Pain can arise from many different injuries and medical conditions, ranging from mild and short-lived to severe and long-lasting. It may occur as a symptom of another illness, develop as a side effect of treatment or exist as a condition on its own.
Since pain is complex, arriving at an accurate diagnosis requires specialised expertise. Specialists in pain management use advanced assessments, imaging studies and clinical evaluations to identify the cause and severity of discomfort. This allows them to develop tailored treatment plans to improve the patient’s quality of life.
The First Consultation
Your first visit to a pain specialist is an important step in understanding and managing your condition. Here’s what you can expect:
Comprehensive Patient History
The doctor will thoroughly review your medical background and ask about any past injuries, surgeries or chronic conditions that may be contributing to your pain. They will also want details about your current symptoms—when the pain started, what makes it worse or better and how it affects your daily activities.
Physical Examination
The doctor will perform a physical examination to assess the severity and impact of your pain. This may involve evaluating your posture, range of motion, strength and flexibility. They will gently press around the affected area to identify points of tenderness, discomfort or muscle tightness. These observations provide important insights into the possible source of your pain and guide further testing or treatment recommendations.
Diagnostic Tools and Procedures
Pinpointing the source of pain sometimes require more than a physical examination. Pain specialists may use diagnostic tools and procedures to better understand the underlying cause. These tests provide detailed insights into the bones, joints, muscles, nerves and soft tissues that may be contributing to chronic or acute pain. These diagnostic procedures include:
Imaging Studies
Imaging is one of the most common ways to assess pain, allowing doctors to see inside the body and identify abnormalities.
- X-rays: X-rays use radiation to produce images of bones, joints and certain organs. They can reveal fractures, arthritis, scoliosis, infections, tumours and more.
- CT (Computed Tomography) Scans: CT scans combine X-rays and computer technology to create cross-sectional images of the body. They are often used to identify structural changes, herniated discs or complex bone injuries. In some cases, contrast dye may be used for clearer imaging.
- MRI (Magnetic Resonance Imaging): MRIs use powerful magnets and radio waves to produce detailed images of soft tissues, such as muscles, discs and ligaments. They are particularly useful for diagnosing spinal problems, joint issues and nerve compression.
Muscle and Nerve Studies
These tests help doctors determine whether symptoms such as weakness, tingling or chronic pain are caused by muscle disorders, nerve damage or problems affecting the connection between nerves and muscles.
- Electromyography (EMG): During an EMG, very fine needles (electrodes) are inserted into specific muscles to measure their electrical activity both at rest and during contraction. This test is particularly useful for diagnosing conditions such as herniated discs, sciatica, carpal tunnel syndrome, peripheral neuropathy, amyotrophic lateral sclerosis (ALS) and muscular dystrophy.
- Nerve Conduction Studies (NCS): In an NCS, small electrodes deliver mild electrical impulses to a nerve to measure signal speed and strength. Delayed or weak responses may indicate nerve damage, making NCS useful for diagnosing conditions like carpal tunnel syndrome, ulnar nerve entrapment, diabetic neuropathy and other peripheral neuropathies.
Diagnostic Injections
In some cases, medication or contrast dye is used to highlight, reproduce or relieve pain during minimally invasive procedures. These injections not only help confirm the underlying cause but also guide doctors in choosing the most effective treatment.
- Nerve Blocks: A nerve block involves injecting a local anaesthetic around a targeted nerve to temporarily numb the area. Significant pain relief confirms the nerve’s role, making nerve blocks useful for diagnosing and managing conditions like sciatica, spinal stenosis, complex regional pain syndrome and chronic headaches. They are often performed under X-ray or ultrasound guidance for greater accuracy.
- Discography: This test is used for severe back or neck pain in patients considering surgery. During the procedure, a contrast dye is injected into the suspected spinal disc. If it reproduces pain and shows abnormalities on imaging, the disc is confirmed as the source, helping identify degeneration, tears or other structural problems.
- Myelogram: A myelogram involves injecting contrast dye into the spinal canal to make nerve pathways visible on X-rays or CT scans. It helps detect compression from herniated discs, bone spurs, tumours or fractures, and is especially useful when an MRI is not possible or unclear.
- Bone Scans: Bone scans detect abnormalities not seen on standard X-rays. A small radioactive tracer highlights areas of unusual bone activity, helping identify fractures, infections, arthritis, tumours or bone metastases.
How is a Pain Management Plan Developed?
Once a diagnosis is confirmed, your doctor will develop a personalised and targeted treatment plan. This will be tailored to the type, cause and severity of your pain, while also factoring in your overall health and lifestyle. The goal is to ease symptoms, restore function and support long-term wellbeing.
To provide comprehensive care, pain specialists may sometimes collaborate with other healthcare professionals—this may include neurologists, orthopaedic surgeons, physiotherapists and psychotherapists. This multidisciplinary approach ensures an accurate diagnosis and a treatment plan that addresses both the physical and emotional aspects of pain.
Pain management options may include:
Non-surgical Therapies
These may include medications such as non-opioid pain relievers, nerve pain medicines or muscle relaxants. Physiotherapy programmes are also commonly prescribed to improve strength, flexibility and mobility. In addition, image-guided injections like nerve blocks or epidural steroid injections may be used to target specific sources of pain.
Minimally Invasive Procedures
Advanced options such as radiofrequency ablation can be performed to disable pain-causing nerves. Another option is spinal cord stimulation, which uses mild electrical impulses delivered to the spinal cord to reduce pain signals.
Surgical Interventions
In severe or complex cases, surgery may be recommended and the patient will be referred to a relevant surgeon. This approach is generally reserved for patients whose pain does not respond to conservative treatments and continues to interfere significantly with daily life.
If pain has been affecting your daily life, consider consulting a pain specialist for a thorough evaluation and treatment plan designed to support your long-term well-being. Contact us at 8860 1861 to schedule an appointment with Dr Thor Timothy today.
Frequently Asked Questions
What conditions do pain specialists commonly treat?
Pain specialists see patients with a wide range of issues, including back and neck pain, joint pain, nerve-related pain and chronic musculoskeletal conditions. They also help people dealing with post-surgical pain, cancer-related pain and persistent headaches or migraines. Because pain can stem from many sources, their expertise allows them to address both common and complex types of pain.
What happens if my pain cannot be fully cured?
In some situations, pain cannot be completely eliminated, so the focus will be on reducing its intensity and frequency instead. The goal is to restore as much function as possible so that daily activities become easier and more manageable. Long-term management usually involves a tailored mix of therapies that improve both physical and emotional well-being.
How soon will I feel relief after starting treatment?
The time needed for pain relief depends on the type of therapy being used and your individual response.
Medications may start to relieve symptoms within days, while physiotherapy usually requires weeks of consistent effort before noticeable improvement occurs. Procedures such as nerve blocks or injections may offer quick relief, but the length of benefit differs for each individual.
A pain specialist will guide you on what to expect and monitor your progress closely, making adjustments when needed.