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Types of Chronic Pain Specialist

NACPAC North American Chronic Pain Association of Canada
Phone:(905)793-5230 Fax:(905)793-8781 Contact Us TOLL FREE: 1-800-616-PAIN (7246) ------ Directory of Canadian Pain Clinics and Pain Specialists: Chronic pain may be caused by many different conditions, syndromes and diseases, from severe pain associated with systemic diseases such as cancer to chronic lower back pain due to failed back surgery, Diabetic Neuropathy and migraines. Chronic Pain is persistent disabling pain that fails to heal over a prolonged period of time, usually 3-6 months and does not respond to conventional treatment by one's Family Physician or other Medical Specialists. This is when a person suffering from chronic pain may want to be seen by a Pain Specialist (also called Pain Physician) or visit a Pain Clinic for evaluation and treatment. One's Family Physician is usually required to make the referral. Traditionally, pain management has been the responsibility of Anesthesiologists, also referred as Anaesthetists. However, today, Pain (Management) Clinics and Pain (Management) Specialists from various disciplines, often associated or Hospital based, offer many different treatments/ modalities, diagnostic/evaluation procedures and therapies to treat the many types of chronic pain. Treatments may range from one or combination of drug therapy, Cognitive-Behavioral Therapy (e.g. relaxation techniques), psychological or psychiatric treatment, anaesthesia, physiotherapy, neurosurgical treatment, to alternative therapies, occupational therapy and more. Larger pain clinics, the majority hospital based, typically offer a multidisciplinary approach where the medical and health professional staff may include, anesthesiologists, psychologists or psychiatrists, neurologists, neurosurgeons, physical and occupational therapists and other health professionals, all trained in pain management to treat chronic pain patients. These medical and psychosocial professionals work in consultation to decide what course of treatment to offer for each patient. Pain clinics also offer assessment of compensation claims. Many pain clinics describe themselves as multidisplinary but may vary in focus. Some may be centred around "an approach called functional restoration, a concept based on gradual increases in exercise or physical therapy, and behavioral-modification services and vocational rehabilitation." Others may be centred around diagnosis and medical treatment; surgical invasive procedures and/or pharmacological treatments (drug therapy). Often, also providing services such as physiotherapy and Cognitive-Behavioral therapy (which usually includes relaxation training and counselling). Medical Specialists such as Anesthesiologists trained in pain management (pain medicine) may offer such treatments as nerve blocks and epidural steroid injections in joints or around nerves for diagnosis and treatment of pain. They may also offer drug therapy, prescribing pain medicines to treat severe chronic pain. Neurosurgeons specializing in pain management may offer surgical treatments such as spinal cord stimulator implant systems, intraspinal drug infusion pump implants and nerve destroying surgery to treat severe intractable chronic pain that does not respond to other therapies. Rheumatologists usually treat patients suffering from arthritis, including Fibromyalgia and Neurologists may treat patients suffering from chronic pain such as migraines. Some pain clinics, typically private, may offer treatment of only one type of chronic pain, such as headaches or may offer only one type of treatment such as Acupuncture. Rehabilitation Centres may offer treatments such as physiotherapy, occupational therapy and massage to work hardening. Alternative therapies, such as Acupuncture and various massage treatments may be offered in a pain clinic or private practice. Currently, there exists no Government or Medical regulatory body to monitor and regulate Pain Clinics in Canada. This directory does not include Physiotherapists or Physiotherapy clinics, Chiropracters, Massage Therapists, Accupuncture practitioners or related therapy based clinics, including any practitioners of Alternative Medicine. This does not imply that such health professionals do not offer pain relieving treatments or therapies but due to administrative website restrictions they will not be included in this directory. Please refer to your local telephone directory. Comment: NACPAC does not endorse any specific pain clinic or physician. NACPAC gratefully thanks Medtronic of Canada, Ltd. for providing information. NACPAC also thanks the Canadian Coordinating Office for Health Technology Assessment (CCOHTA) for providing names of Canadian Pain Management Centres from their Technology Brief Issue 5.5 Feb/96. For Dentists who treat TMJ refer to directory by location from the American Academy of Head, Neck and Facial Pain web site.

The Canadian Back Institute is the largest chain of rehabilitation clinics in Canada specializing in back and neck rehabilitation with over 60 locations across Canada.

Last Updated: 09/30/00 (Hamilton, ON) 09/21/00 (Surrery BC) 09/20(Toronto, Montreal). Copyright 1999 2000 NACPAC (content)