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Introduction



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Unique Approach to Pain Management

We believe that traditional approaches to pain management were based on outdated models of treatment and that effective management of pain was rarely, if ever achieved by taking these approaches. At the Bay Area Pain & Wellness Center, we hope to change the practice of pain medicine by incorporating the latest care techniques in a sophisticated manner which addresses the entire person, not just the symptoms themselves.

What should I expect?

Because we are attempting to create a change in the way that pain management is practiced, we would like to provide you with some basic concepts about our process that can help you understand our multidisciplinary approach to an often-complex pain problem.

Recent Injuries or Pain

First, if you have recently injured yourself or developed pain (within the last six months), you are likely experiencing acute pain. Our approach to acute pain problems includes a full evaluation of the likely causes of your pain. This evaluation will include a review of available records and/or test results from previous doctor visits. This review process will outline which tests or treatments have already been done, other doctors’ opinions and recommendations, and your response to their treatments. We will also have you complete a questionnaire before your visit.

Our evaluation will include a physical examination. At the end of the visit, we will give you our best diagnosis. Occasionally, we may reserve judgment until you receive additional testing to help us make a more informed analysis of your pain problem. Once we have established what we believe to be your diagnosis, we will then provide you with information about our philosophy of care for this problem and information about what to expect in terms of treatment. If we feel that we have a good idea of the cause of your pain, we may also recommend specific medical treatments at the end of your first visit. These treatments may include prescriptions for medications, therapeutic or diagnostic injections, and/or physical therapy. Once we have established what we believe to be your diagnosis, we will then provide you with information about our philosophy of care for this problem and information about what to expect in terms of treatment.

Treating a person as a whole also means looking out for your emotional well being. It is our experience that pain often creates huge emotional stressors for people since it disrupts their lives in terms of the normal activities of living, including family, job and financial responsibilities. We believe that these emotional consequences can intensify the experience of pain, and we also know that having support in managing the emotional and social consequences of pain can help an acute problem heal faster and more completely.

Because we attempt to treat the whole person, and not just the affected body parts, we may send you to meet with our medical psychologist as a part of the initial evaluation. By doing this, we are not implying in any way that your pain is not real or is caused by mental factors. If you have had pain for quite a while, we will still make every effort to determine the underlying causes of the pain and to remedy these to the best of our ability. Often after significant time has passed we cannot offer a quick “fix” to the problem. This may be due to several reasons.


First, some types of pain are caused by several underlying problems rather than just one cause. In these cases, a simple fix may not be helpful, and it might lead to a worsening of your pain problem.

Secondly, when pain has lasted beyond the expected and normal healing phase (usually three to six months), the body changes in ways that makes the cause of your pain more complex. In some situations, your entire nervous system becomes involved in the experience of pain, not just the area where you feel the pain. In other situations, multiple systems of the body become involved, including muscles, nerves, bones, ligaments, tendons and discs. A pain problem that is the result of multiple causes is obviously more difficult to manage from a medical perspective and often requires a shift in the way the problem is treated.

What if My Pain is Chronic?

People with chronic pain problems (pain that has lasted for more than six months and is likely to be ongoing) must be managed in a very different way than people who have just been injured or have just experienced the first symptoms of pain. If a “cure” is no longer possible, we feel the best approach is to work with patients to help them learn to manage their pain more effectively. In our experience, the effective management of pain requires a very well designed plan that includes many different levels of intervention. We believe that the best way to understand our approach is to compare pain to other chronic illnesses like diabetes or high blood pressure. Both of these other conditions must be managed over time, primarily by the patient. Either of these conditions can be life-threatening if they are not properly managed. The goal of treatment is to educate patients about how to change their lifestyles so that the conditions are stabilized and do not create significant disruptions in their lives. We want to help you develop your own tools for managing pain so that you can both reduce your usual pain and avoid excruciating flare-ups.

When the physician sees you for your first visit, he or she will attempt to understand the causes of your chronic pain and whether or not your previous treatments were appropriate and sufficient. If your doctor does not feel that he has enough information, you may be asked to complete more testing and assessment. Because of the complex nature of most chronic pain problems and the often dramatic effect that it has had on your life, your care may include participation in a multidisciplinary treatment plan. This will include education (on the causes of your pain and effective ways to manage your specific condition), psychological services (to address the emotional consequences of your pain and the effect on family), and physical rehabilitation (to help you get stronger and stay fit).

At the end of your medical evaluation visit(s), your doctor may refer you to one of our psychologists for an assessment of behavioral or emotional factors that are likely caused by your pain. After your visit, your physician and psychologist will discuss your case and develop the most effective treatment plan for your particular pain problem. They may also give you educational materials to take home and read on your own about things you can do to manage your pain in addition to trying the treatments recommended by your doctor. Our years of experience have taught us that the best pain management occurs when both the doctors and the patients work together to manage the disease of chronic pain.