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General Information
Q: How quickly can you get me in for an appointment?
A: We don’t want you to be in pain for longer than you need to be, so we make every effort to get your treated as soon as possible. Our scheduling staff is devoted to finding appointments for new patients within ten business days of initial contact.

Q: How do I schedule an appointment?
A: To schedule a new patient appointment please call (502) 890-5639 or email us at and we will be happy to assist you.

Q: What should I bring to my first appointment?
A: For your convenience, you can download and complete your NEW PATIENT FORMS on our website. Please bring these with you to your appointment along with: your current insurance card(s), photo ID, method of co-payment and any recent imaging or consultations with other specialists. Please be prepared to describe your pain clearly and in as much detail as possible. We will ask that you describe your level of pain on a scale.

For follow up appointments, please arrive 15 minutes before your scheduled appointment time.

If you are being seen by one of our providers for the first time, please plan to arrive 30 minutes early to ensure that you have adequate time to complete our new patient intake paperwork (if not downloaded and completed in advance)

For procedures, patients need to arrive thirty minutes before their scheduled procedure time. It takes time to prepare for your procedure including check-in, sedation etc. We want to make sure we have enough time to give you with exceptional quality care and not rush anything.

Q: What types of insurance do you accept and how long will it take to get prior authorization?
A: Commonwealth Pain & Spine is an in-network provider with most insurance companies. Our new patient scheduling staff will help verify your insurance coverage prior to scheduling an appointment or procedure. they may also be able to answer any questions you have related to your benefits including patient responsibility for services. This will give you a better understanding of what will be covered by your insurance company. A Self-Pay option is available to accommodate uninsured patients only.

Because each insurance company has its own unique requirements for authorization, it can be hard to predict how long your authorization will take. Some only take a few days, while others can take weeks. In certain cases, patients can significantly expedite their authorization by contacting their insurance provider directly.

Q: Do I need a referral to be seen?
A: Referrals are needed for most insurances plans. There are rare occurrences that a referral may not be needed. Our dedicated new patient scheduling staff will be happy to assist you in obtaining the necessary referral.

Q: Do you treat motor accident vehicle victims and worker’s compensation cases?
A: Yes, we are able to treat motor accident vehicle victims once PIP is exhausted. Treatment for worker’s compensation needs authorization before scheduling.Call (502) 919-9781 to speak with our Occupational Medicine Specialist directly.

Q: What if I cannot make my appointment?
A: We understand that things happen! We ask that you please contact our office as soon as possible to reschedule. Cancellations with less than 24-hour notice are subject to a $50.00 fee

Q: Can I get directions to your office?
A: Yes you can. Click here
Chronic Pain Management
Q: What is Chronic Pain Management? A: Anyone who has on-going pain that has not been eased with the help of a primary care physician should be evaluated by a Pain Management Specialist. The goal of chronic pain management is to improve your function and reduce suffering. We strive to give you as much pain relief as possible with the least amount of risk. Our team of professionals are specifically trained to treat various chronic pain problems and are experts in all aspects of your health which may be affected by your chronic pain. Our physicians have completed a fellowship program and most are Board Certified in both Anesthesiology and Pain Management- having completed four years of medical school, four years of training in anesthesiology and pain medicine, and an additional year of training to become experts in treating chronic pain. If interventional procedures are considered, real expertise is critical since the spine and nerves that register pain are delicate and everyone’s anatomy may be different. In addition, many of the medications used to treat pain are strong or may interact with other medications and can be harmful if not administered by a physician with appropriate training. Your Pain Management Specialist will us a medical history and physical examination, as well as radiological studies, such as an MRI, CT, bone scan, and x-rays as recommended to evaluate your needs. Our physicians and their staff will work in collaboration with you to develop a plan of care to ease the pain and improve your quality of life. This plan is very individualized and may consist of medications, treatments, procedures, physical therapy and in most cases, a combination of these options. Q: What is the difference between acute pain and chronic pain? A: Acute pain is pain of a short, limited duration, usually the result of an injury, surgery or medical illness. Acute pain often goes away with the healing process. Chronic pain continues for longer periods of time, sometimes even a long time after the healing of the original injury is expected to have occurred. Chronic pain can be associated with frustration, depression and anxiety. Chronic pain may produce feelings of anger, sadness, hopelessness and even despair – this is common and you are not alone. In addition, it can alter one’s personality, disrupt sleep, interfere with work and relationships and even have a profound effect on other family members. Treatments for acute and chronic pain are quite different. Q: Can a person’s pain be all “in their head”? A: Pain that is “all in the head” is not very common. Some people do turn the emotional symptoms of anxiety or depression into the physical symptom of pain. It is more common; however, for people with physical pain to have more intense pain because of their anxiety or depression. Anxiety and depression lower people’s pain tolerance. Although it’s not all in their head, emotional disturbances definitely worsen the pain problem. This is why it is important for people with chronic pain to also see a psychiatrist to have those emotional issues treated at the same time as their physical pain issues. Q: Can you help me or my loved one? A: This is one of the most common questions we receive and, we hope that the answer is YES. Ideally, everyone wants to be pain free, but realistically, not everyone can be completely relieved of pain. Every patient is different and will have different results. The treatment of pain requires a dedication to the patient that surpasses that in many medical fields and pain problems can be very complex. Patients often do not get better with one treatment or with the help of a single medication. Our staff is committed to sticking with you until we’ve exhausted all efforts to make you feel better. We believe a balanced approach is the only way to treat pain and will do our best to help you. Q: How can I avoid chronic pain problems? A: The best way to avoid chronic pain is to treat acute pain aggressively and appropriately. For example, when a person first experiences severe pain, anti-inflammatory medications like Ibuprofen help promote healing and prevent abnormal pain impulses from developing. Prolonged, severe pain can cause anxiety, depression and insomnia which in turn decreases a person’s pain tolerance. Pain causes depression which causes more pain. This cycle of pain can be very difficult to break once it starts. This is why it is important to work in collaboration with a trained pain management professional. Q: Do I have to suffer with chronic pain for the rest of my life? A: Not necessarily. With proper treatment, people can live full, normal lives after having experienced chronic pain. Your length of management under our care depends on your diagnosis and the plan that your doctor recommends. Some patients need only one visit for treatment suggestions that their primary care physician can carry out. Other patients may need to see their pain management specialist on a regular basis for quite some time depending on the severity of their pain. Q: What are my options? A: We’ll discuss all the options available to you and come up with a custom plan of care. Options include: Medication Management: From over-the-counter remedies, such as acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs), to powerful prescription drugs such as opioids, medications may help ease the pain. Other medications can help too, including antidepressants, anti-seizure medications and steroids. Your physician may suggest a combination of medications that can address different aspects of your pain. Physical therapy: As directed by a physical therapist, specific exercises can help you build up muscle and ease pain. Commonwealth Pain & Spine can refer you to the best-in-class therapists in your area. Procedures and Treatments: A number of procedures can help with pain control, from nerve blocks to surgery to snip overactive nerves. Lifestyle changes: You can help your pain management efforts by being as healthy as possible. For example, if you smoke, get help so you can stop. Try to maintain a healthy weight to avoid the stress excess weight puts on your joints, resulting in hip and knee pain. Good nutrition is important even if you’re trim, and exercising can often relieve or prevent pain.
Treatments and Procedures
Q: How long will the procedure take and will it hurt? A: Although most procedures take five to fifteen minutes, you may remain at our facility up to 2 hours because of admission, evaluation, sedation, procedure, recovery, and discharge time. The vast majority of our patients indicate that the procedures are relatively painless. Most procedures are performed with a local anesthetic, which usually reduces the discomfort of the procedure. If a patient elects to undergo IV sedation, vital signs and oxygen levels are monitored to assure safety during the procedure. Q: Why can’t I eat or drink before a procedure? A: We do everything we can to make your procedure as comfortable for you as possible. However, some people become nauseous due to anxiety or discomfort. Additionally, the IV sedation we offer can make you at increased risk for vomiting and aspiration. For this reason, an empty stomach is required. You may take medications with small sips of water. Q: Should I stop taking medications before the procedure and how long before I resume taking them? A: Generally, you should continue your medications as prescribed by your treating physicians including pain medications. If you are taking any blood thinners such as Coumadin, Plavix, Persantine, or Heparin, you should inform our staff and discontinue these medications prior to your procedure ONLY if your treating physician approves the temporary discontinuation. You may resume your blood thinners immediately after the procedure. If you are a diabetic do not take your insulin or oral hypoglycemic medicines before the procedure. Please bring your medicine with you and you may take it after the procedure. Q: Will I need someone to drive me home? A: Yes, if you have a procedure performed with sedation, you need someone to drive you. This is due to the fact that the sedation used can impair your reaction time and make you groggy. Q: When will I be able to return to work after my procedure? A: Return to work depends on what your doctor’s care plan is and what your job requires you to do. If you were working before the procedure, you would most likely be able to return to work the next day, if not the same day. Q: Will I need more than one treatment? A: Most of the time, yes. Most procedures are performed in a series of two or three (over the course of several weeks). Occasionally just one procedure provides lasting pain relief. Q: What if a procedure doesn’t work for me? A: We will see you in the office to discuss any remaining available options. We work with excellent surgeons, physical therapists, occupational therapists, psychologists, psychiatrists and chronic pain medication physicians and can refer you to them if necessary. Q: Are there risks to interventional pain procedures? A: Yes, all medical management tools from medicines to invasive procedures such as surgery carry risks. Generally, interventional pain management techniques carry unlikely and minimal risk. Upon your consultation visit, these risks will be explained.
Medication Management
Q: Which pain medication is the most effective? A: The most effective medication depends on what is causing the pain. For example, narcotic medications are very helpful for certain severe pain problems, but may do very little to help pain which is due to chronic tissue inflammation, muscle spasm or nerve irritation. All pain problems cannot be alleviated with the same medication. To make matters more complex, different people may respond to the same medication in different ways. One person may have great pain relief with medication A and another person may not have any relief with the same medication. This is why a doctor’s full evaluation is necessary before prescribing any pain medication in order to identify all of the possible factors which may be causing the chronic pain situation. Q: What are the common side effects of pain medications? A: The most common side effects include sleepiness and constipation. People who are very sensitive to these types of medications may also experience itching, nausea, dizziness, hallucinations or changes in memory and thinking. Alcohol and sedatives and even allergy medications make these symptoms worse. Anyone who needs pain medication should never drink alcohol or use similar medications without their doctor’s knowledge. Q: What is the difference between regular pain medications and “slow-release” pain medications? A: Most pain medications are meant to be used for short term pain problems such as after surgery or for an acute injury. Those medications typically provide pain relief for only 3 to 4 hours and then they wear off. Medications that provide pain relief for 8 to 24 hours at a time are better for chronic pain problems. One pill is slowly released into the blood stream to provide superior pain relief that lasts longer. Studies have also shown that slow-release pain medications cause a lesser incidence of tolerance and work very effectively at the same dose for years. Q: Should I take my prescribed pain medication only when I have a lot of pain? A: No. Don’t wait until pain becomes severe to take pain medication. Pain is easier to control when it is mild. You should take your pain medication regularly, just as prescribed. Sometimes this means taking medicine on a regular schedule, even when you don’t feel pain. Q: Why do I need to keep taking more of my medicine to have the same effect? A: This situation occurs when you have developed tolerance to a drug. Tolerance is a normal physiological response to narcotics and occurs when the initial dose of a substance loses its effectiveness over time. Changing the dose or the medication often solves the problem. Just because you have become tolerant to a drug does not mean that you are addicted to that drug. Q: Will I become addicted to narcotic pain medications? A: Not necessarily, if you take your medication exactly as prescribed. A person’s likelihood of becoming addicted depends, in part, on his or her addiction history. Addiction is less likely if you have never had an addictive disorder. If you are not misusing your medication, such as taking more than has been prescribed or using it for reasons other than pain relief, it is unlikely that you will become dependent.
There is a phenomenon called “physical dependence” which is the natural effect of using narcotic medications. Essentially, over time, your body gets used to the medication and if you abruptly stop taking it, you will experience withdrawal side effects. Withdrawal side effects are avoided by slowly weaning the medication off and are not an indication of addiction. Many other types of non-addictive medicines can produce withdrawal effects if abruptly discontinued. Ask your doctor about any concerns you may have. It is extremely important to realize; however, that prescription pain medication is currently the most widely abused substance recently surpassing marijuana. It is your responsibility to ensure that your medication isn’t taken by anyone else but you. Q: Once I start using pain medications will I always have to take them or will my pain eventually go away? A: The answer to this question is different for everyone. In some cases, the medication allows the painful areas to “calm down” or heal after which time the medication can be discontinued. Our objective for all patients is to incorporate other pain management therapies, such as injections and physical therapy, to allow our patients to potentially discontinue their medications. There are other types of pain problems called “degenerative or progressive” such that the abnormality is expected to continue and therefore medication will need to be continued on a long term basis. Sometimes it’s difficult to predict who will need long term treatment and who won’t. This is why regular assessment of pain issues and adjustments in therapies and medications as symptoms change, are important. Q: I’ve been having pain in my legs and back for a long time and my medication is not helping. My family member has the exact same symptoms and has been prescribed a different medication which seems to work well. Why isn’t my doctor giving me the same medication? A: Even if your symptoms sound alike, it is most likely that the two of you are having different problems. Patients often ask me if they can take the same medication that their friend is taking, but it’s not that simple. Doctors treat the problem not just the symptoms. Different problems oftentimes cause similar symptoms, but because they are different problems each person needs to be treated individually.