Deliberately not opioid-first, and explicitly including getting people off medications they no longer need.
What it is
Different pain responds to different drugs, and the commonest error is treating nerve pain with anti-inflammatories or treating inflammatory pain with nerve agents. Choosing correctly matters more than escalating dose.
What we use it for
- Nerve pain agents for neuropathy and radicular pain
- Anti-inflammatories where inflammation is genuinely the driver
- Muscle relaxants, used briefly rather than indefinitely
- Structured opioid tapering — see opioid stewardship
- Deprescribing where the medication list has grown beyond its usefulness
What to expect
- A full review of everything you take, including over-the-counter and supplements.
- Attention to interactions, particularly in older patients where falls risk rises with each sedating drug.
- A plan with an endpoint rather than an indefinite prescription.
Risks
Every agent used here has its own profile, and the review exists partly to surface risks that have accumulated unnoticed: gastrointestinal and renal effects from long-term anti-inflammatories, sedation and falls risk from muscle relaxants and gabapentinoids in older patients, and interaction effects where several prescribers have contributed. Nothing is stopped abruptly.
To discuss whether this is appropriate for you, call (314) 310-5577 or request an appointment.
How we judge whether it worked
The measure is whether the medication is doing enough to justify what it costs — in side effects, in interaction risk, and in what it obscures.
Deprescribing is judged the same way. A drug that has been taken for years without anyone testing whether it is still working is not evidence that it is.
Before and after your procedure
Bring every medication you take, including over-the-counter drugs, supplements and anything prescribed by another clinician — a photograph of the bottles is fine. Bring the doses and how long you have taken each. If a taper is being discussed, bring a sense of what your worst and best days look like, because the plan is built around that rather than around an average.
Common questions
Will you take away my medication?
Nothing is stopped abruptly or without discussion. Where a medication is doing more harm than good we will say so and plan a change with you.
Hurt in an accident? Start here.
You do not need a lawyer, a police report or a referral to be seen. Bring your symptoms and we will work out the rest.
Monday–Friday, 8:00 a.m. – 4:00 p.m. Same-day appointments are often available for new accident and injury patients.