Brain, Nerve & Chronic
Chronic Pain
When pain has lasted months — modern interventional options.
Chronic pain — pain lasting more than 3 months — is a different problem than acute pain. It often involves changes in how the nervous system processes pain signals, not just ongoing tissue damage. Effective management is rarely a single intervention; it's a combination of interventional procedures, physical therapy, medication management, and lifestyle work. Dr. Steve Hong, our interventional pain specialist and a five-time D Magazine Best Doctor, leads our chronic pain program.
Understanding the Condition
What is Chronic Pain?
Acute pain serves a purpose — it warns of injury and protects healing tissue. Chronic pain often outlasts that purpose, sometimes after the original injury has healed, sometimes from ongoing structural issues, and sometimes from changes in the nervous system itself ('central sensitization'). Common chronic pain syndromes include chronic back/neck pain, failed back surgery syndrome, complex regional pain syndrome (CRPS), neuropathic pain, and persistent post-surgical pain.
The goal of chronic pain management is functional improvement — getting back to the activities that matter — not just numerical pain scores. Modern care emphasizes interventional procedures (epidurals, ablation, spinal cord stimulation) over long-term opioid reliance.
Common Causes
- Structural spine disease (herniated disc, stenosis, failed back surgery)
- Joint disease (arthritis, post-traumatic arthritis)
- Neuropathic pain (diabetic neuropathy, postherpetic neuralgia, CRPS)
- Persistent post-surgical pain
- Central sensitization (the nervous system 'volume turned up')
- Cancer-related pain
- Headache disorders
Common Symptoms
- Pain lasting more than 3 months
- Pain interfering with sleep, work, or daily activity
- Mood symptoms (depression, anxiety, frustration)
- Sleep disturbance
- Decreased physical activity and deconditioning
- Reliance on pain medications without adequate functional improvement
When to Seek Care
When Should You See a Specialist?
See an interventional pain specialist when pain has lasted 6+ weeks despite standard care, when it's limiting work or daily function, or when you're being managed primarily on opioids and want to reduce reliance. New patients are typically seen at Axis within one week.
Treatment Options
How We Treat Chronic Pain
We always begin with the least invasive treatment that's likely to work for you. Surgery is reserved for cases where conservative care has been given a fair trial — or when the situation truly requires it.
Conservative (Non-Surgical) Care
- Image-guided epidural steroid injections
- Facet joint injections and radiofrequency ablation
- Sacroiliac joint injections
- Peripheral nerve blocks
- Spinal cord stimulation (for refractory neuropathic pain)
- Trigger point injections
- Botox for select chronic pain syndromes
- Multidisciplinary pain management (PT, behavioral health, medication management)
- Opioid tapering programs when appropriate
Surgical Options
- Spinal cord stimulator implantation (after successful trial)
- Peripheral nerve stimulator implantation
- Intrathecal pump implantation (for select cases)
- Underlying surgical lesion repair (referred to spine, joint, or neurosurgery as appropriate)
Recovery & Outlook
What to Expect After Treatment
Chronic pain rarely 'goes away' completely, but it can reliably be reduced and made manageable. Most patients in our chronic pain program report significant improvement in pain severity, function, and quality of life. Spinal cord stimulation specifically has 60–80% success rates in well-selected candidates.
Meet Your Team
Specialists Who Treat Chronic Pain
Chronic Pain — Frequently Asked Questions
Related Conditions
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Low Back Pain
The most common musculoskeletal complaint, with causes ranging from muscle strain to structural issues.
Headache & Migraine
Cervicogenic headaches, chronic migraines, and surgical migraine treatment for medication-resistant cases.
Neuropathy & Nerve Pain
Damage to peripheral nerves causing weakness, numbness, and pain in hands and feet.
Arthritis
Degenerative joint disease causing pain, stiffness, and reduced range of motion.
Get Expert Help for Chronic Pain
Our specialists can diagnose your condition and design a personalized treatment plan that gets you back to the life you love.