as was stated above.They will not let Drs give certain pain meds for any longer unless they are PM...Believe me you better follow the rules and take exactly what you are suppose to and do not take anything else even if you think it is close to what you are taking and do not know different and do not have your meds on you for they do pacific drug screening and everything shows up,I have never had dealing with drugs except by by Dr and i took 2 pills that an older lady had at work we thought were about the same thing which I have never done but was in pain at work and did not want to leave for I lived aways from home so I took a couple of hers that day and now they have taken to lab I may get kicked out next month not sure yet..I know I should have not done that but just wanted to warn you how strict they are....Best of luck and hope they get your pain under control.ldy
    Onehurtguy replied to ldycountry's response:
    In my case, prolonged chronic pain, I was sent to a PM to "manage pain", thus the whole "Pain Management title". Your primary care MD is there to treat health issues which included pain or injuries causing pain, but after a couple months, their job is done. If your still in pain, you need to see someone who specializes in pain, and can treat and monitor your pain and medications much better.

    They often have rules, and will administer drug tests etc. so if you're not there for treatment of pain and just seeking medication or using non-prescribed or illegal substances, that isn't going to end well. Why wouldn't you want to see a PM vs. your regular MD?

    For most of us in pain, these people are our life savers, as they understand pain, treatment for pain besides medication, and all available medicines to custom fit our individual needs.

    If you're suffering from chronic, long term pain, there is no better or safer place for you. There are reasons for their strict rules and ursine testing, as there are probably more people out there seeking drugs than there are actual chronic pain sufferers which creates issues for us because they look at us the same as a typical drug seeker.

    Good luck!
    annette030 replied to ldycountry's response:
    This is apparently not true in every state. I see my primary care doctor, an internist, and she manages my pain meds for me. I see her every three months.

    I do agree about following the rules though. If you sign a contract, keep a copy, and follow it to the letter.

    Take care, Annette
    ldycountry replied to annette030's response:
    I also agree with the above you should read your contract and follow it to the letter,that is where I made my mistake...I have had chronic pain for several yrs.
    I have went to pc doctor but I had to return to work which required me to have more meds to be able to function and he sent me to PM..
    They are very good at managing your pain I was not saying anything bad about them,just wanted to let you know to please follow the contract and not make a crazy mistake like I did..
    I do not know much about meds but I sure am learning and this web page is a good place to come to for advice for it has help me learn alot that never even cross my mind without having the knowledge..
    I am not just seeking drugs,as some may be I have never taken any street drugs,I just need my meds to function after 2 back surgeries and knee problems..
    In Pm I have to go every month as to when going to PC I went every 3 months also,so guess it is according to the state or doctor I am not sure how it works but your Pc doctor could probably tell you why,mine said he cold not manage chronic pain like mine longer than 3 months and I live in Tennessee
    best of luck to you it hard living with chronic pain when you have always been healthy but as time by we learn to adjust
    take care and good luck...
    Onehurtguy replied to ldycountry's response:
    Anyone who runs out of medication because they take more than prescribed will raise red flags with their PM docs. They will probably believe your story that the levels are not enough and up your dosage once every 6-12 months, but its up to you to let them know this is occurring before you run out against he next cycle.

    My PM and I talk about the excuses that people make when they lie about running out, some of which are fairly creative, but still not convincing. It's the same excuse the patient before used, and many more the same .
    lorigibs40734 replied to ldycountry's response:
    "take exactly what you are suppose to and do not take anything else even"

    I take my medicine exactly like it's prescribed to me, 3x a day.. sometimes, (very rarely) I only take it twice a day. I don't take anymore then what I'm suppose to. I respect my PM doctor and I also respect my meds. And I NEVER take anything that isn't prescribed to me by my PM doctor... OTC meds don't count as they are not opioids...

    Best of luck to you!!
    ctbeth replied to ldycountry's response:
    Hi folks,

    I am wondering if it is yet law that chronic pain patients have to be treated by the pain management specialist, or just the trend.

    Personally, I would much rather have my pain treated by a doctor who specializes in pain.

    These MDs have more knowledge of treating pain, and advanced treatment methods besides just pain meds.

    To me, the analogy is like going to my primary care MD for a bone disease. I'd want an orthopaedist to treat my bone disorder as he/ she is the expert.

    Same with pain.

    If you are prescribed a controlled med (opiate, narcotic), then the MD usually has you review and sign a contract. The articles mentioned are for your safety and to protect the MD.

    These contracts are NOT punishment. There should not be any negative connotation. The rules are for our safety.

    It is important to read and understand each item on the contract. If there is something that is unclear, ask the MD to clarify.

    Also, keep a copy of your contract.

    Some of the things commonly mentioned are:

    You will not take more-than what is prescribed.
    You'll have all of your meds filled at the same pharmacy.
    You won't get narcotics from any other MD or from anothre patient.

    In case of emergency, for example, if you're in an accident or injured and in an emergency room, the MD will have to contact your pain MD before giving you any pain meds.

    If you have a surgery scheduled, the pain MD will have to consult with the surgeon for guidelines.

    You will probably have a random (not scheduled) urine screen to see that you're not taking other meds, and that you are taking the meds that have been prescribed for you.

    You may be called in for a pill count for the same reasons.

    I have been with pain management MD for over five years. I have had two random urine tests and never have been called in for a pill count.

    The only regulation on these items is that certain meds can only be written for 30 days at a time, so you may have to pick up a prescription once a month. The regs also specify that, if you're prescribed this sort of med, you'll have to see your MD once every three months.

    Being referred to pain management means that your pain will be treated by an MD whose specialty is treating pain.

    There is no reason to worry; it may be the best thing that can happen for your pain treatment.

    Best wishes,

    blessedladyptl replied to ctbeth's response:
    It doesn't appear any Laws stating chronic pain must be treated by pain management specialists are on the books. I agree with you that it is a "trend." It does seem that when a physician doesn't want to treat a chronic pain patient that they tell patients they "can't" or "aren't allowed" to treat chronic pain. Reading the Revised Statues for your state as well as Statements of Position by state medical boards is the best way to get accurate and current information.
    ctbeth replied to blessedladyptl's response:
    Hi Blessed,

    Yes, I know. I was being facetious as the popular fallacies are that the DEA is controlling how our MDs treat us and how the pharmacists can dispense, or not dispense.

    Due process may make treatment of chronic pain specific to pain management specialists, but there is no state or federal regulation/ mandate initiated right now.

    If you peruse the site for a lengthy discussion that commences with someone writing a petition to President Obama regarding the DEA, do have a read.

    You shall discover that there are many unfounded fears and fallacies circulating.

    A few of us encouraged others to research the claims that were made, but it fell upon blind eyes.

    Well, 3 AM in Connecticut, so I shall say bon soir and bid you peace.

    _swank_ replied to ctbeth's response:
    I don't know about other states, but in Georgia, doctors who treat chronic pain must have a certification in pain management or they must do so many hour of continuing education. Along with that there are many rules and regulation for prescribing controlled substances. For most family doctors this is too much of a burden so they refer patients to pain management. I imagine rules are similar in other states. You can do a search for your state's medical board and find the information. It may very well be that your doctor "can't" treat chronic pain.
    blessedladyptl replied to _swank_'s response:
    The Georgia Medical Board issued New Pain Management Rules January 6, 2012. This is the link to that info.
    blessedladyptl replied to blessedladyptl's response:
    I forgot to include these. This is about chronic non cancer pain also, although the title may not read that way.

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