What We Do
Why We’re Here
We are committed to alleviating pain, restoring health and improving quality of life. Our goal is to help our patients live healthier lives while gaining control over their pain.
Why We’re Different
“If the only tool you have is a hammer, every problem will look like a nail”
The problem with many approaches to painful conditions is that one size definitely does not fit all. Many pain clinics have a single modality that is emphasized, when, in fact, most pain problems require a multimodal approach. For example, treating chronic back pain often requires more than just medications, physical therapy or injections. Other modalities including appropriate exercise, smoking cessation, or an anti-inflammatory diet are critically important. An ergonomic assessment is sometimes required.
At Pain Consultants of WA, we have expertise in all of these areas and have a longstanding collaboration with other medical providers including chiropractors, acupuncturists, naturopathic physicians as well as orthopedic spine surgeons, neurologists/neurosurgeons and physiatrists/rehab medicine specialists. It is also critical to have a logical and methodical treatment plan instead of using a chaotic “shotgun” approach. We also work hand-in-hand with pain psychologists, counselors and addiction medicine doctors.
The Importance of Precision Diagnosis
At PCW, we have seen many patients that do not have a clear picture of their pain diagnosis or have not been given a satisfactory explanation of the source of their pain problem. We go the “extra mile” to go over your medical history, physical exam as well as diagnostic tests including previous x-rays and MRIs. Often additional testing or diagnostic procedures may be required. Many patients may have more than one “pain generator”. Educating our patients regarding their diagnosis, prognosis, as well as treatment options, is one of the most important aspects of the overall treatment plan.
A Word About Pain Medications
Recently, pain medications have been in the news media. Many of these news stories include the illegal use of pain medications and also the increasing number of “pill mill” clinics across the country, as well as a number of stories regarding pain medication related overdoses and deaths.
In December 2011, The Seattle Times featured a three day series entitled “Methadone and the Politics of Pain” about the prescribing of pain medications in Washington state. The articles discussed the effect of the new Washington state opioid prescribing law. In effect, the new law adds restrictions to prescribing over 120 mg ME (morphine equivalents) per day to patients without the consultation of a pain specialist.
Although we have some concerns about the new law with regard to the effect on access to care for some patients, overall there are many positive things about the law as far as setting a standard for the medical community. At PCW, we employ a variety of strategies and state of the art technologies to help patients eliminate or markedly reduce their dependence on pain medications. We work closely with our referring providers to organize a rational plan to address the use of pain medications by their patients. At times, we will take over the prescribing of medications while we are implementing an interventional treatment plan. Often we will recommend an opioid “taper” or drug rotation as part of the treatment plan. In many cases, our goal will be to eliminate or markedly reduce patient dependence on opioid medications. Rarely, a patient may be referred to a drug treatment center or addiction medicine specialist as part of our treatment plan.
Prior to prescribing any controlled substances, a medication risk assessment is critical. Screening for individual or a family history of substance abuse is essential along with conditions such as sleep apnea or pulmonary disease. Ongoing patient education regarding the risk of chronic opioid and controlled substances is part of our treatment plan. We also employ “periodic review” to go over all medication aspects of the treatment plan on a regular basis and to make changes when necessary. All patients must sign a CSA or “Controlled Substance Agreement” for ongoing medication refills.