# Is there a specialty for physicians who treat chronic pain? **URL:** \ **Category:** Factual Questions\ **Created:** [November 15, 2018, 2:38am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538 "2018-11-15T02:38:30Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [November 15, 2018, 2:38am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/1 "2018-11-15T02:38:30Z")
Is there a name for a physician who specializes in treating chronic pain? I’ve heard of pain doctor, but is there a term (like cardiologist, orthopedist, neurologist, internist, etc) to describe a pain doctor? The closest term I can think of is anesthesiologist, and thats not the same thing. Is this a specialty any physician can get into, or does it require a special residency and/or fellowship? ---
**Author:** ![hajario](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hajario/32/171_2.png) [@hajario](https://boards.straightdope.com/u/hajario)\ **Post date:** [November 15, 2018, 2:41am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/2 "2018-11-15T02:41:38Z")
My friend’s wife is a doctor who specializes in pain management. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [November 15, 2018, 2:44am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/3 "2018-11-15T02:44:26Z")
> [@hajario](#): > > My friend’s wife is a doctor who specializes in pain management. But what does that mean exactly? Does that mean any physician can set up shop as a pain management doctor? Or does it require special training? Is there a residency or fellowship you have to complete? Is there a special term for a doctor who does this? ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [November 15, 2018, 2:45am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/4 "2018-11-15T02:45:52Z")
Ive always heard them referred to simply as a pain management specialist/doctor. I’ve sarcastically always interpreted that to mean, “drs who specialize in denying you pain medication.” :D. I’m not serious about that tho. Not all the way serious at least. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [November 15, 2018, 2:53am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/5 "2018-11-15T02:53:44Z")
The medical treatment of pain is called algiatry, and a doctor who specializes in pain medicine/management is an algiatrist. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [November 15, 2018, 3:04am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/6 "2018-11-15T03:04:22Z")
> [@Kimstu](#): > > The medical treatment of pain is called algiatry, and a doctor who specializes in pain medicine/management is an algiatrist. Thank you. Do you know if a physician needs to complete a residency or fellowship to be an algiatrist? If not do only certain kinds of physicians get to practice in this field? Is there special training if you don’t have to do a fellowship? Can a cardiologist or podiatrist just set up shop as an algiatrist, or do they need special training first? ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 15, 2018, 3:07am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/7 "2018-11-15T03:07:26Z")
There is an [American Academy of Pain Management](http://www.painmed.org/membercenter/about/) and there are [specific](https://www.feinberg.northwestern.edu/sites/anesthesiology/education/fellowships/multidisciplinary-pain/index.html) [fellowships](http://anesthesiology.hopkinsmedicine.org/pain-medicine-and-pain-research/pain-medicine-fellowship/) [in it](https://www.uvmhealth.org/gme/pages/fellowships/pain-medicine.aspx). These are often under the Anesthesiology banner but not necessarily. Most often, or at least most ideally, Pain Management Clinics are staffed in a multidisciplinary manner, with docs who are trained as spine surgeons, physiatrists, and anesthesiologists collaborating on care. Not all who practice in the area are Pain Fellows but some are. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [November 15, 2018, 3:12am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/8 "2018-11-15T03:12:58Z")
> [@Wesley\_Clark](#): > > Do you know if a physician needs to complete a residency or fellowship to be an algiatrist? If not do only certain kinds of physicians get to practice in this field? Is there special training if you don’t have to do a fellowship? Well, IANAD, but here’s what [the American Board of Pain Medicine has to say about it](http://www.abpm.org/about), apparently as of 2016: > [@](#): > > Goals and Objectives > > To establish Pain Medicine as a primary medical specialty. Objectives to meet this goal include: > > 1. Maintenance of a high-quality Certification and Maintenance of Certification (MOC) process consistent with those of Member Boards of the American Board of Medical Specialties. > 2. Collaboration with national organizations to advance this goal. > 3. Promotion of ABPM Certification at the State level, furthering recognition of ABPM certification as a valued and respected designation for physicians practicing algiatry that is equivalent to ABMS certification. > 4. Promote ABPM Certification with the public, professional organizations, health care agencies, regulatory bodies, and payors as a valued and respected designation for physicians practicing algiatry that is equivalent to ABMS certification. > > To evaluate Applicants who voluntarily present for examination eligibility and to certify as Diplomates in Pain Medicine those who are qualified. Objectives to meet this goal include: > > 1. Determination of whether Applicants comply with ABPM’s ethical standards and have received adequate preparation in accordance with the educational standards established by the ABPM. > 2. Creation, maintenance, and administration of comprehensive, psychometrically-valid examinations to evaluate the knowledge and experience of those who complete such examinations. > 3. Issuance of certificates to those Examinees found qualified under the stated requirements of the ABPM. > 4. Creation, maintenance, and administration of examinations for purposes other than board certification that promote the goals of the ABPM . > > To maintain and improve the quality of graduate medical education in the field of Pain Medicine by collaborating with related organizations.Objectives to meet this goal include: > > 1. Development of standards and requirements for graduate medical education in Pain Medicine in collaboration with other concerned organizations and entities. > 2. Approval of programs and facilities for training physicians in the specialty of Pain Medicine as necessary. > > To provide information about the specialty of Pain Medicine to the public. Objectives to meet this goal include: > > 1. Maintenance of a registry for public information about the certification status of physicians certified by the American Board of Pain Medicine. > 2. Provision of information to the public and concerned entities about the rationale for certification by the American Board of Pain Medicine. > 3. Facilitation of discussion with the public, professional organizations, health care agencies, and regulatory bodies regarding education, evaluation and certification by the American Board of Pain Medicine So that seems to suggest that the specialty doesn’t have an official certification process yet. The abovementioned American Board of Medical Specialties [lists Pain Medicine as a subspecialty of Anesthesiology](https://www.abms.org/member-boards/specialty-subspecialty-certificates/). Here’s the [ABMS Guide to Medical Specialties](https://www.abms.org/media/176512/abms-guide-to-medical-specialties-2018.pdf), listing the different specialty boards and describing what certification entails. ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [November 15, 2018, 3:42am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/9 "2018-11-15T03:42:41Z")
And if you read the rest of the ABMS Guide to Medical Specialties you will find Emergency Medicine, Family Medicine, Physical Medicine and Rehabilitation, Psychiatry and Neurology, and Radiology also offering subspecialties in Pain Management–not just Anesthesiology. ---
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [November 15, 2018, 3:49am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/10 "2018-11-15T03:49:08Z")
So it does. Thanks, **PastTense**. ---
**Author:** ![hajario](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hajario/32/171_2.png) [@hajario](https://boards.straightdope.com/u/hajario)\ **Post date:** [November 15, 2018, 4:26am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/11 "2018-11-15T04:26:44Z")
> [@Wesley\_Clark](#): > > But what does that mean exactly? > > Does that mean any physician can set up shop as a pain management doctor? Or does it require special training? > > Is there a residency or fellowship you have to complete? Is there a special term for a doctor who does this? She is a pediatrician also. I believe that she did her residency in pediatrics and then a fellowship in pain management. He job is to manage the pain medication for children in the ICU of a large hospital. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [November 15, 2018, 4:32am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/12 "2018-11-15T04:32:18Z")
> [@hajario](#): > > She is a pediatrician also. I believe that she did her residency in pediatrics and then a fellowship in pain management. He job is to manage the pain medication for children in the ICU of a large hospital. TYVM to her. THAT would be a tough job, harder than managing pain in adults. The doctors at the legitimate pain clinic in my town are all board-certified anesthesiologists, and work with neurologists, orthopedists, etc. Back when I worked at the grocery store, they also avoided narcotics whenever possible. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [November 15, 2018, 4:59am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/13 "2018-11-15T04:59:40Z")
> [@nearwildheaven](#): > > The doctors at the legitimate pain clinic in my town Are there doctors who work at non-legitimate “pain clinics”? What does that mean? An entire clinic that bases its operation on writing illegitimate prescriptions for painkillers to “patients” for profit? ---
**Author:** ![TSBG](https://avatars.discourse-cdn.com/v4/letter/t/77aa72/32.png) [@TSBG](https://boards.straightdope.com/u/TSBG)\ **Post date:** [November 15, 2018, 5:13am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/14 "2018-11-15T05:13:30Z")
> [@Ambivalid](#): > > Are there doctors who work at non-legitimate “pain clinics”? What does that mean? An entire clinic that bases its operation on writing illegitimate prescriptions for painkillers to “patients” for profit? In short yes. The glut of opioids pushed out by the pharmaceuticals was good for patients who really needed them, and for doctors who were legitimately trying to alleviate pain, and they were also good for unscrupulous doctors willing to write prescriptions for anyone who would pay. ETA, this is the reason for the big crackdown on prescription opioids in the past few years. ---
**Author:** ![F.U.Shakespeare](https://avatars.discourse-cdn.com/v4/letter/f/aca169/32.png) [@F.U.Shakespeare](https://boards.straightdope.com/u/F.U.Shakespeare)\ **Post date:** [November 15, 2018, 10:34am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/15 "2018-11-15T10:34:58Z")
> [@Ambivalid](#): > > Are there doctors who work at non-legitimate “pain clinics”? What does that mean? An entire clinic that bases its operation on writing illegitimate prescriptions for painkillers to “patients” for profit? [Yep.](https://www.amazon.com/American-Pain-Unleashed-Americas-Deadliest/dp/B016P66NIK) > [@](#): > > The king of the Florida pill mills was American Pain, a megaclinic expressly created to serve addicts posing as patients. From a fortresslike former bank building, American Pain’s doctors distributed massive quantities of oxycodone to hundreds of customers a day, mostly traffickers and addicts who came by the vanload. Inked muscleheads ran the clinic’s security. Former strippers operated the pharmacy, counting out pills and stashing cash in garbage bags. Under their lab coats, the doctors carried guns, and it was all legal…sort of. ---
**Author:** ![Giles](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/giles/32/60_2.png) [@Giles](https://boards.straightdope.com/u/Giles)\ **Post date:** [November 15, 2018, 11:10am UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/16 "2018-11-15T11:10:51Z")
In my experience, there are also specialists in dental pain, since I needed to consult one about pain that I had in one tooth. My GP dentist had not solved the problem, and the orthodontist that he referred me to could not solve it either. However the dental pain specialist diagnosed it as trigeminal neuralgia just from my description of the symptoms, without actually examining me. The required therapy was not pain-killing drugs – I was already taking those – but neurosurgery, and the dental pain specialist referred me on to a neurosurgeon who specialised in this kind of operation. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [November 15, 2018, 12:48pm UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/17 "2018-11-15T12:48:49Z")
> [@Ambivalid](#): > > Are there doctors who work at non-legitimate “pain clinics”? What does that mean? An entire clinic that bases its operation on writing illegitimate prescriptions for painkillers to “patients” for profit? When I was 16 and needed a physician to sign my paperwork to obtain a driver’s license, I made an appointment with a random doctor. Sitting in the waiting room, I realized I was the only male; every other waiting patient was a woman in her 30s. The waiting room was packed, but a name was called every two minutes. When my name was called I went in and the doc, a morbidly obese man in a chair, filled out and signed my papers without ever looking at me. The only thing he said was, “pay her” and his “nurse” (imagine a Halloween sexy-nurse costume) took my ten dollars. A year later I was not surprised to read that he was writing prescriptions for “diet pills”. Women (mostly) paid him to write prescriptions for amphetamines. He allowed zero refills, so his patients had to come in and pay on a regular basis. He got away with this for years. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [November 15, 2018, 1:08pm UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/18 "2018-11-15T13:08:08Z")
> [@kayaker](#): > > Women (mostly) paid him to write prescriptions for amphetamines. He allowed zero refills, so his patients had to come in and pay on a regular basis. He got away with this for years. Schedule II prescriptions (such as amphetamines and most opioids) cannot be refilled. A new prescription must be generated each time. Of course it’s not necessary to see the patient each time this is done, but it is good practice to do so for most patients maintained on schedule II drugs. At a minimum they should be seen every 3 months. This is not to say the gent you describe wasn’t a pill doc, just point out that scripts without refills are mandatory at times. ---
**Author:** ![ohiomstr2](https://avatars.discourse-cdn.com/v4/letter/o/82dd89/32.png) [@ohiomstr2](https://boards.straightdope.com/u/ohiomstr2)\ **Post date:** [November 15, 2018, 2:05pm UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/19 "2018-11-15T14:05:27Z")
> [@Ambivalid](#): > > Ive always heard them referred to simply as a pain management specialist/doctor. I’ve sarcastically always interpreted that to mean, “drs who specialize in denying you pain medication.” :D. I’m not serious about that tho. Not all the way serious at least. No need to be sarcastic. i have been more or less successful with chronic pain management through my regular doctor for five tears now. When I tried, through him, to get into a pain management program, i was rejected because I was taking pain meds! Seems the only way to get more advanced medical assistance is to go back to living with debilitating pain for the several months it takes to actually get an appointment. It is no wonder folk turn to illegal means. Smack is easier and cheaper to manage than this Catch 22 horse hockey. ---
**Author:** ![Telemark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/telemark/32/372_2.png) [@Telemark](https://boards.straightdope.com/u/Telemark)\ **Post date:** [November 15, 2018, 2:20pm UTC](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538/20 "2018-11-15T14:20:53Z")
> [@Wesley\_Clark](#): > > Can a cardiologist or podiatrist just set up shop as an algiatrist, or do they need special training first? I’ve read that this is a real problem with the lucrative cosmetic surgery market. Any doctor can set up shop for cosmetic medicine; an MD is an MD. But there are board certifications that you should look for when choosing a doctor - [Qualifications of Board Certified Cosmetic Surgeons | ABCS](https://www.americanboardcosmeticsurgery.org/patient-resources/choose-abcs-surgeon/) But in the US, as far as I know, any doctor can perform any number of procedures or prescribe treatments without being certified in a specialty. Hospitals may require those certifications and fellowships, but if they set up shop on their own I don’t think there’s much to stop them. [Next page](https://boards.straightdope.com/t/is-there-a-specialty-for-physicians-who-treat-chronic-pain/824538.md?page=2)