You have tried Tylenol, ibuprofen, and perhaps even physical therapy, but the pain has not gone away. Is it finally time to see a pain management specialist? 

The answer depends on what has already been investigated. 

In this episode, Dr. Albert Takem and Dr. Tiffany Russ discuss what patients should expect before being referred to pain management. They explain why basic imaging, conservative treatment, and the appropriate medical evaluation should usually come first. 

Pain management can offer important treatments, including targeted injections and nerve blocks. But pain in areas such as the abdomen or pelvis may have several possible causes. Before treating the pain itself, physicians must make sure serious or treatable underlying conditions have been properly evaluated. 

They also address a common patient misconception: an MRI is not automatically the first or best test for every type of pain. In many cases, a physical examination and a basic X-ray provide the information doctors need to decide what should happen next. 

We discuss: 

•  When a patient should be referred to pain management 
•  What should happen before the referral 
•  Why Tylenol, ibuprofen, and physical therapy are often tried first 
•  When basic X-rays may be enough 
•  Why an MRI is not always the necessary next step 
•  The importance of investigating abdominal and pelvic pain 
•  How pain specialists treat chronic pain after a diagnosis 
•  Why primary care helps patients navigate the correct medical pathway 
•  The risks of choosing a specialist without a proper evaluation 
•  When surgery may become the next consideration 

Pain management is not simply the place patients are sent whenever pain continues. The goal is to make sure you reach the right specialist, at the right time, with enough information to receive safe and effective treatment.

Questions for Dr. Takem and the team

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