This section has been provided as assistance to you regarding common questions that we usually get in the pain manage-ment center. The answers to many of these questions have been made as specific as possible to assist you; however, if you have any additional questions or desire a more detailed answer to any of these questions, you may feel free to contact us either by phone or e-mail. We would be glad to assist you.
 

1. How long does it take to get an appointment?

2. Can I get my first pain block on the first visit?

3. If I have no insurance coverage but need treatment, can I get it as a self-pay patient?
   If so, can I get a reduced bill? Can I pay with a credit card?

4. What if my pain requires me to have orthopedic or neurosurgery?

5. Does this pain management center treat children and the elderly?

6. What is interventional pain management?

7. What are interventional pain management techniques?

8. Who are doctors specializing in interventional pain management?

9. What is the difference between acute pain and chronic pain?

10. Can an interventional pain management physician find the cause of my pain?

11. Are there psychological effects of chronic pain?

12. What types of pain problems can be addressed by pain management?

13. Are there different types of pain treatment facilities?

14. What are some treatments for my pain?

15. Is an interventional pain management specialist appropriate for me?

16. What are the goals for treatment?

17. What are my responsibilities?

18. What are my rights?

19. Will you give all of my medications?

20. Do I have to sign a Controlled Substance Contract?

21. How can I be referred?

22. Does my insurance cover your services?

Answers

1. How long does it take to get an appointment? When there are no insurance or preauthorization obstacles, new patients are seen within one or two working days. In some cases, new patients can be seen on the same day. [ top ]
    
2. Can I get my first pain block on the first visit? Depending on your clinical evaluation as well as what your insurance allows, most people can get a pain block on the same day if you need it and have radiologic and laboratory test results already available at your first visit. [ top ]
    
3. If I have no insurance coverage but need treatment, can I get it as a self-pay patient? If so, can I get a reduced bill? Can I pay with a credit card? Yes, you can get help. You will, however, be required to make an initial minimum deposit and you can pay that also with a credit card. We accept Visa and MasterCard. Your bill can be significantly adjusted if you demonstrate need in writing. You can also pay your bill in installments, as you agree with the billing department, based on a payment contract. [ top ]
    
4. If I need physical therapy and massage can I get it in this facility? We have a well-run physical therapy department staffed by experienced, trained personnel that is led by a licensed physical therapist who has worked as a member of our team for several years. You will get all physical therapy tailored to your diagnosis and treatment need. [ top ]
    
5. What if my pain requires me to have orthopedic or neurosurgery? Our pain management center has worked with a number of experienced surgeons in the area to provide coordinated quality care for our patients who need orthopedic or neurosurgery. We will refer you to these specialists/surgeons and help you secure an appointment before you leave our facility. We will also get feedback from the surgeons about what is being done for you surgically. In many instances, you may also need to continue your non-surgical care with us in our facility. Each case is dealt with independently. Our pain management center is able to offer a number of minimally-invasive surgical procedures to relieve your pain. [ top ]
    
6. Does this pain management center treat children and the elderly? Yes. People of all age groups are evaluated and treated. [ top ]
    
7. What is interventional pain management? Interventional pain management is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders with application of interventional techniques in managing subacute, chronic, persistent and intractable pain independently or in conjunction with other modalities of treatment. [ top ]
    
8. What are interventional pain management techniques? Interventional pain management techniques are minimally-invasive procedures including percutaneous precision needle placement with placement of drugs in targeted areas or ablation of targeted nerves and some surgical techniques such as laser or endoscopic discectomy, intrathecal infusion pumps and spinal cord stimulators, for the diagnosis and management of chronic, persistent or intrathecal pain. [ top ]
    
9. Who are doctors specializing in pain management? Pain specialists come from various primary specialties with advanced training and expertise. There mainly are anesthesiologists, physical medicine rehabilitation specialists and neurologists. However, they may include neurosurgeons, orthopedic surgeons and interventional radiologists.
    
10. What is the difference between acute pain and chronic pain? Acute pain is a pain of short, limited duration, usually as a result of an injury, surgery or medical ailment. Acute pain often goes away with the healing process. Chronic pain continues for longer periods of time, sometimes even long after the healing of the original injury has occurred. Chronic pain is associated with frustration, depression and anxiety. Treatments for acute and chronic pain are often quite different. [ top ]
     
11. Can interventional pain management physicians find the cause of my pain? Pain specialists are not only experts at treating pain but also at helping to diagnose the source of the pain. They will conduct a physical examination and review your medical records in addition to analyzing the description of your pain. Sometimes, supplemental diagnoses are helpful. More importantly, an interventional pain physician recognizes the fact that the precise cause of back pain is determined in only 15 percent of patients based on all x-rays, CT scans, myelograms, MRIs, EMGs, nerve conduction studies and history and physical examination. With the help of modern technology, precision diagnostic techniques with injection of a small dose of a local anesthetic (numbing medicine) close to the nerves (pain sources) or other structures under x-ray can we determine causes of pain in at least 80 percent of the patients (versus 15 percent). [ top ]
     
12. Are there psychological effects of chronic pain? Yes, chronic pain may produce feelings of anger, sadness, hopelessness and even despair. In addition, it can alter one's personality, disrupt sleep, interfere with work and relationships and even have a profound effect on other family members, _____ sadness, hopelessness and even despair. It is normal and expected to have psychological problems with pain. [ top ]
     
13. What types of pain problems can be addressed by pain management? Problems commonly treated in pain management centers include, but are not limited to, low back pain, neck pain, headaches, cancer pain, shingles, sympathetic dystrophy, nerve problems and occasional arthritis.  [ top ]
     
14. Are there different types of pain treatment facilities? Some so-called "pain clinics" offer only one type of treatment, such as acupuncture or manipulation and others treat only special types of complaints, such as headaches or back pain. Complete pain management centers, on the other hand, are usually directed by physicians who specialize in pain treatment with a staff of nurses, therapists and medical professionals who are experts in the management of pain disorders. These centers generally have a variety of treatments and treat all types of pain. Centers such as "pain clinics" or "pain service," "pain unit" or "pain center" are similar. [ top ]
     
15. What are some treatments for my pain? Due to the rapid advances of modern medicine, there are many varieties of treatments available for pain. The degree of pain varies from person to person, so your treatment plan with be tailored to your specific need and circumstance. Treatment may include a single-approach of a combination of medicines, therapies and approaches such as: medications, injection treatment, physical therapy, surgery, psychotherapy.
    a. Pain medicines. Narcotic pain medicines are often used to treat pain or cancer pain. They are prescribed for chronic pain also in conjunction with other modalities of treatment or after other modalities have failed.
    b. Anti-inflammatory drugs. Aspirin-like drugs are the most commonly used medications of this type. They not only reduce swelling and irritation, but they can relieve pain.
    c. Antidepressants. Originally used only to treat depression, studies have shown that these medications can alleviate pain in certain situations. Some of them may have added benefit of helping the patient to sleep at night.
    d. Anti-seizure medications. These medications may help relieve certain types of pain by reducing abnormal electrical discharges.
    e. Other medications. You may be prescribed other types of medications that are more specific to the type of pain you are experiencing.
    f. Injection treatments. Local anesthetics, with or without cortisone-like medicines, can be injected around nerves, epidural spaces or into joints. These may act to reduce swelling, irritation, muscle spasms or abnormal nerve transition that can cause pain.
      

    i.	Epidural injections
    ii.	Facet joint blocks
    iii.	Intradiscal thermal therapy
    iv.	Sacroiliac joint injections
    v.	Lysis of adhesion
    vi.	Spinal endoscopy
    vii.	Spinal cord stimulation
    viii.	Morphine pump
    ix.	Trigger point injections

    g. Physical Therapy. Exercise and education are some of the treatments that a physical therapist may provide for you. A physical therapist is also trained in the use of, what are called, modalities that you are not able to obtain or use in your home to achieve pain relief for you. These modalities include ultrasound, deep electrical stimulation, whirlpool therapy, iontophoresis, phonophoresis, among others.
    h. Surgery. When necessary, often surgical treatment will be recommended. Some minimally-invasive surgeries (disk heating, etc.), spinal cord stimulation or morphine pumps are offered.
    i. Psychotherapy. When necessary, psychotherapy along with medication management is offered. However, psychotherapy is usually done by a clinical psychologist or psychiatrist to whom we refer the patient while the medication prescriptions are done mostly in our practice. [ top ]
     

16. Is an interventional pain management specialist appropriate for me? Many painful conditions can be successfully treated by your local family physician. If your pain persists and does not improve with treatment, discuss with your family physician whether a referral to a pain management specialist or comprehensive pain management center might be appropriate for you. You may also be considered for evaluation at a pain management center without a referral. We will review your records prior to evaluation and judge suitability for further evaluation. If we believe we may be able to assess you, we will conduct a comprehensive evaluation and inform you about your suitability for management. We will accept you without referral if you meet the criteria and your insurance does not need a referral to cover your services. Multiple advantages of pain management center treatment include a comprehensive program, holistic approach, and precision techniques for diagnosis required in 85 percent of patients. [ top ]
     
17. What are the goals of treatment? Reduced pain, improved quality of life, and increased dependence of the health care system. [ top ]
     
18. What are my responsibilities? The care a patient receives at the center depends partially on the patient himself/herself. Therefore, in addition to the Bill of Rights, a patient has certain responsibilities as well. These are presented to the patient in a spirit of mutual trust and respect.
    a. The patient must provide accurate and complete information concerning his or her present complaint, past medical history, and other matters about his or her health.
    b. The patient is responsible for making it known whether he or she can comprehend the cost of his or her medical treatment and what is expected of him or her.
    c. The patient is responsible for following the treatment plan as determined by his or her physician including the instruction of nurses and other health professionals as they carry out the physician's orders.
    d. The patient is responsible for keeping appointments or notifying the facility or physician when he or she is unable to do so.
    e. The patient is responsible for his or her own actions should he or she refuse treatment or follow his or her physician's orders.
    f. The patient is responsible for assuring the financial obligation of his or her care and fulfill as promptly as possible.
    g. The patient is responsible for following the facility policies and procedures.
    h. The patient is responsible for being considerate of the rights of other patients and facility personnel.
    i. The patient is responsible for his or her personal property and those of other patient in the facility.
    j. The patient is responsible to report complaint(s) or grievance(s). [ top ]
     
19. What are my rights?
    a. The patient has the right to receive treatment in the center without regard to race, color, religion, sex, age, handicap or national origin.
    b. The patient has the right to refuse treatment to the extent permitted by law and to be informed of the medical consequences of his or her actions.
    c. The patient has the right to obtain from his or her physician complete and current information regarding the diagnosis, treatment and prognosis.
    d. That the patient will be a participant in the decision regarding the intensity and scope of treatment.
    e. The patient has the right to receive from his or her physician information regarding the necessity to give informed consent prior to the start of any procedure and/or treatment.
    f. The patient has the right to obtain information from his or her medical records for use in other health care and educational institutions.
    g. The patient has the right to expect that all communication records pertaining to their care should be treated as confidential.
    h. The patient has the right to expect reasonable continuity of care.
    i. The patient has the right to receive an examination of his or her regardless of the source of payment.
    j. The patient has the right to know that the facility personnel who cares for the patient and qualifies through education and experience to perform the services for which they are responsible.
    k. The patient has the right to be informed that he or she may change primary or specialty physicians if other qualified physicians are available.
    l. The patient has the right to know that he or she is responsible for providing his or her caregiver the most accurate and complete information.
    m. The patient has the right to be advised if the center proposes to engage in or perform human experimentation affecting his or her care or treatment. (The patient has the right to refuse participation.)
    n. The patient has the right to express grievances and suggestions to the organization.
    o. The patient has the right to have an Advanced Directive, such as a Living Will or Health Care Proxy.
    p. The patient has the right to be fully informed before any transfer to another facility or organization.
    q. The patient has the right to participate in the consideration of ethical issues that arise in the care of the patient.
    r. The patient has the right to know about the center's rules and regulations that apply to his or her conduct as a patient.
    s. The patient has the right to know that this organization affirms that physical, sexual and verbal/psychological abuse is prohibited.
    t. The patient has the right to be informed if a health care provider does not have liability coverage. [ top ]
     
20. Will you give all of my medications? We will give medications we recommend under the terms of the Controlled Substance Contract. This pain management center is not for drug distribution and we have very strong policies that try to help us to combat drug abuse and diversion. Drugs are prescribed based on individual considerations and clinical need. It is also the policy of the practice to not deny any patient that needs the medication they need as long as they cooperate with other planned care and treatment that will help the pain management center to remove the source of such pain, with the goal of ultimately eliminating the use of narcotics or reducing the quantity of narcotics in use and improving the patient's quality of life as well. Pain management with drugs is only when all else fails and there is nothing else to offer, and there is a willingness by the patient to help manage his or her care. Compliance to the narcotic contract becomes very crucial at this stage. [ top ]
     
21. Do I have to sign a Controlled Substance Contract? Yes. If you receive controlled substances from this center you may view a sample contract. However, if you receive medications from other physicians or do not need controlled substances, you do not need a contract. [ top ]
     
22. How can I be referred?
    a. Ask your physician.
    b. Call the office to schedule an appointment if you do not have a referral. [top]
     
23. Does my insurance cover your services? Most insurance companies cover interventional pain management as medical and surgical services. However, check your policy. Medicare and most Medicaid (MassHealth) cover these services. We also accept ConnectiCare and United Health Care as well as some other insurance coverage from the state of Connecticut. [ top ]