What to Expect at Your First Pain Specialist Consultation
If you have been referred to a pain specialist, you may be wondering what will happen at your first appointment. Persistent pain can be complex, so an initial pain consultation is usually more detailed than simply discussing where it hurts or reviewing pain medication.
At Specialists on Hutt in Adelaide, Dr Taras Hembram's initial pain management consultation aim is to develop a comprehensive understanding of your pain, how it is affecting your life and what factors may be relevant to your ongoing management.
1. Talking about your pain
Your pain specialist will usually begin by asking about the history of your pain.
This may include:
when and how the pain started
how long it has been present
where you feel the pain
how you would describe it
whether it changes during the day
what makes it better or worse
other symptoms that occur with it.
You may also discuss previous injuries, illnesses and other relevant medical conditions.
Your specialist will want to understand what has already been tried, including medications, physiotherapy, psychological therapies, procedures and investigations, and whether these treatments helped or caused side effects.
2. Understanding how pain affects everyday life
Pain severity is only one part of the assessment. Your specialist may ask how pain affects your ability to:
walk, stand or sit
work
cook, clean or shop
drive
look after yourself
exercise
sleep.
An important part of pain management is understanding what pain is preventing you from doing and what you would like to be able to do again.
3. Questions about sleep, mood, work and stress
A pain consultation can include questions that may initially seem unrelated to the painful part of your body.
For example, your specialist may ask about:
sleep
employment and work circumstances
family and social support
stress
mood and anxiety
coping
other health or personal circumstances.
These questions do not mean that your pain is considered imaginary or “all in the mind”.
Persistent pain can be influenced by biological, psychological and social factors. Understanding these areas helps your specialist build a more complete picture of your individual pain experience.
4. Discussing what you want to achieve
Your goals are an important part of the consultation. You may be asked:
“What are you hoping to achieve from pain management?”
For different people, this could mean:
improving sleep
increasing mobility
being more physically active
becoming more independent
returning to work
returning to hobbies or social activities
improving overall quality of life.
Persistent pain cannot always be completely removed, so pain management also focuses on identifying realistic and meaningful goals that matter to you.
5. Examination and review of previous investigations
Following the discussion, your pain specialist may perform an appropriate clinical examination. Previous imaging, investigations and responses to treatment may also be reviewed where relevant.
This information is considered together with your history to develop a working understanding of the factors that may be contributing to or maintaining your pain.
6. Developing an individualised pain management plan
There is no single treatment plan that is appropriate for everyone with persistent pain.
Depending on your individual circumstances, your management plan may consider:
medication review and optimisation
physiotherapy or physical rehabilitation
exercise and activity-based strategies
sleep management
psychological therapies or pain psychology
education about persistent pain
interventional procedures where clinically appropriate
occupational or vocational rehabilitation
input from other health professionals where required.
The aim of the first consultation is therefore not simply to identify a medication or procedure. It is to understand your pain in the context of your overall health and circumstances and develop an individualised plan based on your needs and goals.
Preparing for your appointment
Before your appointment, it may be helpful to think about:
when your pain began
treatments you have already tried
medications you are currently taking
activities that have become difficult because of pain
what you would most like to improve.
Bringing an up-to-date medication list and any relevant investigations or specialist correspondence that have not already been provided may also assist with your assessment.
Pain Specialist in Adelaide
Dr Taras Hembram is a Pain Specialist consulting at Specialists on Hutt. If persistent pain is affecting your everyday activities, you can speak with your GP or treating specialist about whether referral for pain specialist assessment may be appropriate.
