Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group pain clinics r they worth it

My GP has finally thrown her hands in the air over my AS and referred me to a public pain clinic. I have no idea what this is going to mean to me. I live in Australia. Am I about to be besett by religious bigots telling me it is all in my mind?? Who has been to one of these things? Not sure about this at all. Can someone please tell me their experience of such processes? I have had AS for about 18 years now, slept in chairs for 5 during the SI joint phase and it is now tearing my thoracic region apart and fusing me stiff as a plank. 2 hours sleep max, then more codeine.thanks.

Not sure about Australia, but here in US, 'pain clinic' could mean anything from pill mills to a detox center to a real 'pain management' clinic. I hope it is the latter for your referral.

I only have experience with the latter, so I'll write about that....

A little over a year ago, my former primary doc did essentially the same thing and was tired of writing rxs for my narcotic pain meds (hydrocodone). He referred me to 'pain management'. I was worried about the new doc taking away the narcotics on the first visit and telling me I had no need of them. I knew I'd have to do a urine test and sign an opiate contract and it's very long, but fair, and protects both the patient and the doctor. My DH said it's a terrible thing and I shouldn't do it. All the things that I thought could happen....they didn't.

The doctor is a wonderful woman, compassionate and competent. First visit was 45 minutes while she checked me out physically, asked me questions and learned more about me. She gave me a chance to ask questions, but there were few because she was so thorough. She said she would leave me on the meds for now and wait till some MRIs were done, etc. The requisite urine drug test was done.

Since that initial visit, she was able to blast pain from an old spinal compression fracture into submission (3 epidural steroid injections), blast a large portion of my SI joint pain into submission (bilateral steroid injections, then bilateral RF ablations). I had a few trigger point injections into my right hip area (bursitis). For lumbar pain, she is proposing facet injections. For that I'm waiting to see if Enbrel is going to help (and she understands why I want to wait) When needed, she has increased the number of pills I get each month....probably a slow rise since the disease is progressing. She has tried different 'meds' to see if they help: lidoderm patches (not so great), Voltaren gel (pretty good for some stuff), and a TENS unit (pretty good for back stuff), so it's not just narcotics. In a twist of fate--my DH had a back injury last winter, which required surgery (kyphoplasty). Again, our (previous) primary doc was fed up and DH asked for referral to this pain doc. She is helping him, too....and he said he was sorry to have hassled me..LOL.

I suppose Australia could have pill mills, where shady docs hand out rxs for narcotics until the authorities close them down (leaving the patients hooked and having no where to go) or detox centers where they try to get you off the narcotics and relying on meditation, biofeedback, etc. Personally, I think all those modalities are okay for some people, but no one should be forced to use only that. You want a doctor with a large arsenal of tricks/treatments, from small to large and from weak to strong. Hope you get a good clinic. Sorry for the length---I got carried away.

I don’t know about Australian Pain Clinic but I went to a pain management doctor for several years. They taught me the best exercises to strengthen my core, stretches to relieve some pain and tricks to work thru pain instead of making it worse. I found it very useful and no one telling me ‘it is all in my mind’ -at least not in the states.

one of my physiatrists (the one who does cortisone injections to the SI joint) is part of the pain center / pain clinic at the teaching hospital here in town. when i first got to town, i was seeing a doctor at the same pain center who was giving me trigger point injections.

i've found that pain centers often employ a range of doctors (physiatrists, anaesthesiologists that do a variety of things, "pain doctors", etc., and have found them all to be good at what they do, though it seems to vary more from doctor to doctor than anything else, in my experience, just like any other medical profession.

this pain center also has an acupuncturist that is affiliated with them; either you can see him at the pain center, or go to his office where the tables are more amenable to acupuncture.

they also send me off to PT, etc.

and they prescribe my muscle relaxants, tried me on lyrica, etc.

overall, good, useful experiences.

Thanks very much for all the replies, guess I will just go and see what happens. cheers. scott J

Hi Scotty,
I go to a Pain Management Specialist in Perth. I had 3 level bilateral facet joint injections and nerve block last week. Go back again in early August. I have had some pain relief since the injections. The Dr was impressive and helpful. He said he wil start minimally and next visit hear what I have to say and also take a MRI and bone scan.
I went down to Perth with a bad attitude and came back glad I went.
Cheers,
Debra

I think pain management docs are great. My GP works in a specialty clinic for pain mgmt and sports injury. She has WAY more training and better options that other docs in the area. Good luck!