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What is Pain Management?

I started to answer this question in a copyrighted piece entitled “Top Ten Questions” that I wrote in 1997. When I look back, I am surprised how much of this still applies to my patients today. While technological advances in medical therapeutics change the field of Interventional Pain Management on an almost daily basis, the way we relate to our patients doesn’t change. See for yourself.

To my way of thinking, the term Pain Management can be a bit misleading. The term “management” sort of implies that you are always going to have significant pain and that the pain specialist is there to simply help you live with it. More often than not, that is simply not the case.

While it is true that some patients may always have pain from a chronic condition, at Comprehensive Pain Management, we believe in minimizing pain and optimizing your potential. Therefore, our emphasis is on helping you to recover as much function as possible with the minimum invasiveness.

While our injections and other therapeutic modalities utilized are extremely important components in the pain process, we use these techniques to enhance the rehabilitative component of the process to get you stronger, more in balance, and able to function better through your activities of daily living. We rely on you and your motivation to take you to the next level. In other words, you, the patient, are our secret weapon in the war on pain.

What does 'Interventional Pain Management' mean?

Interestingly, the word Interventionalist still comes up as a misspelled word on my spell check! Those of us that have been around for a while in Pain Management know that this word came into heavy use in our world around 15 years ago. We kind of invented it to describe what we do. That is, as interventionalists, we intervene to break the cycle of pain. The interventionalist has a number of tools at his/her disposal that may include injections for disc pain (epidural injections), arthritic pain of the neck and back (facet injections and radiofrequency ablation), hip and pelvic pain (sacroiliac injections), muscular pain (trigger point injections), headaches (facet and occipital blocks) and many other types of injections for various types of pain syndromes. It is important that you understand that the injections are never the only option, but an injection may significantly reduce your pain so that you can effectively enter the rehabilitative process. However, injections are almost never the only treatment used at Comprehensive Pain Management.

Our treatment plan may employ many different treatments including physical therapy, Chiropractic, massage therapy, spinal decompression, acupuncture, medication management, and counseling, in addition to the injections we provide. Hence, we use the term Multidisciplinary Pain Management. We work with a number of highly skilled medical specialists including TMJ, Orthopedic, Neurology, PM&R, Neurosurgeons and Rehabilitative Psychologists to try to optimize your response to treatment.

How do I get started?

Many times, your Primary Care Physician (PCP) will already have discussed a referral to our office with you and will have faxed a request to our office and we will get in contact with you. Other times, your PCP may simply hand you a card or contact information for Comprehensive Pain Management and you can contact us directly for an appointment. Many insurance plans do not require a referral from your PCP and you can call our office directly for an appointment. If you do require a referral from your PCP, you can request Comprehensive Pain Management if we are contracted with your health plan. When in doubt, just give us a call. We’ll help you sort it out.

Is my treatment covered by health insurance?

Generally yes if you have health insurance. We participate in most major commercial insurance plans. We understand that, in these difficult financial times, there may be costs to treat you that are known as co-insurance, co-pays, deductibles and other costs and, at Comprehensive Pain Management, we understand this. If you are concerned about costs, please let us know. We will do everything in our power to help you evaluate and manage your costs and help you obtain the treatment you need.

What will happen at my first appointment?

When you first see Your Provider he will take some time to get to know you and review your pain problems with you. Generally, your PCP will already have sent us reports, such as X-rays and MRI, so that we have as much information as possible to understand your pain problem. Your Provider will examine you. Then you and Your Provider will team up to develop a treatment plan. This is known as an Initial Consultation. Generally, we do not perform any injections at the first appointment, although the play may, or may not include injections.

How soon can I have an injection?

Many times, the first step is not an injection. There are many conditions in which effective treatment can be provided with no injection at all. If you are in a lot of pain and an injection is indicated, you can often have an injection within a week. You may have to wait a little longer if you have certain medical conditions or are on certain medications, you may have to wait a little longer.

What if I am injured and don't have health insurance?

A lot of people who are injured in accidents don’t know where to get help for their injuries. The answer is simple-see a doctor. If you believe your injuries are serious, start with the emergency room. We’ll see you after that if you need treatment. Although many people who are injured in an accident don’t have insurance, there are often other forms of insurance coverage available. First of all, if you are injured on-the-job, there is often coverage through your place of employment.

If you are injured in a car accident there is often coverage through an auto insurance policy. In many cases, we work with auto insurance carriers and through your attorney on a lien. That means that if you have coverage through an automobile insurance policy, there may be no out of pocket costs to you and we will wait to be paid by the insurer. If you have a Family Physician or Chiropractic Physician, we will work together with them to help you through your recovery from the injury.

If you do not have health insurance and were not injured in an accident, please feel free to discuss your special circumstances with our staff to see if we can help.

If I am considering an injection, how can I find out more about it?

First of all, if Dr. Schurgin recommends an injection procedure as one alternative, he will explain your injection to you in detail in the office, long before you decide to go forward. When you see Dr. Schurgin, you are encouraged to ask questions. Dr. Schurgin will sit down with you and explain what the procedure means, how it is done, and what your experience will be like.

We use spine models and other types of educational materials to make sure you understand. Also, you can discuss your concerns with Dr. Schurgin about any component of your treatment. We will also direct you to other educational material that may be helpful in understanding the process. If you still want more information, we will refer you to educational sites where more detailed information is available. At Comprehensive Pain Management, we believe that the more you understand, the more comfortable you will be.

Where are procedures performed?

Many of our procedures can be performed at the office. Other procedures are performed in an out-patient center, depending on the nature of the procedure. When you see Dr. Schurgin, if an injection is discussed, you will learn more about it and together you and Dr. Schurgin will decide which location makes the most sense for you.

Do injections always contain Cortisone?

No. Many of our injections, such as Trigger Point injections, Sacroiliac Injections and deep muscle injections may contain a combination of non-steroid ingredients including Traumeel™ and local anesthetics. Please be aware that, contrary to the suggestion of some Pain Clinics that you may see on television or in print, the non-steroidal medication, Traumeel™ cannot be injected in the epidural space to treat a herniated disc.

If you do require an injection containing a steroid, such as Kenalog (Triamcinalone), Dr. Schurgin will be extremely cautious with the dosage and talk to you about it. In the right setting, judicious use of corticosteroids can make a huge difference. Dr. Schurgin will take great care to avoid overuse of these important medications for the treatment of conditions like a herniated disc. It is important that you don’t confuse the corticosteroids that Dr. Schurgin uses with the more dangerous anabolic steroids abused by some athletes and body-builders that we hear so much about on the news. If you have concerns, please ask us.

Is an injection painful?

Most of our patients tell us that they were very comfortable during their injection. While there is occasionally some minor discomfort during a procedure, at Comprehensive Pain Management, we take great care to make sure you feel relaxed and comfortable during your procedure. We have many tools at our disposal to make sure your experience is a good one. When you come to our office, don’t be afraid to ask.

Where do I go from here?

The first step is to call us now at (602) 971-8200 and make an appointment at one of our many convenient locations throughout the Valley. Then we can talk to you in a personal and confidential way about your pain problem. Please be aware that when we make your initial appointment, we are reserving almost an hour of Dr. Schurgin’s time FOR YOU ONLY, so please be there. If you know you cannot make your appointment, please give us plenty of notice (several days) so we can give your time to another patient who needs it.

We look forward to seeing you!