Neurology

Traditionally neurologists have been considered masterful diagnosticians. Fellow physicians often rely on neurologists to sort out complex historical and examination data in order to arrive at a diagnosis and plan of action. Our specialty is also known for its expertise in the continuing longitudinal care of patients with serious illnesses that impact social and occupational function. Several neurologic diseases result in chronic pain, e.g., stroke, multiple sclerosis, and radiculopathy. For these reasons, neurologists are well suited to the practice of pain medicine.

One of the first US neurologists to contribute to pain medicine was Silas Weir Mitchell. In Injuries of Nerves and Their Consequences, he gave detailed case descriptions of causalgia (complex regional pain syndrome) and phantom limb pain. Subsequently, the concept of multidisciplinary pain management was pioneered by John Bonica, who founded the first interdisciplinary pain clinic in 1947 at Tacoma General Hospital. Currently, the practice of pain medicine involves physicians from multiple specialties including physiatry, psychiatry, anesthesiology, neurosurgery, and neurology.