The Direction
"There appears a light on the ocean of sorrow, suffering and pain... ...which brings new hope, Pleasure and comforting gain."

~ Dr.P.S Ajrawat

Pain Specialist Qualification

THE QUALIFIED PAIN SPECIALIST

(Fellowship Trained & Certified)


Due to the complexities of pain and ineffectiveness of traditional treatments, the medical community now recognizes the Pain Specialist as an important member and specialty of Pain Management an integral part of the profession of medicine.  Based on new awareness and growing demand there has been a trend in the recent times, where physicians from different medical specialties have become motivated to market themselves as pain specialists and have been advertising themselves to that effect without the necessary and appropriate training.   Unfortunately that has lead to more confusion and dismay on the part of much needy pain sufferer who are looking for definite answers especially having been an unwilling rider on the never ending merry-go- round in search of pain relief.

Traditionally the medical specialties like Neurology, Physical Medicine & Rehabilitation, Anesthesiology, Orthopedic Surgery and Neurosurgery has addressed the problem of pain especially chronic pain utilizing unidimensional and single modality approaches leading to sub optimal results and excessive iatrogenic morbidity and pain. With that frame of reference, pain sufferers often become more disabled, depressed, experiencing more pain and getting addicted to pain medication. In addition adjunctive interventions like prescription of drugs by a family physician, physical therapy by a physical therapist in an isolated setting, manipulations or mobilization by a chiropractor, usually does not bring a resolution to underlying pathology. Hence various unidimensional and single modality approaches lead to perpetuation and complementation of cycle of pain and associated disabilty.

Based on such experiences and obsolete frame of reference the modern or multidisciplinary concept of pain management was introduced by pioneers like Dr. John J. Bonica. With this approach the pain patient must be assessed in a multidisciplinary setting to make a concrete diagnosis and then treated utilizing mutimodality treatments for optimal outcome. This has further lead to development of specialty of Pain Management and training called Pain Fellowship. It is the fellowship training in pain management where a physician is trained as a specialist under various specialties like anesthesiology, psychiatry, psychology, physical medicine and rehabilitation, neurology and orthopedic surgery. It is during this fellowship trainingwhere the pain fellow acquires necessary didactic and clinical skills to evaluate and treat pain appropriately and effectively.

During fellowship training, the fellow receive training in theory, indications, complications, and clinical applications of various procedues and techniquesutilized to treat pain, which include the following:

Thorough evaluation of pain patient including

 . Detailed history and physical exam .

 . Diagnostics including x rays, scans,emg, blood work.

 . Concrete diagnosis and treatment plan utilizing multimodality treatments.

Procedures include:

. Trigger Point Injections

. Nerve Blocks: Epidural Injection, Individual Nerve Block, Sympathetic Nerve Block, Celiac . . Plexus Block, Trigeminal Nerve Block, Sacral Nerve Root Block and others.

. Peripheral Nerve Block, Bier Block

. Facet Joint Block, Sacroiliac Joint Block. Joint Injections

. Epidural and Intrathecal Infusion

. Radiofrequency Ablation, Nucleoplasty

. Psychotherapy: Individual and Group Psychotherapy

. Pharmacotherapy

. Detoxification

. Behavioral Therapy

. Physical Therapy

. Physical Rehabilitation

. Biofeedback

. Acupuncture

. Hypnosis

. Dr. Ajrawat's Air Pulse Autonomic Meditation Therapy™(New scientific breakthrough        autonomic meditation therapy used exclusively at Ajrawat Pain Management Center)

Most importantly

. Prevention, recognition and management of risks and complications of procedures.

. Airway management and cardiopulmonary resuscitation.

 

Hence a qualified pain management specialist is fellowship trained from a Multidisciplinary pain management center who by virtue of his or her training has acquired the necessary skills to evaluate and treat all the components of pain, utilizing the Biopsychosocial Model of illness and multi-modality treatments in an interdisciplinary setting. When necessary he will seek consultation with other specialties.

As pain is a global problem and pain specialists are in high demand, there is initiative at global level to induce pain management as a specialty in medical schools and produce qualified pain specialists to meet that demand. At present a one-year fellowship is being offered in teaching programs throughout the United States. Pain Specialists also learn cost containment in the present healthcare system and reduction of iatrogenic morbidity and pain.

WHAT IT DOES.
Pain is a complex problem. Consulting with specialists from other medical disciplines, Pain Specialists run the center for the sole purpose of alleviating the suffering of pain patients. This work is guided by the Bio-psychosocial Model of illness. That means that each patient receives a full range of somatic, cognitive and behavioral therapies in a treatment program which has been tailored to the individual's own needs.

FOR WHOM
For the benefit of the patients. Both acute and chronic pain have profound affects on the mind and body. Such pain may change the patient's personality and attitude, leaving behind a feeling of futility and despair. Depression, irritability, loss of sleep, isolation and lack of activity make life an endless misery. The patient becomes trapped on a merry-go-round of doctor shopping, excess medication, drug dependence, and even surgery. The center breaks that vicious cycle.

BY WHOM
By specialists. The pain center is run by physicians who are trained and certified in the field of Pain Medicine/Pain Management, and in the psychiatric and psychological aspects of pain and stress.

The Director, Paramjit Singh Ajrawat, M.D., P. A., received his training at the Multidisciplinary Pain Management Center at the University of Texas Health Science Center in San Antonio, Texas. He was trained under various disciplines, including Physical Medicine & Rehabilitation, Anesthesiology, Psychiatry, and Psychology, among others. Dr. Ajrawat is also a trained Anesthesiologist.

Staff Psychiatrist , Sukhveen K. Ajrawat M.D., is board certified. She received her specialized training in the Psychiatric and Psychological aspects of Pain and Stress at the University of Texas Health Science Center in San Antonio, Texas.

TRAINING OF PHYSICIANS
P.S. Ajrawat, M.D., Director, Asst. Clinical Professor, Algologist, Specialist (Fellowship Trained and Certified from a Multidisciplinary Pain Center) in Pain Management/Medicine, received his specialized training in Pain Management at University of Texas Health Center, San Antonio, Texas. Dr. Ajrawat was trained under various disciplines including Anesthesiology, Physical Medicine and Rehabilitation, Psychiatry, Psychology, Neurology and Orthopedic Surgery. In addition, Dr. Ajrawat received his training in Anesthesiology at Albert Einstein College of Medicine, New York City, New York. Dr.Ajrawat is a member of various national and international organizations, including International Association of the Study of Pain, American Pain Society, American Academy of Pain Management, American Academy of Pain Medicine. Dr. Ajrawat is founder of the International Association of Pain Specialists (IAPS), Dr. Ajrawat's Air-Pulse Meditation and Image Therapy.

S.K. Ajrawat, M.D.,
Staff Psychiatrist (Board Certified), Specialist in the Psychological aspects of Pain and Stress, is trained at the University of Texas Health Science Center, San Antonio, Texas and Albert Einstein College of Medicine, New York City, New York. Dr. S.K. Ajrawat

CONSULTANTS

The Washington Pain Medicine Center is careful to give each patient care which is focused on the individual situation of the patient. Therefore, this Center has employed a wide variety of consultants. These include specialists in Orthopedic Surgery, Neurosurgery, Neurology, Oncology and Hematology, Internal Medicine, Physiatry, and Gynecology, as well as others.

 

The Ajrawat Washington Pain Medicine Center is committed to the field of Pain Medicine as a whole. Therefore we have worked to support medical education, the teaching of medical students and residents, and the International Exchange Program for the Training of Physicians from Overseas. As we are concerned with the growth of the field, we also support clinical research; and being part of the community of Greater Washington, we support community education and public education through media. Indeed, Doctor Ajrawat has appeared on a number of television programs in the Washington Area.