The type of clinic selected is highly dependent on the type of practitioners who work in the clinic. Some examples of clinics that are especially designed to treat pain include the following:
■ Anesthesia-based clinics, where anesthesiologists provide various interventional pain management options, such as epidural steroid injections
■ Interdisciplinary or multidisciplinary clinics, which are made up of anesthesiologists, physiatrists, rehabilitation specialists, nurses, physical therapists, psychologists, and so forth, and where the patient receives specialized therapy, depending on the pain condition
■ Rehabilitation clinics, where the clinic staff are trained to help patients manage their pain and return to work, focusing on mobility and reconditioning
■ Specialty clinics, which are focused on a specific type of pain, such as headache (International Association for the Study of Pain [IASP], 2008)
Since 1950, when the first pain clinic was started, chronic pain patients have benefited from having access to a specialist who is interested in treating chronic pain conditions. As these clinics became popular with both patients and referring physicians, the number of pain clinics grew dramatically to 1,200 pain facilities in 1987, and even more dramatically from 2,650 to 3,000 pain facilities today.
Considering the large number of patients with chronic low back pain alone, the number of clinics still is insufficient to meet the increasing demand for services. Most chronic pain conditions are treated at the onset in primary care practices. The health care provider tries to bring the pain under control with medications, physical therapy, and other treatment options that are known to be useful for the condition. For most patients, this approach will work, but only 58% of patients with chronic pain are satisfied with their analgesics (American Pain Foundation, 2005). For many patients with chronic pain, an interven-tional option with or without medication management may be needed to help relieve or decrease pain and increase functionality.
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