What is the difference between acute and chronic pain?

Answer: Acute pain is usually the result of an injury, surgery or illness. The sensation of pain decreases as the injury heals and eventually disappears. Chronic pain is an ongoing condition, often experienced in the spine or head. You may also suffer from neuropathic pain (nerve injury pain), musculoskeletal pain, and pain related to illness at any location in the body. Your physician may refer you to the pain management center because your chronic pain condition has not responded to conventional therapies.

Treatments for acute and chronic pain are generally quite different. In some cases, acute and chronic pain can be stopped or alleviated by a single procedure or series of procedures. Sometimes, chronic pain is part of a widespread disease process, and the specific cause may be difficult to pinpoint. Once we have identified the specific factor causing the pain, we may be able to treat it so that the condition no longer occurs. In some patients, the specific factor causing the pain–such as cancer–cannot be changed, but we may be able to reduce the pain or help the patient to better cope with the pain through a combination of medical, psychosocial and rehabilitation techniques.

 

What are the most common problems that result in chronic pain?

Answer: While there are a multitude of conditions that may lead to chronic pain, we have found the following to be most prevalent in our patients:

  • Back pain
  • Neck pain
  • Muscle Pain (Myalgia)
  • Nerve Pain
  • Headaches
  • Post Herpetic Neuralgia (Shingles)
  • Fibromyalgia
  • Osteoarthritis
  • Carpal Tunnel Syndrome

 

What is pain management?
Answer: Pain is a complex medical problem that can have profound effects on your physical and mental well-being. The goal of pain management is to help you decrease your level of pain and suffering, to return you to your maximum level of functioning and independence, and to help you restore your quality of life.

 

When should a person seek a pain management specialist?
Answer: Seek out a pain management specialist when pain does not respond to the usual and customary treatments within a reasonable period of time. All too often, people see pain management as a last resort for pain, instead of a first stop on the road to wellness. Be aware of your body and take note when you are in pain. If that pain persists — contact your doctor or an accredited pain management specialist immediately.

 

What is the economic impact of pain?
Answer: The Nuprin Pain Report specifically notes that 4 billion work days are lost each year that result in a financial loss to the economy in the amount of $79 billion per year. The personal consequences of mismanagement of patients suffering from pain are immeasurable. (Source: R. Sternbach, Survey of pain in the US: The Nuprin Report, Clinical Journal of Pain, 2:4, 1986.)

 

What are the major issues surrounding pain?

Answer: Chronic pain can become so intense and overwhelm the body and mind to such a degree that it can affect all areas of life. People become so afflicted that they often cannot work. Their appetite falls off. Physical activity of any kind is exhausting and may aggravate the pain. Often, the person becomes the victim of a vicious cycle in which total preoccupation with pain leads to irritability and depression. Adding to these ailments is the fatigue sufferers experience from not being able to sleep at night.

In other cases of chronic pain, issues of secondary gain may arise. This may develop when patients associate pain with some form of benefit — as when a sufferer has a coworker help out at work, or a spouse is extra- supportive. In these cases, the sufferer may receive a benefit for not treating the pain effectively.

At Auburn Pain Specialists, we will work with the patient to identify and alleviate these issues.

 

What medications are most commonly used to manage pain?

Answer: While drug therapies differ for each person, the most common are:

  • Adjuvant pain medications, including: antidepressants, anticonvulsants and muscle relaxers.
  • Opiates or “pain killers” used to treat acute pain or cancer-related pain, and often prescribed for chronic pain.
  • Anti-inflammatory drugs to alleviate pain by reducing swelling and irritation.

There are alternative delivery methods for medications. Common methods used at the office are oral medications, topical creams, sublingual medicines, nasal sprays, injections and patches.

 

What about the stories of addiction surrounding opiates? Is there a difference between physical dependence and addiction?

Answer: The practice of pain management involves the treatment to relieve or reduce pain. The truth regarding opioids, “narcotics” or “painkillers,” is simply that they all have the potential for serious adverse side effects, including addiction, even when monitored appropriately.

These side effects and adverse effects are explained in more detail in our opioid prescribing policy, and must be discussed prior to the initiation of any opioid regimen for the treatment of chronic pain of non-cancer origin. Remember, the most effective treatment plans don’t involve opioid medications by themselves. Patients and physicians must work together using several treatment strategies along biological, psychological, and social areas to achieve stated goals prior to starting any treatment plan.

Tolerance, or loss of pain-relieving effects of pain medication may occur over long period of time. This is usually less of an issue than was once suspected as long as activity levels are maintained. Benzodiazepines (sedatives) are not concurrently administered along with opioids.  Withdrawal, or feelings of anxiety, nausea, increased pain, and/or sweating are expected from abruptly discontinuing any opioid, no matter what the substance or form it may come in. Addiction is defined as: impaired control over use of medication; craving, preoccupation with obtaining and using the drug; and continued use despite harm (physical, psychologic, social). If a patient has an issue with addiction to a controlled substance such as opioids, he or she will be referred to the appropriate specialist for treatment of this condition.

 

 

Is pain management covered by health insurance?
Answer: Most policies provide for pain management. Please call our office for more information.

 

Do these procedures hurt?
Answer: Regional anesthetics or conscious sedation is available for procedures. Most procedures are minimally invasive with only a needle entering the skin.

 

How long do most procedures take?
Answer: Most procedures take less than 15 minutes. With preparation time and recovery, expect to be in the office 30 to 45 minutes for a procedure.

 

When will I be able to return to work?
Answer: In most cases, if you were able to work before the procedure, you will be able to return to work the next day.

 

Do I need a referral from a doctor?
Answer: Yes, since we are a specialty practice, we work closely with your primary care physician and other treating providers to insure the best possible care.

 

Why must you have my information before my visit?
Answer: To simplify the registration process, we ask that new patients provide information in advance of their visit. This is so that we are able to verify your insurance information. Each insurance plan is different and this allows us to obtain the correct information prior to your arrival.

 

What should I bring with me to my appointment?
Answer: Please bring a valid copy of your driver’s license and current insurance card. It is extremely helpful to have any X-ray films, MRI films, and CT films or a CD/DVD with the images. In addition, bring any other pertinent test results with you.

 

What if I am late for my appointment?
Answer: If you are a new patient, we ask that you arrive 15 minutes prior to your scheduled appointment time, to fill out the necessary paperwork. If you are scheduled for a follow up appointment, and arrive greater than 15 minutes late, you will be rescheduled.

 

What should I do if I am unable to attend an appointment?
Answer: Please inform our office 24 hours before your scheduled appointment. We will be happy to reschedule you. By notifying us, we are able to provide another patient the opportunity to see the physician.

 

What is your policy regarding missed appointments?
Answer: If you miss your appointment, and did not provide us with a 24 hour notice, it will be considered a “No Show” unless your absence is due t o a serious emergency. After your second “No Show” a charge of $50 will be applied to your account. If you fail to contact our office a third time, a charge of $50 will be applied to your account, and you will be discharged from our practice. Your primary care physician will be notified of your dismissal. If you are scheduled for a procedure and do not notify us, a charge of $75 will be added to your account. If a second “No Show” occurs for a procedure, your $75 will be added to your account AND you will not be placed back on the Procedure Schedule.

 

Do you accept my insurance?
Answer: We accept most insurances; however, please call your carrier to verify that Auburn Pain Specialists is a participating provider.

 

Do I need a referral from my insurance?
Answer: Most managed care programs and First Health-Medicaid require a written referral from your primary care physician. Without this, your insurance company will not pay for your visit and therefore you will be responsible for the cost of your visit. It is intimately the responsibility of the patient to make sure that a referral is obtained.

 

What if my referral does not arrive in time of my visit?
Answer: Your appointment will be rescheduled until we receive the referral authorization.

 

What is your policy regarding co-pays, co-insurances, and deductibles?
Answer: All co-pays, co-insurances and deductibles are required at the time services are rendered. If you are going to undergo a procedure at our office, we will calculate the amount owed by you prior to scheduling your appointment so that payment arrangement can be made.

 

Do you accept Workers’ Compensation?
Answer: Yes. An authorization from your Workers’ Compensation carrier must be obtained. All billing information must be provided to us so that we may bill the carrier. If you have a work related injury, and you have seen a Workers’ Compensation Provider, we cannot bill your private insurance unless the claim has been discharged from Workers’ Compensation.

 

I was involved in a Motor Vehicle Accident. I have an attorney and he is handling all my medical cost. Can I make an appointment?
Answer: You may make an appointment; however, if you have an insurance policy that has a “Non Subrogation Clause” you may bill your private insurance. If your private insurance does have a “Subrogation Clause” you must pay for the cost of the office visit at the time your services are rendered. Please contact your insurance for your benefits. Auburn Pain Specialists does not accept payments from third party payers.

 

Will my health information be kept confidential?
Answer: All personal health information will be kept in the strictest confidence. In all disclosures outside of Auburn Pain Specialists, you will not be identified by name, social security number, address, telephone number, or any other direct personal identifier unless disclosure of the direct identifier is required by law.

 

Why must I sign a consent form to see the doctor?
Answer: HIPAA requires all patients to be familiar with their physician’s privacy policy so that they will know their rights. Therefore, after April 14, 2003, all patients will be asked to read the policy and sign the appropriate form.

 

If I am scheduled for a procedure, where will my procedure be performed?

Answer: Most of our procedures are performed in our Fluoroscopy Suite located in our office in Auburn.Those patients that require surgical intervention will be scheduled at EAMC Lanier Outpatient Surgery.