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One model for chronic pain treatment involves multiple injection series used alone for the treatment of
chronic pain. Whereas in acute or sub-acute diagnostic situations (new disc herniation, new sacroiliac
disorder, etc), it is perfectly acceptable to render only injections to patients since often these conditions are
short lived. However, after pain has been present for 3-6 months, injection therapy alone will not permit
most pain patients to continue functioning without supplemental medications. "Block jocks" fail to
recognize the difference between these two types of pain, acute and chronic, and continue in error providing
expensive injections over and over until the insurance is exhausted. The pain patient knows these injections
are not effective for long term treatment of chronic pain, and often seek medication management to
supplement their pain control. Most block jocks will refuse to give narcotic medications, are not interested
in long term progress of their patients, and see each patient as another injection. The family doctors are
understandably confused at this behavior since they sent the patient to a pain doctor for long term care, but
with the block jocks refusing to prescribe narcotics, the family doctor is often left in unfamiliar territory
prescribing narcotics in doses for which they have no training or expertise.
Many of the block jocks make over 1 million dollars a year for lining patients up like cattle every day and
pummeling them with needles and steroids with short term effective pain relief only.
Pain physicians on the other hand, treat patients with a large array of medications including narcotics,
injections, minimally invasive spine surgery, physical therapy, functional rehabilitation, and develop long
term relationships with patients. This is quite contrarian to the block jocks who jettison the patient after the
insurance approved injections are no longer approved by the patient's insurance company.
Block jocks, except those diagnosing and treating acute pain are reprehensible, represent the worst side of
our profession, and should be avoided like the plague. It is unethical to treat a patient solely with injections
for chronic pain. It is very much akin to a surgeon who only operates on patients, and has nothing else to
offer because long term patient care with office visits is less lucrative than surgery.
Not all patients are candidates for narcotic therapy due to their inability to control their use of the drug,
because of illegal sales or giving away the drug to others, or due to medical conditions which make it
dangerous to be taking narcotics. However, there are exercise classes and tapes, physical therapy,
inversion tables, interferential stimulation, topical compounded drugs, non-narcotic therapies, etc. which
may be used instead of narcotics.
Advanced Pain Management uses injections as but one of the therapies offered, not as the sole therapy for
the treatment of chronic ongoing pain when there is no definitive surgeries or procedures which would help
significantly lessen the pain.