Pain management clinics-tell me about them

[phorsenuf]

Saw my PCP this morning and I am being referred to the pain management clinic for the pinched nerves in my back caused by bulging disks.

I have no idea what they do and what to expect. Can you share your experiences.

Thanks!

 

[blanq]

I hope you don't mind that jump in here for any answers you might get. I am in a similar boat. I have lived with chronic pain in my neck for three years, and finally got an MRI. I got the results last week, and I have a bulging disk with spinal canal narrowing. I was referred to a spinal surgeon to discuss options and have an appointment to see him next month but am interested in pain management options that do not include surgery so would love to read the responses you receive.

 

[LindaR]

Well I have had two spinal surgeries (laminectomy and fusion) with continued issues. I went to a "pain management clinic".....what a joke. It is just a pharmacy. All they want to do is write prescriptions.

I went in, spoke to the "doctor" about all my spinal issues and what I was looking for (I don't take any pain meds other than an occasional Motrin type). He said he "understood" my dislike for narcotics........and then proceeded to write a prescription for Oxycontin (sp?). Ummm, NO! He then tried something else!

He clearly did not listen to what I said. There was no alternatives offered OTHER than narcotics (massage, yoga, heat/cold, etc). Drugs only.

This is not MY idea of pain management. Clearly I am in the minority and most people prefer to be stoned out of their minds. Not for me

 

[hiwaygal]

My experience was a bit different.

I went to a pain management center years ago for a dizziness problem that we could not resolve.

My first (and only) appointment there was a full day thing. They did different tests (hearing, eyes, balance, and a bunch of others that I don't remember - and they may do different ones depending on the symptoms).

Then they had me take some kind of psychological "stress" test (multiple choice questions) and I had like four of the five or six top stressors at the time.

They basically told me my problem was stress and that I should join their group therapy sessions and have regular appointments with their therapist.

Yeah, I never went back.

On another note, I had back surgery 5 years ago for bulging/herniated/ruptured disc in the L4-L5-S1 area. They did a discectomy/laminectomy and I haven't had any significant problems since. I left the hospital the same day and was back at work within two weeks. If I had to do it over again, I would in a hearbeat.

However, I would never allow a fusion surgery.

 

[LindaR]

Hiwaygal,.....trust me, there will never be a second fusion!!! That was the ONLY option I had left (spinal cord completely compressed) because I was at risk for paralysis.

My "idea" of pain managment is.....learning how to live with pain and exercising or holistic (i.e. non-drug) type things that are non-invasive and help relieve the pain.

 

[hiwaygal]

I apologize if I offended you LindaR, that was not my intent. And I'm sorry that was the only option for you.

When I knew I would need some kind of surgery, I did as much "research" as I could online. I saw post after post from people who had had the fusion and were having problems again within 2 years. I knew then that it wasn't right for me. Although I'm not sure what I would have done if they had told me there was no other option!

I agree with you to a point about pain management...whatever we can do to help ourselves we *should* do. But I'm also not against good meds!

I think the biggest thing about meds is that you don't necessarily need stronger and stronger meds if you are taking something regularly, you just need to be careful to not let the pain get out of control (that's pain management too!).

 

[phorsenuf]

Hmmm.....interesting.

Me, personally, I'd just like to have the surgery and get it over with. I'm tired of the pain and walking is getting tougher and tougher. Standing in line? Forget about it. 10 minutes and I'm spent. I have a numb spot in my leg.

My pcp does not seem to be a jump into surgery type hence the reason for going to the clinic. I'm waiting to hear from them and go from there.

My treatment is through the VA so for now I'm doing what they want.

 

[hiwaygal]

phors, talk to your neurosurgeon about the surgery.

I would think the numbness alone would make you a candidate for surgery!

 

[arminnie]

I am wary of any practice that puts pain management in big letters on their signs, ads, etc. There are SO many "pain clinics" out there that really are just legalized pushers.

Now I'm all in favors of using any and all narcotics when NEEDED and monitored by a responsible doctor. There are some excellent pain management programs. But those will usually involve all alternatives available not just what comes from the pharmacy.

My best friend was on the state medical board for many years. There are so many doctors out there that really operate in the grey area. Way too many patients who went for help ended up as addicts when they just wanted some short-term relief. It is legally very difficult to remove their liscense to dispinse controlled substances.

Well I have had two spinal surgeries (laminectomy and fusion) with continued issues. I went to a "pain management clinic".....what a joke. It is just a pharmacy. All they want to do is write prescriptions.

I went in, spoke to the "doctor" about all my spinal issues and what I was looking for (I don't take any pain meds other than an occasional Motrin type). He said he "understood" my dislike for narcotics........and then proceeded to write a prescription for Oxycontin (sp?). Ummm, NO! He then tried something else!

He clearly did not listen to what I said. There was no alternatives offered OTHER than narcotics (massage, yoga, heat/cold, etc). Drugs only.

This is not MY idea of pain management. Clearly I am in the minority and most people prefer to be stoned out of their minds. Not for me

Good for you for recognizing what they were trying to do.

 

[cruisnfamily]

Well I have had two spinal surgeries (laminectomy and fusion) with continued issues. I went to a "pain management clinic".....what a joke. It is just a pharmacy. All they want to do is write prescriptions.

I went in, spoke to the "doctor" about all my spinal issues and what I was looking for (I don't take any pain meds other than an occasional Motrin type). He said he "understood" my dislike for narcotics........and then proceeded to write a prescription for Oxycontin (sp?). Ummm, NO! He then tried something else!

He clearly did not listen to what I said. There was no alternatives offered OTHER than narcotics (massage, yoga, heat/cold, etc). Drugs only.

This is not MY idea of pain management. Clearly I am in the minority and most people prefer to be stoned out of their minds. Not for me

I am wary of any practice that puts pain management in big letters on their signs, ads, etc. There are SO many "pain clinics" out there that really are just legalized pushers.

Now I'm all in favors of using any and all narcotics when NEEDED and monitored by a responsible doctor. There are some excellent pain management programs. But those will usually involve all alternatives available not just what comes from the pharmacy.

My best friend was on the state medical board for many years. There are so many doctors out there that really operate in the grey area. Way too many patients who went for help ended up as addicts when they just wanted some short-term relief. It is legally very difficult to remove their liscense to dispinse controlled substances.

I have a neighbor who is young(like 23 years old) who goes to a pain center due to issues with his back and this is his experience.....drugs and more drugs. No therapy or anything else just Rxs.

 

[LindaR]

Oh NO! You didn't offend me!

I learned SO much after the surgery than my doctor would EVER tell me about before (of course). Most of the things I learned were not good.

I am 8 years post fusion. I have pain every single day, all day. BUT!!!, I am in better shape than I was before the surgery.

I am just personally very anti narcotics.

Anyway, here's to all of us that are trying to manage our pain! Hang in there!

 

[redsunfish]

I was referred to a pain clinic after 6 weeks of physical therapy that had done nothing for the crazy intense sciatic pain down my leg and a small area of numbness caused by bulging discs at L4-L5 and L5-S1. I was never prescribed narcotics there. What they did for me, after an evaluation appointment, was an epidural steroid injection. I've now had 3 injections over the course of 2 years when I had flare ups and they have always been a god send. I've heard they don't work for everyone so I count myself among the lucky. Anyway, in my personal experience it wasn't just about pushing pills on me and I was really glad I went after suffering through the 6 weeks of non-invasive treatment before they would do the injections!

 

[Jennasis]

Very good friends of mine own a pain management clinic. The doctor is one who pioneered many of the techniques and advancements in pain management. They unfortunately get "seekers" all the time and are very careful and selective about what the prescribe. After years of back issues, I had a terrible episode early this year that left me nearly incapacitated. They mentioned I should come in for an epidural (which was a GODSEND), but it only relieved me for a few weeks and then it got worse....much much worse.

I had herniated a disc at L5-S1 so badly that the pain shooting down my leg was completely crippling to the point of making me unable to walk...or sit...or stand...or sleep. I wanted to die. And then my leg went numb in addition to the pain.

I called the pain doc's wife (my friend, she is also the manager) and she freaked out and had her husband send me for an MRI the next day. An HOUR after the MRI her husband calls me and says "Do NOT move...I am referring you to a surgeon. You are in very bad shape".

Surgery was scheduled 6 days later. It saved my life and my mobility (discectomy).

Surgery sounds scary, but living with pain is not living. Do what it takes to make life bearable. NOt all "pain management" docs are the same.

 

[laurie31]

I was referred to a pain clinic after 6 weeks of physical therapy that had done nothing for the crazy intense sciatic pain down my leg and a small area of numbness caused by bulging discs at L4-L5 and L5-S1. I was never prescribed narcotics there. What they did for me, after an evaluation appointment, was an epidural steroid injection. I've now had 3 injections over the course of 2 years when I had flare ups and they have always been a god send. I've heard they don't work for everyone so I count myself among the lucky. Anyway, in my personal experience it wasn't just about pushing pills on me and I was really glad I went after suffering through the 6 weeks of non-invasive treatment before they would do the injections!

This is exactly the experience DH had. He's been using a pain management clinic to manage his pain from a herniated disc at L5-S1 for 13 years now. He's NEVER gotten any kind of prescription from them (nor does he want one). The epidurals control his pain. When he first went, he was in terrible pain, unrelieved by narcotics, and his foot was numb. They (the epidurals) have made such a difference.

He was told that he shouldn't have surgery unless his foot was totally numb to where he could not walk and epidurals did not help.

 

[arminnie]

I have a neighbor who is young(like 23 years old) who goes to a pain center due to issues with his back and this is his experience.....drugs and more drugs. No therapy or anything else just Rxs.

I hope he's okay. There are valid circumstances where an rx is appropriate. But I hope other things that might help (not just mask) the pain are being considered.

I've personally seen someone be prescribed really hard core pills - oxycontin, etc. She is a hardcore alcoholic in addition. People with known addictions could really end up badly. That drug and alcohol combo is bad. I don't think she is going to survive this. Her brain is already gone.

The only daughter of a friend had been through rehab for an alcohol problem. She'd been clean and doing very well for a couple of years. Until this doctor started prescribing narcotics when he knew of her previous problems. Unfortunately she died.

The doctor from above had his dea approval to prescribe narcotics removed. There were multiple deaths of his patients because he was prescribing huge quantities for minor issues.

All of this is really on my mind right now as the doctor from above is under arrest and a big trial is being held right now. As a reaction to his license being pulled he BLEW UP the head of the medical board. Had a whole hit list.

 

[Ponygirl]

My husband has been to a VA pain management clinic. They required some extensive work up to pin point his spinal problems, such as a nerve conduction study, EEG, MRI's, and some other stuff I can't remember because it has been a few years. After all test results are collected, they also give you a comprehensive pysch test. My husband's primary pain management doctor was an anesthesiologist but he was also seen by a neurologist, a shrink, and another speciality, all at the pain management clinic. They will get together and review everything and make recommendations as to treatment modalities, prescriptions, etc. They even use chiropractors and accupuncture sometimes, so it isn't JUST prescriptions.

You will be followed by pain management for at least 6 months, and then eventually released back to your primary care team.

Did they tell you how long it takes to get into the pain management clinic? It took us over a year to get the ball rolling so you might want to ask so you know what to expect.

I wish you all the best and hope you find some relief. Chronic pain can really suck the joy out of your life.

 

[arminnie]

My husband has been to a VA pain management clinic. They required some extensive work up to pin point his spinal problems, such as a nerve conduction study, EEG, MRI's, and some other stuff I can't remember because it has been a few years. After all test results are collected, they also give you a comprehensive pysch test. My husband's primary pain management doctor was an anesthesiologist but he was also seen by a neurologist, a shrink, and another speciality, all at the pain management clinic. They will get together and review everything and make recommendations as to treatment modalities, prescriptions, etc. They even use chiropractors and accupuncture sometimes, so it isn't JUST prescriptions.

You will be followed by pain management for at least 6 months, and then eventually released back to your primary care team.

Did they tell you how long it takes to get into the pain management clinic? It took us over a year to get the ball rolling so you might want to ask so you know what to expect.

I wish you all the best and hope you find some relief. Chronic pain can really suck the joy out of your life.

Excellent example of what a good pain management clinic should be.

 

[jazzielady]

I didn't go to a pm clinic, but to a pm doc. Referred myself after getting no relief from pcp and physiatrist. Had numerous epi injections with no relief. Have had 2 fusion surgeries, L3-5 and C5-7.

I went back to pm doc for lingering issues (but NOTHING like I had before). He referred me to an intensive rehab program incorporating physical, occupational, and psychological therapy. I've gone 2 days so far and it's been very interesting.

 

[Aristomommy]

Just like any other type of medicine, there are good and bad pain management clinics. Some just write prescriptions and are full of addicts, and others are true pain management clinics. I used to work at one and did physical therapy for them. This clinic did medications, but also pain block injections, acupuncture, counseling and physical therapy. Actually, pain medicine was the least important component of the place. If the Dr. found out someone had been "pill shopping", not following through with their other plan of care, the pain pills would not be prescribed and usually the patient was asked to find another Dr.

These shady "pain management" places really give a bad name to a holistic approach to pain management. To the OP: I would suggest finding a reputable place, an affiliation with a reputable Dr or hospital is usually a good indication. If the only thing you get is a prescription, keep looking. I learned so much from the Dr I worked with and about different ways to help patients in chronic pain. I wish you well

 

[MinnieMe87]

I was referred to a pain clinic after 6 weeks of physical therapy that had done nothing for the crazy intense sciatic pain down my leg and a small area of numbness caused by bulging discs at L4-L5 and L5-S1. I was never prescribed narcotics there. What they did for me, after an evaluation appointment, was an epidural steroid injection. I've now had 3 injections over the course of 2 years when I had flare ups and they have always been a god send. I've heard they don't work for everyone so I count myself among the lucky. Anyway, in my personal experience it wasn't just about pushing pills on me and I was really glad I went after suffering through the 6 weeks of non-invasive treatment before they would do the injections!

The doctor I work for does the injections as well. I wouldn't hesitate to go to him if I had issues. I know there are a lot of clinics out there that are very drug pushy as previous posters have said, but the one in my town is not. Thank goodness! Good luck OP, I hope you get your pain taken care of.

ETA: He also does physical therapy and other exercises as well as an acupuncturist (sp?) who comes in.