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Chronic pain can be one of the biggest challenges that patients and their physicians face. Rheumatology patients are no stranger to pain, and when pain goes beyond the scope of what rheumatologists can treat, collaboration with a pain specialist is common.
“I refer patients to pain management when there is no underlying inflammatory condition, usual pharmacologic treatment has failed, and the patient may need chronic treatment with opioid analgesics or may need epidural spine injections, nerve blocks and other invasive procedures that are not in the rheumatology domain,” says Petros Efthimiou, MD, FACR, associate chief of rheumatology, New York Methodist Hospital, and associate professor of clinical medicine and rheumatology, Weill Medical College of Cornell University, New York.
Patients with chronic spine problems are also often referred to pain specialists, says rheumatologist David G. Borenstein, MD, clinical professor of medicine, The George Washington University Medical Center, and partner, Arthritis and Rheumatism Associates, Washington, D.C. Although a rheumatologist could possibly treat the problem, they would likely not have the same in-depth knowledge of pain treatments that a pain specialist has, he says.