About pain medicine

Pain medicine is a multidisciplinary medical practice, which has matured in recent years.

In 2005, the discipline was recognised in Australia as a medical specialty in its own right and was accredited as a scope of practice in New Zealand in 2012. This recognises the importance of the problem of unrelieved pain in the community and to the need for a comprehensive medical response through education, training and practice.

The field of pain medicine recognises that the management of severe pain problems requires the skills of more than one medical craft group. Such problems include:

  • Acute pain (post operative, post-trauma, acute episodes of pain in "medical conditions").
  • Cancer pain (pain directly due to tumour invasion or compression, pain related to diagnostic or therapeutic procedures, pain due to cancer treatment).
  • Persistent (chronic) pain (including over 200 conditions described in the International
    Association for the Study of Pain (IASP) Taxonomy of Chronic Pain
    2nd Ed, such as phantom limb pain, post-herpetic neuralgia, mechanical low back pain).

The pain medicine specialist serves both as a consultant to other physicians and often as the principal treating physician. The spectrum of care provided by a pain specialist includes prescribing medication, co-ordinating rehabilitative services, performing pain relieving procedures, counselling patients and families, directing a multidisciplinary team, co-operating with other healthcare professionals and liaising with public and private agencies.

Persistent (chronic) pain is seen in every age group from paediatric to geriatric, and across all medical and surgical disciplines. Because of the complexity of persistent pain problems, multidisciplinary pain clinics/centres have been developed throughout Australia and New Zealand.

Such clinics or centres harness the inputs of a range of medical and allied health professionals to assess the multidimensional aspects of pain and to formulate appropriate programs of treatment aimed at control of pain and improvement in function. Equally importantly, these multidisciplinary pain clinics also provide clinical training and foster basic and clinical research in pain medicine.

In Australia and New Zealand, a career in pain medicine is generally obtained by qualifying as a Fellow of the Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists (ANZCA). The fellowship in pain medicine is an "add-on" specialist degree. Thus, those wishing to enter the field usually will have or be training toward a specialist qualification in one of the participating specialties, namely anaesthesia, medicine, surgery, psychiatry or rehabilitation medicine.

Entry into pain medicine training has been broadened to include Fellows of the Royal Australian College of General Practitioners or Royal New Zealand College of General Practitioners or a faculty or chapter of one of the participating colleges (other than the Australasian Faculty of Rehabilitation Medicine). For a full list of accepted primary specialist qualifications see By-law 3.

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