Survey of European pain medicine practice.

This survey was undertaken to explore the variation in the functional constitution of pain clinics in Europe. In addition, we also explored the amount of training which doctors practicing pain medicine typically receive. Approximate hospital charges for common pain interventions and the source of funding were also surveyed. Members of the British Pain Society (Interventional Pain Medicine-Special Interest Group) and other pain physicians in Europe responded through the online questionnaire tool "Survey Monkey." About 215 requests were sent; 82 pain practitioners from 13 countries in Europe responded. This survey indicates that chronic pain interventions are primarily funded either through government or insurance companies. The primary chronic pain service members continue to be anesthesiologists, combined with specialist nurses and physiotherapists. There appears to be some consistency, both with regard to working in a multidisciplinary team, and the training required to become a pain specialist. More than half of the respondents reported the cost of common interventions like caudal epidural steroid injection (ESI), transforaminal ESI, 3 level medial branch blocks, and 6 level facet joint injections to fall under the €500 range ($645). Two thirds of the respondents reported the cost of 4-joint radiofrequency lumbar denervation to be less than €1,500 ($1,935). Good practice should ensure an adequate duration of training, and development of a pain faculty to ensure standards of assessments across the continent. A more detailed, large scale survey is perhaps required to map the availability of chronic pain services and understand the health economics in pain medicine across Europe.