Frequently Asked Questions
What is chronic pain?
The term “chronic pain” refers to pain that’s lasted three or more months, or pain that persists after an original injury or surgery has healed.
What type of training do pain management doctors have?
Most pain-management doctors specialized in anesthesiology before subspecializing in interventional pain medicine via a fellowship program. This training uniquely prepares physicians to treat acute, chronic, and cancer pain. To find a reputable specialist in this field, choose someone who is double board-certified, like Dr. Gilthorpe. He is a diplomate of both the American Board of Pain Medicine and the American Board of Anesthesiology.
What can I expect when I see my pain-medicine doctor?
Dr. Gilthorpe will perform a physical exam and review radiographic images and medical records before devising a full treatment plan: one that’s specific to each individual patient. Each regimen includes a multimodal approach that might combine a procedure or minimally invasive surgery paired with physical therapy, counseling, or certain lifestyle changes. Effective and long-term pain relief is best achieved through a variety of methods.
Can I request an injection or procedure on my first visit?
Dr. Gilthorpe may perform certain procedures — like injections and epidurals — on the spot, insurance and other factors permitting. Cash-pay patients can typically undergo procedures in the same visit, since they don't have to wait for authorization approvals from insurance carriers. If you have insurance, our staff works quickly and diligently to obtain authorizations so we can treat you as soon as possible.
How long do steroid injections last?
Immediately following an injection, patients may feel temporary relief from the local anesthesia. This will wear off over the course of the day, but soon after, the second medication begins to kick in. This longer-acting remedy might take up to a week to fully effectuate, but once it does, it can offer relief from six weeks to six months — or longer. Our patients typically schedule periodic steroid-injection appointments, knowing they can always cancel if their pain has fully subsided. Our favorite calls are from patients who say they're feeling great and don't have to return.
Other than injections, what are my options?
Intrathecal pain pumps, kyphoplasty, minimally invasive lumbar fusion and spinal-cord stimulators are among the potential interventional treatments. Medication is prescribed conservatively for those patients who need it.
Am I a good candidate for spinal-cord stimulation (SCS)?
The evidence for effective pain relief by spinal-cord stimulation is strong. In one study, 77% of patients reported a major improvement in pain relief six months from their surgery. “The vast majority (more than 80% of participants) were satisfied or better on subjective reports and would recommend it to others,” the study said.
An important caveat: SCS can vary in effectiveness depending on who performs the implant. If the pain-medicine physician you choose isn’t skilled in implanting stims, your pain-relief results may not be as pronounced. So choose wisely.
An added benefit of SCS is that you have the opportunity to gauge how it will work for you during a one-week trial (here's a peek at a stim trial). If you’re happy with your pain relief during that time, the device will be implanted by-way-of a minimally invasive surgery in an outpatient setting.
You may be a good candidate for SCS if you’ve:
Had spine surgery and continues to have pain.
Undergone multiple surgeries and continue to have pain.
Suffer from Complex Regional Pain Syndrome, Causalgia or Reflex Sympathetic Dystrophy.
Have tried a trial with your doctor’s guidance and found that it provided sustained relief.
If my pain stems from osteoporosis, what might be my best form of treatment?
For many people with osteoporosis, kyphoplasty is a great, evidence-based procedure. It can correct bone deformities and relieve pain from compression fractures (also known as wedge fractures). It entails inflating a balloon inside the compressed vertebral body then placing specialized bone cement that will provide support. Take a look at it in action on our Facebook page.
What is Vertiflex?
Vertiflex is a minimally invasive procedure during which an interspinous spacer is placed to help open the spinal canal. The titanium spacer helps to open the spinal space and keep pressure off of the nerves that can cause back and leg pain.
What is pain management?
Responsible pain management consists of a multimodal approach to controlling and minimizing pain. Treatment plans typically include lifestyle modifications; physical therapy; and interventional procedures such as spinal-cord stimulators, injections, pain pumps and epidurals among others. If these don't adequately address our patients' conditions, we may refer them to other specialists, such as neurosurgeons, with whom Dr. Gilthorpe works closely. Additionally, patients may be referred for cognitive behavioral therapy, or other types of psychological support, since long-term pain can be associated with depression and anxiety. Our goal is to treat you inside-out to improve your quality of life.
Will I ever be asleep — under general anesthesia — for procedures?
Most interventional procedures can be performed at Better Life Spine & Pain Center's in-office procedure suite. For patients who have severe anxiety or needle phobia, procedures can be completed with sedation at Houston Methodist Willowbrook Hospital. Minimally invasive surgeries are performed at Houston Methodist Willowbrook, or other local hospitals, depending on insurance coverage.