Treating Pain Often Involves a Variety of Different Approaches

ByABC News
May 4, 2005, 7:25 PM

May 9, 2005 — -- Dr. Paul Rumble, a veterinarian from Milford, Conn., knows first hand the challenges of living with chronic pain. Following abdominal surgery for diverticulitis, a buildup of scar tissue left him in agony.

Laparoscopic treatments, which use a tiny camera to guide surgeons' hands, provided temporary relief, but not enough. When the problem came back, Rumble's physician prescribed morphine. The drug worked, but taking it also meant relying on a narcotic to be free of symptoms.

"I was doing great on the morphine, and [the doctor] said, 'OK, that's the end of the story. You're on morphine. You're doing great. Adios,' " Rumble said. "But I said, 'I really don't want to be on morphine for the rest of my life.' "

Enter the pain specialist, who eventually helped Rumble overcome his intense discomfort. Chances are, if your regular doctor runs out of options to treat you for chronic pain, you will be referred to a pain specialist or pain clinic that offers a variety of services -- from drugs to acupuncture and psychological help -- to reduce your symptoms.

But what exactly do these specialists offer? And why should you visit them?

Before the field of pain medicine was created, doctors "looked at pain management with blinders on, with one focus," said Dr. Carol A. Warfield, who is the chair of the department of anesthesia, critical care and pain medicine at Beth Israel Deaconess Medical Center in Boston and a professor at Harvard Medical School.

"If all you have is a hammer, everything starts looking like a nail," she said.

In the 1960s, people in the medical community began to consider pain as a specialty, with the idea of bringing together such fields as internal medicine, chiropractics, surgery, psychology and acupuncture to provide many options for success, Warfield said. The movement was popularized in the 1970s and advanced throughout the years.

Anesthesiologists were in the equation early on because of their experience with easing pain during surgery and with drugs such as narcotics, pain relievers, nerve blocks and other treatments, she said. The American Board of Anesthesiology first added a certification in pain medicine in 1993.