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Old 10-19-2012, 09:31 PM
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fmichael fmichael is offline
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Join Date: Sep 2006
Location: California
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fmichael fmichael is offline
Senior Member
fmichael's Avatar
 
Join Date: Sep 2006
Location: California
Posts: 1,239
15 yr Member
Default finding a good - and non-self-interested - pain doc

Dear Denise -

Hi. By way of "quality control," the easiest way to go board certified in pain management by the American Board of Pain Medicine (ABPM), the group which certifies most of the pain management fellowships in the U.S. What this means is that, in addition to a doctor’s residency, s/he took a separate one-year fellowship in pain medicine, and then sat for and passed an 8 hour written exam. They are serious people.

To find ABPM certified specialists in pain medicine in your area, go to its Public Directory. You can search by geographic area, gender and "specialty of origin" - the field in which the doctor completed his or her residency.

That said, not all ABPM certified specialists in pain medicine do a lot of work with RSD/CRPS, in fact, most probably treat lower back pain more than anything else. So for what it’s worth, you probably don’t someone who completed a residency in Physical Medicine for CRPS. In fact, for RSD/CRPS a background in neurology is probably favored, with anesthesiology and psychiatry (or in the case of my pain doc, a combination of the two) coming in tied in close second.

Alternatively, the American Board of Anesthesiology (ABA) maintains a sub-certification program in pain management that also requires a 12-month fellowship following the completion of a residency, but in its case, a residency only in anesthesiology. While I am not aware of any search engine for doctors who are so-certified, you can determine the board certification status of any anesthesiologist by just by accessing the ABA's homepage.

Finally, when you find a doctor, it's important that you do interviewing of your own at the first appointment. In particular, you will want to know whether you will see a physician at all of your scheduled appointments (as opposed to a physician's assistant or nurse practitioner) and, most importantly, inquire as to the physician's long-term protocols for dealing with RSD/CRPS. You are looking for someone who employs multiple therapies simultaneously, such as physical therapy, pain medication, and nerve blocks (injections of local anesthetics, typically close to the spine and performed under fluoroscopy, that are usually most effective if you have had RSD for less than six months), as well as perhaps somewhat more novel therapies, such as "Mirror Therapy and Graded Motor Imagery" and/or extremely low power DC current and/or magnetic stimulation of the brain's motor cortex.

BUT, if what your hear instead is a discussion of implantable medical devices, such as spinal cord stimulators (SCS) or pain pumps, I would personally keep looking for another doctor. The bottom line on implantable medical devices being that while they are highly remunerative for the doctor, there is, for instance, little if any peer-reviewed evidence suggesting that SCS is effective in CRPS patients for more than three years: while there is plenty of evidence of too many people developing nasty side-effects along the way.

I hope this is useful. Good luck in your search!

Mike
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