Working out what is driving the pain
The starting point is a proper history and examination: where the pain is, what makes it better or worse, how long it has been there, what has already been tried and what happened. Previous imaging, laboratory results and specialist letters are reviewed.
Some pain has a clear structural cause, some does not, and treating it well does not always require a definitive answer — but it is worth looking for one.
Approaches that are not medication
Many pain control methods involve no drugs at all: massage, heat and cold, relaxation techniques, distraction, and gentle activity all have a place, and physical activity and sleep affect pain more than most people expect. These are not a consolation prize for people who cannot have medication. In practice, a combination of non-drug and drug treatment usually works better than either alone.
About opioid medicines
As the use of opioid analgesics has grown in the United States, so has the rate of misuse, dependence and overdose. That has to be weighed against the equally real duty to treat pain adequately.
Opioids are sometimes the right medicine, and where they are used they are prescribed carefully and monitored: regular review appointments, current laboratory work before refills, and clear expectations on both sides. Certain controlled prescriptions cannot be handled after hours or at weekends and must be collected in person.
Treating it early
Pain is generally easier to treat the sooner it is addressed. Long-standing pain changes how the nervous system responds, and treatment becomes harder rather than easier. If something has been aching for months and you have been waiting for it to settle, that is a reason to be seen.
Referral when it is needed
Some pain needs a specialist — orthopedics, neurology, rheumatology, physical therapy or a pain specialist. Dr. Gisi will say so and refer you, and will keep managing the rest of your health alongside it.
What to expect at your visit
- A full history of the pain and everything already tried
- Physical examination, and review of any previous imaging or test results
- A plan that usually combines non-drug approaches with medication
- Clear terms if controlled medicines are part of the plan, including review visits and current laboratory work before refills
- Referral to a specialist or to physical therapy where it will help