What chronic pain is
Acute pain is a warning signal that fades as an injury heals. Chronic pain is different. It lasts beyond three months, often long after the original injury has healed, and the nervous system itself becomes part of the problem, amplifying signals and keeping them going. That is why chronic pain does not always match a scan, and why it wears on sleep, mood and concentration as much as on the body.
The patients we see in Davie and Boynton Beach usually fall into a few groups:
- Arthritis and spine wear. Osteoarthritis of the knees, hips, hands and spine, degenerative disc disease and spinal stenosis. The most common source of long-term pain in adults over fifty.
- Fibromyalgia. Widespread muscle pain and tenderness with poor sleep, fatigue and difficulty concentrating, in the absence of joint damage. It is a real diagnosis with real treatments, and it is often missed.
- Old injuries that never settled. A back, neck or joint injury from years ago that left pain behind.
- Nerve pain. Neuropathy, pain after surgery and other nerve conditions, covered on our nerve pain page.
- Pain with no clear cause. Some patients have had every test and been told nothing is wrong. The pain is still real, and we do not need a perfect explanation to treat it.
How our pain physicians treat it
Managing chronic pain well takes time, so the first visit is a full consultation. The doctor takes a complete history of the pain and everything that has been tried for it, examines you, reviews your imaging and records, and asks about sleep, mood, work and what you have stopped doing because of the pain. You leave with a written plan and functional goals.
The plan is built from the options that fit your pain, and usually from more than one:
- Medication management, described in detail below.
- Trigger point and joint injections for muscle and arthritic pain.
- Nerve blocks for pain that follows a specific nerve or comes from a specific joint.
- Knee gel injections for knee arthritis and PRP for joint and tendon pain.
- StemWave shockwave therapy at our Davie clinic for patients who want a non-drug option.
- Referrals we coordinate: physical therapy, epidural steroid injections, spinal cord stimulator evaluation, surgical opinions and counseling.
Does insurance cover it? Pain management consultations, follow-up visits, medication management, trigger point injections, joint injections and nerve blocks are covered by Medicare, Aetna, Blue Cross Blue Shield and Cigna when medically necessary. Some plans require prior authorization for injections or for certain medications, which our front desk handles. PRP and StemWave are cash services. Read more about insurance and self-pay.
Medication management and Florida's rules
Medication is one tool among several, and we use it carefully. The doctor starts with non-opioid options: anti-inflammatories, nerve pain medications, muscle relaxants, topical treatments and, for fibromyalgia, medications that act on sleep and the nervous system. Many patients do well on these alone.
When a controlled medication is appropriate, Florida law sets out how it must be prescribed, and we follow those rules to the letter. In plain terms:
- An exam on the same day as any controlled prescription. The doctor must examine you in person on the day a controlled medication is prescribed or renewed. Prescriptions are not called in or issued without a visit.
- A written agreement. Before starting, you and the doctor sign an agreement that sets out how the medication will be used, that it comes from one prescriber and one pharmacy, and what happens if the terms are not kept.
- Regular follow-up. Patients on controlled medication are seen at set intervals, usually monthly at first and no less than every three months once stable, so the dose stays the lowest that works.
- Monitoring. The doctor checks the state prescription database before prescribing and uses periodic urine drug testing.
What to expect
- Before you come in, we verify your insurance and ask you to bring photo ID, a full list of current and past pain medications, and any imaging or records from other doctors.
- At the consultation, the doctor takes your history, examines you and explains what is driving the pain and what the first steps are.
- You leave with a written plan and functional goals you can measure progress against.
- Follow-up is scheduled based on the plan, monthly or quarterly, and the plan is adjusted at each visit.
Will you prescribe the medication my previous doctor gave me?
Not automatically. The doctor reviews your records and examines you first. If you are on a controlled medication, bring the bottles and your previous doctor's records, and understand that a same-day exam, a written agreement and monitoring are required by Florida law.
Do you treat fibromyalgia?
Yes. Fibromyalgia is managed with medications that address sleep and nerve sensitivity, trigger point injections for the most tender areas, activity guidance and, where helpful, a referral for counseling. Opioids are not recommended for fibromyalgia and we do not use them for it.
What if no one has found a cause for my pain?
That is common with chronic pain, and it does not mean the pain is imagined. The consultation looks for anything that has been missed, and treatment can begin even when the cause is not certain.
How often will I need to come in?
It depends on the plan. Patients on injections or non-controlled medication are usually seen every one to three months. Patients on controlled medication are seen monthly at first, as Florida requires.
Which clinic should I go to?
Both clinics offer pain management consultations, medication management, injections and nerve blocks. Davie serves Broward County and Boynton Beach serves Palm Beach County. StemWave shockwave therapy is available at Davie only.