Medication management here means three things. We match the drug to your type of pain. We check everything you take for interactions. And we build a plan with an end point, not an open-ended prescription.
It is not opioid-first, on purpose. It also includes getting people off medicines they no longer need.
How do doctors choose the right pain medication?
Different pain responds to different drugs. The most common mistake is treating nerve pain with anti-inflammatories, or treating inflammatory pain with nerve drugs. Choosing the right drug matters more than raising the dose.
What medications are used for chronic pain?
- Nerve pain drugs for neuropathy and radicular pain (pain running down a limb from a nerve root)
- Anti-inflammatories where inflammation is truly the cause
- Muscle relaxants, used for a short time, not forever
- Planned opioid tapering (slowly lowering the dose) — see opioid stewardship
- Deprescribing (stopping drugs) where the medicine list has grown past what helps
What happens at a pain medication management visit?
- A full review of everything you take, including over-the-counter drugs and supplements.
- Attention to interactions, particularly in older patients where falls risk rises with each sedating drug.
- A plan with an end point, not an open-ended prescription.
What are the risks of long-term pain medication?
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 us or request an appointment.
How do you know if a pain medication is working?
The test is whether the medicine does enough to be worth what it costs. That cost is side effects, interaction risk, and what it hides.
Deprescribing is judged the same way. Taking a drug for years, with no one checking if it still works, is not evidence that it does.
Before and after your procedure
Bring every medicine you take, including over-the-counter drugs, supplements and anything prescribed by another doctor. A photo of the bottles is fine. Bring the doses and how long you have taken each. If a taper is being discussed, come ready to describe your worst and best days. That is because the plan is built around those, not around an average.
How the procedure is actually done
Medication review here starts with a full list: prescription, over the counter, supplements, and anything from another prescriber. That is because the real risk sits in interactions, not in single drugs. Each medicine is then matched to a purpose and a way to judge whether it is doing its job. Anything that fails that test is a candidate for stopping.
Who it suits, and who it does not
It suits patients on several drugs with unclear benefit. It suits patients whose drug list has piled up over years. And it suits patients who want to lower their opioid load without an abrupt stop. It does not suit anyone who wants an existing opioid prescription kept the same. That is a different service from the one offered here.
What we do before offering this
The assessment comes first. What does the pain do across a day? What sets it off and what eases it? What does the exam bring on? What did past treatments do, and for how long? Partial and short-lived results are very telling, so we ask about them directly. A procedure is offered only when that picture points to a clear structure. The reasoning is explained, not assumed.
Frequently asked questions
Will you take away my medication?
Nothing is stopped abruptly or without talking it through. If a medicine is doing more harm than good, we will say so and plan a change with you.
Will you take over my prescriptions?
When it is medically right and part of a plan, yes. What we do not do is keep an existing drug plan going forever without addressing what is causing the pain.
Will you stop everything at once?
No. Stopping a long-used treatment all at once is harmful in itself. Any drop in dose is planned, gradual and tied to treating the source.
Do I have to bring everything?
Yes, including supplements and anything prescribed elsewhere. Interactions are the reason, not judgment.
What happens if I am already taking opioids?
Medication management here is not opioid-first, on purpose. An existing opioid plan is not just kept the same. For patients who want to lower their opioid load, a planned taper lowers it without an abrupt stop. Any lowering is planned with you, done gradually and tied to treating the source of the pain, because stopping long-used therapy abruptly is harmful in itself.
Why is nerve pain treated with different drugs than other pain?
Different kinds of pain respond to different drugs. Nerve pain, such as neuropathy or pain running down a limb, calls for nerve pain drugs. Anti-inflammatories are used where inflammation is truly the cause. A common mistake is giving anti-inflammatories for nerve pain. Choosing the right drug matters more than raising the dose.
What is deprescribing?
Deprescribing means getting you off medications you no longer need. Every drug on your list is matched to a purpose and a way to tell if it is working. Anything that fails that test is a candidate for stopping. Nothing is stopped abruptly, and any reduction is planned with you and done gradually.
Are muscle relaxants safe to take long term?
Here, muscle relaxants are used briefly rather than indefinitely. In older patients they add sedation and raise the risk of falls, and that risk grows with each sedating drug on the list, including gabapentinoids. Part of every medication review is finding risks like these that have built up without anyone noticing.
Sources
- Finnerup NB et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. The Lancet. Neurology, 2015. PubMed 25575710
- Soliman N et al. Pharmacotherapy and non-invasive neuromodulation for neuropathic pain: a systematic review and meta-analysis. The Lancet. Neurology, 2025. PubMed 40252663
- Balanaser M et al. Combination pharmacotherapy for the treatment of neuropathic pain in adults: systematic review and meta-analysis. Pain, 2023. PubMed 35588148
- Moisset X et al. Pharmacological and non-pharmacological treatments for neuropathic pain: Systematic review and French recommendations. Revue neurologique, 2020. PubMed 32276788
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.