spine vs pain fellowship

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New Member
10+ Year Member
Apr 27, 2009
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Aside from accreditation, could someone remind me again what the differences are between spine and pain fellowships?

Some of the fellowships seem to overlap between the two. In other words, I don't see a clear distinction but it maybe just these programs. Procedural wise, it seems pretty similar. Some spine programs apparently manage chronic pain as well.

Nevermind...I just found a good thread answering my question. But just in case, anyone else want to add anything? :)

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Senior Member
15+ Year Member
Oct 18, 2004
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It all depends on what role you want to play in the care of these patients.

I'm speaking in generalities here, but for the most part, in Pain Management, you don't care so much what the underlying diagnosis is (that's the surgeon's job), you want just enough information to classify the type of pain you're dealing with and to identify contributing factors, so that you can control the pain (generally with pain meds or procedures, but also acupuncture, cognitive/behavioral therapy, etc.) As such, you should also be able to manage pain from a wide variety of non-orthopedic conditions (i.e. central pain syndromes, CRPS, fibromyalgia, etc.)

Spine fellowships can best be described (pumps and stims aside) as non-surgical orthopedic fellowships (Think, similar to primary care Sports Medicine fellowships, but for the spine). Your main concern isn't palliative symptom management, but to identify/correct (as much as possible) biomechanical/anatomic derangements. This is done through thorough physical diagnosis, in some cases electrodiagnostics and imaging, and then treatment with properly structured PT, exercise and procedures.

What I've found is that Pain Management is somewhat analogous to Rehabilitation Medicine (i.e. assumption that the diagnosis has been made and treatment already rendered), while Spine and Musculoskeletal Medicine tends more toward Physical Medicine (Diagnose and Treat).

They really are different disciplines, with the procedures being the common ground.