What a pain management consultation involves
The first visit is the most important one, so we do not rush it. The doctor takes a full history of your pain: where it is, how it started, what makes it better or worse, what has been tried and what it is stopping you from doing. Then a physical exam of the painful area and the joints, nerves and spine around it, because pain travels and the source is not always where it hurts.
Any MRI, X-ray or CT you already have is reviewed with you. If imaging or nerve testing is needed, it is ordered at that visit. You leave with a written treatment plan and functional goals that are specific to you: sleeping through the night, walking to the mailbox without stopping, getting through a shift. Follow-up is monthly or quarterly depending on the plan, and at each visit we measure progress against those goals and adjust.
Dr. Irvine Mason, our medical director, is double board-certified in pain management and neurology with more than fifty years in practice. Dr. Charley Scheim brings twenty years in neurology and chronic pain. Meet the full team.
Medication management
Medication is part of in-network plans but rarely the whole of one. We start with non-opioid options at the lowest effective dose and review at every visit. When a controlled medication is appropriate, it is prescribed under Florida's rules: an in-person exam on the day of each prescription, a written agreement, regular follow-up and monitoring. Read about medication management.
Trigger point and joint injections
Trigger point injections release the knotted bands of muscle behind much neck, shoulder and back pain, usually in a short series. Steroid injections into the knee, hip, shoulder or an inflamed bursa calm the joint for weeks to months and confirm where the pain is coming from. Both are done in the exam room, with ultrasound guidance where it helps. Read about injections.
Nerve blocks
When pain follows a specific nerve, numbing that nerve can relieve it and tells us whether it is the source. We perform occipital nerve blocks for headaches that start at the back of the head, genicular nerve blocks for knee arthritis, suprascapular blocks for the shoulder, and other peripheral nerve blocks, all in the exam room without fluoroscopy. The relief you get is documented so the next step is based on evidence. Read about nerve blocks.
Knee gel injections
Hyaluronic acid injected into an arthritic knee cushions and lubricates the joint. Given as a series, it can provide six months or more of relief and is covered by Medicare for documented knee osteoarthritis. For many patients it is the step that delays or avoids a knee replacement. Read about knee gel injections.
PRP injections
Platelet-rich plasma is prepared from a small sample of your own blood and injected under ultrasound guidance into a damaged tendon or an arthritic joint to support its repair. It is used for rotator cuff and elbow tendon problems, plantar fasciitis and mild to moderate knee arthritis. PRP is a cash service. Read about PRP.
StemWave shockwave therapy
Acoustic wave therapy delivered through the skin to painful tendons, fascia, muscles and joints, with no needles, medication or downtime. It is our lead treatment for plantar fasciitis and tendon pain and an option for patients with back, knee and joint pain who want to avoid injections. Offered at our Davie clinic as a cash service. Read about StemWave.
Conditions we treat
- Back pain and sciatica
- Neck pain and pinched nerve
- Knee pain and arthritis
- Shoulder, hip and joint pain
- Heel pain and plantar fasciitis
- Nerve pain and neuropathy
- Work and auto injury
- Chronic pain
Does insurance cover it? Consultations, follow-up visits, medication management, trigger point and joint injections, nerve blocks and knee gel injections are covered by Medicare, Medicare Advantage, Aetna, Blue Cross Blue Shield and Cigna when medically necessary. Prior authorization is often required for injections and our front desk handles it. We accept workers' compensation and auto injury (PIP) claims. PRP and StemWave are cash services. Self-pay is available for everything. Read more about insurance and self-pay.
Do I need a referral to see a pain physician?
Most patients do not. Some HMO and Medicare Advantage plans require a referral from your primary care doctor, and the front desk will tell you when they verify your coverage.
How do I get an appointment?
Book online through Zocdoc or phone either clinic. The front desk confirms your coverage, offers you a suitable appointment at Davie or Boynton Beach and tells you what to bring.
Will I be prescribed opioids?
Not as a first step. We start with non-opioid medication and procedures. When a controlled medication is appropriate, it is prescribed with a same-day exam, a written agreement, regular follow-up and monitoring, as Florida law requires.
Do you do epidural injections or spinal cord stimulators?
Not in our offices. When imaging and symptoms call for an epidural steroid injection or a stimulator evaluation, we coordinate the referral and continue to manage your care.
Which clinic should I go to?
Davie serves Broward County and Boynton Beach serves Palm Beach County. Both clinics offer the full range of consultations, injections, nerve blocks and medication management. StemWave shockwave therapy is available at Davie only.