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There's a lot of patient history they're going to want, so be prepared to bring a lot of information with you, and arrive at least 30-45 minutes early so you can get everything completed.

  1. Pain / Medical History, including any surgeries, injuries, conditions, diseases, relating to the pain or not. They'll ask for dates for the surgeries, and for any injuries.
  2. Current pain level as shown on a chart.
  3. Pain locations as shown on a chart.
  4. Current medications and dosages, and what you're taking them for.
  5. Pain diaries, if you're keeping them. If not, start, as they'll likely ask you to start one.
  6. Any MRI's/CT's/X-Rays of the injury, condition, or disease that's causing the pain, along with the associated Radiology reports.
  7. Insurance information, including any Workman's Comp or Accident history (e.g., car accident involving legal involvement), and current status of the case.
  8. Most PM clinics will also have you sign an agreement that you'll only use one specific pharmacy for opiate prescriptions, unless otherwise authorized by your doctor if the need arises. That's to prevent abuse, but it's not a big deal for opiate patients. In fact, it's better to use one pharmacy, as they'll know your history and build up a trust/rapport with you over time.
I'd recommend staying away from any clinic that forces or requests that you bring in and discard any unused medication. Not only is it expensive for you, it shows an automatic distrust of all patients and shaky legal footing for the clinic itself. For those that want you to just give it to them, remember it's illegal for you to transfer any narcotics to someone it's not prescribed to, including the prescribing doctor or his nurses.

The 2 other things to expect are a urinalysis to detect any illegal substances, and recommendations for mental health counseling. Usually for first-timers, mental health counseling is a requirement.

The mental health aspect is very common, and not a reflection of you as a person. The plain fact of the matter is that anyone with real pain in their life requiring formal pain management deals with depression and many other mental factors associated with traumatic stress. Mental health counseling is just a part of the deal.

The other reason is that should your doctor prescribe opiate therapy, the side effects of opiates include mood swings, and it's important that you have someone to talk to about it. Involving your family/friends early on will also help keep you from getting alienated or divorced.

I've added links to Partners Against Pain, who have some great Pain Diaries and other charts you can download.

For the consult, the doctor will go over your pain history with you, and get a feel for your pain levels and what has worked/hasn't worked so far. DO NOT ask for opiates or painkillers up front, even though you may be tempted. That can get you tagged as a drug seeker, and they might not take you seriously unless you've got the medical evidence to back it up. Let the doctor assess your condition and then prescibe a treatment plan.

Be frank and honest about your pain also - make sure you make notes about what you want to talk about before you get there, as there's usually only about 30 minutes and it'll go fast. You don't want to forget something important.
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Q: What should you expect on your first Pain Management visit?
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