A Career in Pain Medicine
A Career in Pain Medicine
Pain Medicine is a discipline of medicine involved in the management of patients, of all ages, with acute and chronic pain
What is Pain Medicine?
Pain Medicine work will generally fall into one of three categories:
- Acute/inpatient pain (post-operative, post trauma/injury, pain as part of a medical condition)
- Chronic/outpatient pain (persistent pain, also a condition in its own right, includes issues such as phantom limb pain and mechanical lower back pain)
- Cancer pain (pain directly due to the tumour or secondary to cancer treatment)
The work is complex and stimulating, requiring a holistic overview of the latest science and the interplay of biopsychosocial factors.
Pain Medicine teams are generally run as multidisciplinary teams (MDT), including liaison with nursing, physiotherapy and psychology staff, as well as with primary and community care services. It is a great specialty for anyone who enjoys cross-team working.
Pain Medicine is a specialist area of Anaesthetics. We recommend visiting the RCoA webpages on 'Considering a career in anaesthesia' for further information on our parent specialty.
What do Pain Medicine specialists do?
The day-to-day life of a pain specialist is very varied and can include:
- Outpatient pain clinics and theatre lists
- Inpatient pain management
- Sessions in another specialty, including Anaesthesia or Palliative Medicine
Clinics can be consultant led, in tandem with another member of the team or run as an MDT clinic. The make-up of MDTs varies but is commonly a mix of specialists in pain management from medical, nursing, physiotherapy and psychology backgrounds.
Common invasive procedures lists include interventions targeting the facet joint and its nerve supply, epidurals and simple peripheral nerve blocks. What else is offered varies considerably, and often develops once in a consultant post. There are increasing numbers of high tech interventions available to treat long-term chronic pain. Many centres offer radio frequency ablation and some specialist centres are carrying out neuromodulation with spinal cord stimulators and the insertion of implantable infusion devices.
What are the benefits of working as a Pain Medicine specialist?
- Your own practice: The opportunity to develop their own practice, seeing patients through from referral to assessment. This will include diagnostics and working longer term with patients by building a therapeutic relationship and following up outcomes.
- Work-life balance: The ability to better control your workload and ways of working. Specialists, including those with family commitments, do not undertake on-call.
- Multi-professional colleagues: You get to work in multi-professional teams with specialist pain nurses, psychologists, physiotherapists and occupational therapists.
- Multi-disciplinary working: Pain teams are most commonly multi-disciplinary teams involving decision-making with radiologists, surgeons from varied specialties, palliative medicine physicians and much more.
- Beyond secondary care: Specialists often work closely with colleagues in primary and community care and have strong educational and service development roles.
- Varied and interesting: Specialist can be part of an inpatient pain team in addition to outpatient work.
- Interventions: Interventional practice is often an important part of the pain doctor’s contribution to the team and can be very rewarding when significant improvements in pain levels are achieved.
- Specialised skills: Some pain doctors are involved in specialised services such as inpatient pain management programmes, neuromodulation and implanted drug delivery, cancer pain interventions and paediatric pain management.
- A changing landscape: Research into pain mechanisms and management is a rapidly advancing area and offers many opportunities for pain physicians.
Want to know what it's really like?
Take a look at these career stories of doctors practising Pain Medicine.