What do patients expect from their first visit to a pain clinic?
To examine patients’ expectations of their first outpatient visit to a pain clinic. We asked patients what would be the most satisfying and the most disappointing outcomes of their visit and whether they expected changes in medication and further investigations to result from their consultation.
Patients completed questionnaires and a structured interview to assess expectations before their clinic appointment.
Methods
Seventy-seven patients with chronic pain who were first time referrals to a regional pain clinic participated in the study. Patient expectations and questionnaires measuring depression and pain-related disability were completed prior to the pain clinic appointment.
Results: Most patients expected an explanation or an improved understanding of their pain problem. The most common satisfying outcome was relief or control of pain, and the most common disappointing outcome was being told nothing could be done. The majority of patients expected further medical investigations and changes to the prescribed medication. Depression and pain-related disability strongly influenced patient expectations.
Conclusions: For patients attending pain clinics, the explanation of their pain problem is rated as important as the cure or relief of their pain. Improved understanding of patient expectations by pain clinic clinicians may lead to greater patient satisfaction and reduced treatment dropout.
Your First Consultation
For most people, the decision to see an Interventional Pain Anesthesiologist for spine and pain conditions is full of hope. Some patients may be a little apprehensive after years of pain, but knowing what to expect can help alleviate fear and adjust expectations.
Your First Consultation
Depending on the nature of your condition, some appointments may last longer than most office visits. Our highly personalized approach requires giving you adequate time and attention to help us understand the type of pain condition you’re struggling with.
During the initial appointment, a pain assessment will be performed including questions about your medical history, current prescriptions, pain patterns, and any other specific causes for concern. Depending on your symptoms and type of pain, you may expect orders for additional imaging studies or physical therapy. Some patients may receive treatment during their first visit for conditions such as joint pain. For your own safety and to help us make a precise diagnosis, we ask each patient to be as thorough and detailed as possible.
Wear comfortable clothes that do not restrict your motion in case we need to test your skeletal and muscular abilities. Please bring any recent medical records, MRIs, CT scans, X-Rays, or EMG reports that you have in your possession to your first appointment, as well as your insurance card. Patients will also be responsible for paying their insurance co-payments and deductibles if covered by an insurance plan. If patients are paying themselves, our staff can provide an estimate in advance.
Precision Diagnostics Take Time
The results of your first consultation will rule out certain conditions, and give us a good indication of the possible sources of your pain. It may be necessary to schedule further tests to provide detailed images of your spine to pinpoint the specific source of pain. This will enable us to precisely identify the specific location of pain and most effective treatment.
A visit to Precision Pain Care may take longer than what you usually experience at other doctor’s offices because our team takes the appropriate time and attention to accurately diagnose and treat every patient’s condition. We understand patients are anxious for a solution, and we ensure our time and efforts will produce quality outcomes with adequate and effective course of treatment.
Further Diagnostic Testing
Depending on what we discover during your consultation it may be necessary for you to undergo further tests to help us narrow down the possible sources of your pain, better understand you condition or injury, learn why you’re in pain, make a precise diagnosis, and prescribe an effective treatment regimen.
A Precision Diagnosis
Once we’re ready to give you an accurate diagnosis, we will outline the various treatment options available, and elect the ones the provider believes will work best for your condition.
When to see a pain specialist
While you don’t always need a referral to see a pain specialist, most of the time these visits come after seeing your primary care physician (PCP) and another specialist, such as a neurosurgeon or orthopedic surgeon.
For example, your PCP may order X-rays, prescribe anti-inflammatory medications or send you to physical therapy. In the event those treatments don’t work, they’ll send you to a surgeon for further evaluation. If the surgeon deems you a non-surgical candidate, they’ll refer you to a pain specialist. In some cases, a PCP may have managed an ailment for years with conservative treatment, then refers you directly to a pain specialist when the situation turns chronic.
While pain specialists treat a litany of ailments, spine disorders, including herniated discs in the lumbar (back) or cervical (neck) spine, are the most common issues. You may also see a pain specialist after a hernia repair for a nerve block in your groin, or a neurologist may refer you to a pain specialist to receive nerve blocks for chronic headaches.
Whatever your ailment, a pain specialist will work with your other physicians to provide you with a multidisciplinary plan, whether it’s physical therapy, appropriate medications, injection therapy or surgery.
“A multidisciplinary approach is always my first approach. We do offer multi-modal medicine, whether it’s nerve agents, anti-inflammatory agents or muscle relaxants. “If a patient ever becomes chronic where they’re requiring many prescriptions, they need to see a medical pain specialist, but the initial plan when you see a doctor like me, I’ll tell you the five things we need to do and here’s where we’re going to start. If the plan changes or grows in a different direction, then we’ll accept that if we need to.”
What happens at the first pain management appointment?
It is important to know what to expect at your first pain management appointment. At your first visit, you meet with a pain management nurse who reviews your pain problem and medical history. You will be seen by a nurse, a physician assistant and the physician. A pain management physician performs a medical history, physical examination and reviews any test or X-ray results. Your physician will develop a customized pain treatment plan based on your individual assessment. This initial evaluation is important, because a full and complete assessment is a key component in developing your customized treatment plan.
Will I be treated on the first visit to a pain management clinic?
In some cases, patients are treated on the first visit. However, most patients will be scheduled for their procedure after undergoing appropriate preparation. Einstein’s pain management process consists of communication with the patient’s primary care physician and specialists as part of a team approach to a comprehensive care plan.
Can I go back to work after my visit?
If you receive an epidural injection or any other catheterization procedure, we usually recommend you take it easy and let your body be your guide. Recovery times may vary depending on your occupation. Discuss this with your physician.
What kind of results can I expect after the steroid injection?
Steroid effects usually begin within 2 to 3 days, though response may occur more quickly or slowly. Occasional pain is aggravated for 1 to 2 days until the medication absorbs (begins to take effect). If your pain is responsive to the anti-inflammatory effect of the steroid you may experience full or partial improvement. Many patients require a series of 2 or 3 injections to reach maximum improvement.
Are there any side effects to the steroids?
Most of the time the side effects are minimal but could include insomnia, anxiety, and an increase in your heart rate. Long term steroid use can lend to other side effects and should be discussed with your doctor.
