What is pain medicine?
Pain medicine is a medical specialty that has been growing in recent years with the increased awareness on the part of medical doctors and others in the medical community of the role and value of treating pain.

The field is predominantly filled with anesthesiologists, although in recent years, rehabilitation doctors and others have sought to be trained in this field.

What type of pain is treated by the pain physician?
Patients who have spinal problems such as low back and neck pain are often in need of pain control.
Cancer pain control is another aspect of pain medicine.

There are also syndromes of nerve-injury pain that can be treated. Headaches as well as problems related to stroke related pain may be treatable.

What qualifications should a pain physician have?
The most established and well-recognized board that tests and qualifies specialized medical doctors in the United States is the American Board of Medical Specialties.

Patients and referring doctors can feel comfortable if the pain physician holds a diploma from this board that recognizes the pain medicine qualifications of the various specialties such as The American Board of Anesthesiology.

A diploma holder of this specialty board has had to undergo at least 1 year of specialized training in a program that is recognized by the board as having the depth of knowledge and experience to deal with matters related to pain.

IN OUR OPINION, IT IS VERY IMPORTANT THAT A PATIENT OR REFERRING PHYSICIAN ASK IF THE PROSPECTIVE PAIN PHYSICIAN HAS THIS QUALIFICATION.

What causes pain?
Pain is a complex, multi-factorial experience that may or may not be caused by injury to nerves, tissue or bones, back discs and joints, or even tendons and ligaments.

Signals are transmitted ultimately by the nervous system to the central nervous system and brain, where it is processed and interpreted. This can result in an unpleasant condition that may be short or long term and mild, moderate, or severe in nature.

Mediators of pain include chemicals produced in the body caused by damage to structures in the body or even the nervous system itself.

Pain is also, to a greater or lesser extent, an emotionally straining and draining experience. A vicious cycle of pain that is exacerbated by overlying stress leads to a challenging process of diagnosis and treatment.

What is the difference between acute and chronic pain?
We talk of acute pain being something that is short-lived, generally in the order of 0 to 4 or 6 months. Pain that lasts beyond 4 or 6 months is referred to as chronic pain.

Chronic pain is usually more of a diagnostic and therapeutic challenge than acute pain.

Can pain be treated? If so, how?
The answer, fortunately, is yes.

Improvements in medications, devices, and procedures in recent years have enhanced the ability of the pain medicine doctor to offer a variety of treatments that may enable the patient to cope with the pain and even significantly reduce the symptoms of pain and improve the patient's quality of life.

It requires a process of diagnosis combined with treatment. This diagnosis may take the form of imaging studies, lab work, and even referrals to other doctors. The combination of diagnosis and treatment can lead to a satisfactory outcome.

It is important to note that the patient should be an active participant in their care and be compliant as well as realistic about their situation.

Are there different treatments available?
Treatments range from the simple to the complex.

Something as simple as exercise and weight reduction may be helpful but sometimes medications and procedures and even implanted devices may be necessary depending on how complex that a patient's pain problem is.

A lot of our patients undergo minor procedures that involve in-clinic cortisone shots done under x-ray guidance and joint or nerve blocking with local anesthetics, with some sedation, that treat the affected areas.

The worst pain may require implanted devices such as spinal cord stimulators. Also, implantable pumps that contain morphine or other substances, which are delivered into the spinal fluid by a catheter, may be effective. These procedures are done as out-patient surgeries.

It is important to mention that each individual's problem is different and may require different approaches.

What should the patient expect on the first visit to the clinic?
The patient's first visit will be a comprehensive examination of the patient's medical history as well as a physical examination. At the conclusion of the visit, the physician will discuss the problem with the patient and get a treatment plan, which often involves a minor procedure such as a cortisone injection or a nerve or joint block. It may also involve further studies. However, it may also involve only recommendations for that patient to follow.

It is very rare that a patient will get a procedure performed on the first visit, as it is felt that the pain physician needs to get a good idea of that particular patient's problem.

If a procedure is recommended, it will be scheduled at the time of the visit and the instructions will be given to the patient. The majority of the procedures are done in the clinic itself in a procedure suite. This may involve a series of procedures over a matter of a few weeks.

What if the procedure does not help?
The majority of patients get significant relief with the various procedures that are performed. However, if a given procedure does not help, then the possibility of other sources of the pain must be considered. This may involve further procedures to isolate the cause of the pain or possibly further testing or referral.

Are these procedures covered by insurance and if so, what types of insurance are accepted at the clinic?
Yes, these procedures are generally covered by insurance(Please note that individual policies vary in their coverage of certain procedures).

The clinic accepts the majority of private insurance carriers with indemnity, PPO and HMO, such as: Aetna™, Blue Cross/Blue Shield™, United Healthcare™, Cigna™, and Humana™, as well as other private insurance.

The clinic also treats injured workers with worker's compensation.

The clinic accepts Medicare patients.

Does the patient have to pay a large deductible for the procedures?
For in-office procedures, the cost to the patient is generally less expensive than a similar procedure done in a surgical facility or hospital.However,the fees for the patient depend on the individual insurance plan, please discuss this with our billing department.