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Frequently Asked Questions (FAQ)

 

What is pain management?

Pain management is dedicated to the correct diagnosis and comprehensive treatment plan to help restore basic and advanced functioning of individuals who suffer from debilitating pain, lasting longer than 3-6 months and presenting at the same location with similar quality and severity.  Chronic pain is a complex process that may require a combination of treatments in order to achieve the best results. Goals of treatment are to find the most effective, safest, and most tolerable methods to help restore normal functioning of the individual, utilizing the best available evidence in research.


When should I see a pain specialist?

If your pain persists after the healing process should be over, you might have chronic pain. If the current treatment you are receiving stops working or your pain begins worsen over time, your primary care doctor may suggest that you see a pain management doctor.


What can I expect when I see my pain management provider?

After completing a detailed history and physical exam, your pain management provider may order tests such as radiographic images (including x-rays, MRIs, etc.) or blood tests, unless they have recently been done.  A treatment plan tailored to the individual patient will be discussed and initiated that may include medications, possible minimally-invasive procedures and/or physical therapy. Pain management requires active joint effort from both the individual suffering from the chronic pain and the healthcare team.


What should I have prepared prior to my first appointment?

It is expected that each new patient receives a referral from their primary care provider and that all pertinent records are forwarded from your primary care office.  Pertinent records include current treatment plan with updated medication list, summary of recent encounters, and any diagnostic testing, including recent imagining. Any records from specialist care would also be required.


What can I expect from my first visit?

Beyond a comprehensive review of your records, history, and physical exam, you may be asked to submit a sample for toxicology and may have to return in frequent follow up appointments for further evaluation and determination of your treatment plan and your readiness for chronic pain management.


Does insurance pay for pain management?

Appointments and procedures are covered by most insurers and an updated list of participating insurance providers are available upon request.


Do you keep my primary care provider informed of our work together?

A strong working relationship with your primary care provider (PCP) is imperative to the success of your treatment.  It is required that you maintain recommended follow up with your PCP throughout your pain care and your PCP will receive written updates after each and every encounter you have with your pain specialist.


Will I become addicted if I start taking medications for pain?

It’s very common for people to be confused about the difference between physical dependence and addiction. The main difference is that addiction includes a psychological (or mental) craving for the medication that can lead to self-destructive behavior. Physical dependence only means that your body needs the medication, and you have symptoms when you do not take it. People become physically dependent on many kinds of medicines, including insulin, antidepressants, and others. It is a normal part of using some medications.

When you use a pain medication, after awhile, your body becomes used to having that chemical on a regular basis. Your body needs that medication to function normally. If you stop taking it or lower the dose, your body reacts badly, with physical withdrawal symptoms like headaches, nausea, shakes, and other more serious problems. This is physical dependence, and it is not at all the same as addiction.

Addiction is a psychological problem that causes people to lose control over their use of a medication. People with this problem sometimes think the drug is the most important thing in their lives. They might raise their dosage or continue using the medication without their doctors’ permission, or seek other sources of medication that their doctors don’t know about. They take the medication even when they know it is not good for them, and they might do risky and irresponsible things to get the medication.

Addiction is avoidable. If you think that you might be taking a pain medication that you do not need for pain, talk to your doctor about safely reducing the dose. Also, if you become preoccupied with the medication, thinking about how soon you can take more or worrying excessively that you might run out, that can be a warning sign to talk to a health care professional about changing your treatment. The act of taking pain medications alone does not lead to addiction.

There are certain factors that increase the possible risk of addiction when taking opioids. This includes a previous history of substance abuse, usage of psychiatric medications, depression, and in general, younger patients are at greater risk.


What can I expect if I'm taking opioids and my referring provider will no longer write the prescriptions?

Pain medications are sometimes utilized as one component of a balanced, comprehensive plan for the management of your pain. On an initial visit, your provider will review your history, perform a physical exam, review imaging if available, and then come up with a plan tailored uniquely for you.

In addition, we will evaluate your list of medications during the initial visit and provide our recommendation to you and your primary care provider about continuing opioid therapy. We may recommend another course of treatment that does not include opioids. We do not always write a prescription for opioids, so please do not arrive with the expectation that we will automatically refill your prescription. If we opt to prescribe opioids as part of your care plan, we may adjust the medication to a more appropriate dose, a better dosing schedule, or a better medication.


What can I do if I am addicted to opiates?

There are many options for you, however, the key is to ask and seek help.  Currently, we are in the presence of an opioid epidemic that only seems to worsen with each passing day.  Measures are being taken to reduce the availability of illicit opiates, including prescription opiates, that are diverted away from their intended purpose. Treatment comes in many forms, including the use of out-patient buprenorphine (Suboxone) medication assisted treatment (MAT).  Please call for more information as treatment space is regulated.


Where do I find information regarding the NYS medical marijuana program?

Information can be found at the NYS department of health website and you can access their website here.  Before enrolling in the NYS medical marijuana program, NYS requires that you are to be evaluated by a credentialed provider, such as Dr. Pawlowski. Once you are evaluated and approved, you will obtain a patient certification and then will need to register online with the state health department.  More information can be provided at the time of your appointment.