- Arthritis
- Primary CareThe field of allopathic medicine is rapidly growing and is almost as vast and complex as the human body for which it exists. For these reasons, the process of becoming a medical doctor is lengthy and involves rigorous training. Not only that, but medical technology advances at an extremely rapid pace as scientists worldwide make new medical discoveries daily. No one doctor, no matter how talented, can possibly stay current on all human health topics—the body of information is simply too vast and rapidly expanding. Therefore, some doctors specialize in one or a few related areas of medicine after they complete their foundational medical training. This is certainly not to say that primary care doctors are inferior. In fact, their role is a difficult one: to keep up to date on all health topics and monitor the overall health of their patients. Primary care doctors typically refer their patients with conditions they cannot manage to specialists who focus their entire professional attention on these conditions. Specializing has many advantages, most important of which are the abilities to stay current and provide the best, most well-informed patient care in specific areas.
- Emergency CareVenkat A, Fromm C, Isaacs E, Ibarra J. An ethical framework for the management of pain in the emergency department. Acad Emerg Med. 2013;20(7):716-723.
- NeurologyA pain fellowship is a fellowship in pain management or pain medicine. As explained, the medical fellowship is often a doctor’s final stage of training in her specialty and for a pain doctor, the pain fellowship is a capstone experience before being certified and practicing independently in pain management. There are a number of academic medical institutions in the U.S. with pain fellowship programs, and many tend to be housed within anesthesia departments. The American Pain Society maintains a list of domestic pain fellowship programs on their website. Many programs consider applicants with primary training in several specialties, including Anesthesiology, Neurology, Physical Medicine and Rehabilitation, and Psychiatry. Anesthesia residents tend to be the largest group of applicants for pain fellowships. Each program usually accepts a very small number of fellows each year (as few as one to three), and competition for pain fellowships is high. Some programs are offering a second year to successful year one fellows.
- Depression
- Psychiatry
- Anxiety
- Diabetes Care
- UltrasoundPain fellowship programs may have accreditation by the Accreditation Council for Graduate Medical Education (ACGME) and are mostly housed in academic research and training hospitals. There are over 100 ACGME-accredited pain fellowship programs, the vast majority of which are in anesthesia, whereas about ten to twenty percent may be in other areas such as physical medicine and rehabilitation. Pain fellows typically commit to twelve months of both in- and outpatient care with a focus on evaluation and management of a variety of pain cases including acute, chronic, and cancer pain. Because of the vast array of conditions that cause pain, the pain fellow trains in a multidisciplinary environment, working closely with other specialists including surgeons and neurologists. Moreover, pain fellows learn to utilize all of the available pain treatment modalities including pharmacological, non-pharmacological, surgical, implant-based, and non-surgical procedures with varying levels of invasiveness and permanence. One important goal of the pain fellowship program is to provide experience in both basic and advanced pain management procedures including sympathetic blocks, neurolytic techniques, head and neck blocks, neuraxial injections and blocks, ultrasound-guided injections and blocks, and headache-specific management procedures. Fellows may also participate in a variety of didactic studies as well, including lectures, seminars, and conferences. It is a lot to pack into one year, and pain fellows are kept very busy during their final phase of training.
- MRIThe pain diagnosis process may include some familiar things like X-rays and blood draws. The pain doctor may also order procedures the patient may have heard of but has never experienced before. These include powerful imaging techniques including computed tomography (CT), computed axial tomography (CAT), and magnetic resonance imaging (MRI). These imaging techniques use radiation (CT and CAT) or electromagnetism (MRI) to produce high-resolution images of internal tissues and may reveal abnormalities or injuries in these tissues. Ultrasound is another imaging technique that may be ordered for looking inside the body. All of these techniques are non-invasive. Discography and myelogram are ways to improve the information gained by X-ray by introducing contrast agents into the intervertebral disc or area of the spinal cord and nearby nerves that may be a source of pain. Disorders in bone often cause pain that may be difficult to diagnose, so a pain doctor may order a bone scan that relies on a small amount of radioactive substance that seeks the bone after injection. This material may then provide a measurable signal used for bone imaging. The images may reveal fractures, infections, or other problems in an affected bone. Together, these and other diagnostic procedures and techniques form a powerful toolkit for the pain doctor to use in diagnosing pain conditions. A correct diagnosis is crucial for effective subsequent management and treatment.
- X-Rays
- Computed Tomography
- SciaticaInjuries to the knee are fairly common, especially among athletes. Meniscus tears are extremely common among professional athletes, as they are required to place extreme force and pressure on their knees as they pivot and move. Hip pain can be caused by arthritis, but can also be due to sciatica or other nerve damage in the back.
- Sports MedicineAt Nevada Pain, our professionals are specifically trained to the highest level to evaluate and treat sports injuries of all types, subacute spine and other musculoskeletal and neurological injuries.
- Tennis ElbowOne of the most common upper extremity injuries is a torn rotator cuff in the shoulder. Elbow injuries occur among both professional and recreational athletes, and can include tennis elbow and golfer’s elbow. Shoulders, elbows, wrists, and fingers can be affected by rheumatoid and osteoarthritis, and will cause upper extremity pain. Sometimes, pain, numbness or tingling in the arm may be associated to nerve damage in the back.
- Neck Pain
- Back Pain
- Manual Therapy