Transitioning to Pain Management
Many CRNAs consider moving from OR anesthesia to interventional pain management, attracted by regular hours and different practice style.
What Pain Practice Involves
Common Procedures
| Procedure | Frequency | Duration |
|---|
| Epidural steroid injections | Very common | 15-30 min |
| Facet injections | Very common | 20-40 min |
| Nerve blocks | Common | 15-45 min |
| Radiofrequency ablation | Moderate | 30-60 min |
| Spinal cord stimulator | Less common | 60-120 min |
| Intrathecal pump | Less common | 60-90 min |
CRNA Role in Pain Practice
| Model | CRNA Responsibility |
|---|
| **Sedation provider** | MAC for procedures |
| **Procedure assistant** | Assist pain physician |
| **Independent proceduralist** | Perform procedures (scope varies) |
Compensation
Salary Ranges
| Setting | Range |
|---|
| Hospital-based pain | $190,000 - $230,000 |
| Private pain practice | $180,000 - $220,000 |
| Multi-specialty | $185,000 - $225,000 |
Comparison to OR
| Factor | OR Practice | Pain Practice |
|---|
| Base salary | $215,000 | $200,000 |
| Call pay | $15,000 | $0 |
| Total | $230,000 | $200,000 |
Pain typically pays less but offers no call.
Lifestyle Benefits
What Makes Pain Attractive
✅ No call — Office hours only
✅ Predictable schedule — Same hours daily
✅ Lower physical demands — Less standing
✅ Patient relationships — Longitudinal care
✅ Regular lunch breaks — Scheduled downtime
Typical Schedule
| Hours | Pattern |
|---|
| Start | 7:30-8:00 AM |
| End | 4:00-5:00 PM |
| Weekends | Off |
| Holidays | Off |
Training and Transition
What Training Is Needed?
| Training Type | Duration | Notes |
|---|
| Ultrasound-guided blocks | Weeks | Most have OR experience |
| Fluoroscopy | Months | Certification often required |
| Pain fellowship (formal) | 6-12 months | For proceduralist role |
| On-job mentorship | 6-12 months | Common pathway |
Where to Get Training
- Current employer — Ask about pain rotation
- Formal fellowship programs — Limited availability
- Pain practice mentorship — Negotiate during hiring
- CME courses — SIS, ASRA offerings
Scope of Practice Issues
CRNA Pain Practice Models
| Model | CRNA Role | States |
|---|
| **Proceduralist** | Performs procedures independently | FPA states |
| **Team member** | Works with pain physician | All states |
| **Sedation only** | Provides MAC, no procedures | All states |
Know your state's scope before transitioning.
Is Pain Practice Right for You?
Good Fit
- CRNAs burned out on OR
- Those prioritizing lifestyle
- Interest in chronic pain patients
- Comfortable with repetition
- Independent practitioners
Less Ideal
- Those who love OR variety
- CRNAs wanting maximum income
- Those who don't enjoy clinic environment
- New graduates
Finding Pain Positions
Search Strategies
- Pain physician practices — Direct contact
- Hospital pain departments — Growing demand
- Search "interventional pain" + CRNA — Specific listings
- Network with pain physicians — Referral opportunities
Conclusion
Pain management offers CRNAs excellent work-life balance with no call and predictable hours. The trade-off is typically lower compensation and narrower scope. For experienced CRNAs seeking lifestyle improvement, pain practice provides a sustainable long-term career path with growing demand.
Career information from Anesearch, January 2025.