Patient Frequently Asked Questions

DSC_0177 (2)How do I become a new patient?

We prefer that you are referred to the UF Pain and Spine Center by your primary care physician, surgeon or specialist. The referring physician can complete our consult questionnaire and fax – (352) 265-7778 – it directly to us. We will evaluate the form and contact you to schedule an appointment for consultation. If your insurance requires you to have a referral, you must also obtain an appropriate referral from your primary care physician. If your insurance does not require a referral, then we accept self-referrals from the patient.

What types of insurance do you accept?

We accept most major health care plans. Please contact us at (352) 265-7777 – and speak with a representative to verify that we accept your insurance. What kind of bills will I receive? Since we are a university and hospital-based clinic, you will receive two bills if you have a procedure performed. The first bill is from the physician for his/her services. The second is a facility fee from the clinic.

What can I expect during my first visit?

You will be evaluated initially by one of our physicians assistant (PA), resident physicians or pain medicine fellows who will gather important information about your pain and perform a physical exam. After hearing about your pain history and pain examination, one of our faculty pain physicians will discuss options for treatment and answer your questions. The faculty physician will guide your course of treatment, although you will encounter different residents and fellows during your visits.

Who will be involved in my care?

You will be seen by various medical professionals during your visit. Since we are an academic teaching institution, there will be residents and fellows involved in your care working under the direction of your attending physician. This offers the advantage of many physicians thinking about your conditions and care. There will also be nurses and medical assistants who assist with your care during your visit.

What can I expect when I call to speak with my doctor?

We do offer a physician answering line that allows you to leave a message for a physician. Your call will usually be returned by one of our nurses or physicians assistants who have access to your medical records from our clinic. If they are unable to assist with your question or problem, your questions will be directed to the attending physician.

What course of treatment can I expect from this clinic?

We typically perform an initial consultation and then decide on the best course of treatment. This may include injections, implantations, medications, physical therapy, behavioral therapy (pain psychology), pain psychiatry, addiction medicine, enrollment in one of our research studies, or even no further clinic treatment. If we recommend certain pain medications, we may ask your primary care physician to assist us in prescribing them, especially once you have achieved a stable dose of medication. We strive to schedule injections within two weeks of the initial consultation. If we have an opening in the schedule, we may be able to schedule an injection on the same day of your initial clinic consultation.

What can I expect if I’m talking opioids (narcotics) and my doctor will no longer write the prescriptions?

We will evaluate your list of medications during the initial visit and provide our recommendation to yourself and your primary doctor about continuing opioid therapy. We may recommend another course of treatment that does not include opioids. We do not write prescription for opioids , so please do not arrive with the expectation that we will automatically refill your prescription.

My doctor says that because of the new Florida law (anti-Pill Mill Law) he/she cannot prescribe pain medications including opioids and only pain doctors can, what do I do?

This is not quite accurate.  The law bans dispensing (in other words acting like a pharmacy) opioid (narcotic) and other schedule II medications (Xanax and the like).  It does not change the primary care doctor, surgeon, or other non-pain specialists’ ability to write these medications.

Where are the procedures (injections, interventions, surgeries) performed?

All pain procedures are performed at the new Shands Florida Surgical Center (note: the surgical center is not on the campus of the main Shands Hospital, map it)

Location: Shands Florida Surgical Center.

The Shands Florida Surgical Center is an outpatient, ambulatory surgical center that provides services to a diverse group of patients from all age groups. University of Florida physicians and Shands HealthCare staff members are committed to providing quality medical care in a fully equipped setting. You will find that our skilled staff offers excellent physical and emotional support to our patients and families at every point in their stay – before, during and after surgery.

Why can’t I drive or eat if I’m scheduled for a procedure?

Some procedures may require sedation that prevents you from safely eating or drinking. Also, some procedures may inhibit movement in parts of your body that would make it difficult or unsafe for you to drive. Since we cannot be sure how the treatment will affect you, we require you to follow instructions that will be provided.

What is chronic or persistent pain?

Chronic pain is pain that persists for weeks, months or years despite medical therapy and intervention. Unlike acute pain, it doesn’t subside after an initial injury or illness. In fact, some people suffer through decades of chronic pain in the absence of any specific past injury or evidence of disease.

Chronic pain may be intermittent or continuous. It may affect people to the point that they cannot work, eat properly, participate in physical activity, or enjoy life. It is considered a major medical condition that should be treated and can be managed effectively. Autoimmune conditions, diabetes and heart disease can also bring on chronic pain.

Chronic pain is one of the most costly health problems in the US. Increased medical expenses, lost income, lost productivity, compensation payments, and legal charges are all negative economic consequences of chronic pain.  See IOM Report Relieving Pain in America.

According to the American Pain Society, about 86 million people in the United States cope with some form of chronic pain.

Low back pain is one of the most significant health problems. According to the Centers for Disease Control and Prevention (CDC) 70 percent to 85 percent of all people have back pain at some time in their life. Back pain is the most frequent cause of activity limitation in people younger than 45 years old.

Cancer pain affects the majority of patients in intermediate or advanced stages of cancer. About 1.4 million new cases of cancer are diagnosed each year in the US.

Arthritis pain affects nearly 46 million Americans each year.

Headaches, according to the National Institute of Neurological Disorders and Stroke (NINDS), affect millions of US adults. The three most common types of chronic headaches are migraines, cluster headaches, and tension headaches.

What are the major issues surrounding chronic pain?

Chronic pain can become so intense and overwhelm the body and mind to such a degree that it can affect all aspects of life. Pain often becomes so invasive they often cannot work, their appetite falls off, physical activity of any kind is exhausting and often aggravates the pain, and fatigue is common due not being able to sleep at night. The person then becomes the victim of a vicious cycle in which total preoccupation with pain leads to irritability and depression.

What medications are most commonly used to manage pain?

While drug therapies can differ, the most common are:

Adjuvant pain medications, including: antidepressants (nortriptyline), anticonvulsants (gabapentin) and muscle relaxants (baclofen, flexeril).

Opioids (morphine) or “narcotic pain killers” used to treat acute pain or cancer-related pain, and are occasionally recommended for persistent pain.

NSAIDs (ibuprofen, naproxen) are anti-inflammatory drugs to alleviate pain by reducing swelling and irritation.

There are alternative delivery methods for medications. Common methods used at the office are oral medications, topical creams, sublingual medicines, nasal sprays, injections and patches.

What are the most common problems that result in chronic pain?

While there are a multitude of conditions that may lead to chronic pain, we have found the following to be most prevalent in our patients:

  • Low back pain
  • Spinal stenosis
  • Vertebral Compression Fractures
  • Cervical and lumbar facet joint disease
  • Sciatica/Radiculopathy (“pinched nerve”)
  • Sacroiliac joint disease
  • Failed back surgery pain (FBSS) / Post-Laminectomy Neuropathic Pain
  • Neuropathic (Nerve) pain
  • Head pain / Occipital neuralgia (Scalp/head pain)
  • Hip pain
  • Intercostal neuralgia (Rib pain)
  • Peripheral neuropathy (Diabetic nerve pain)
  • Complex regional pain syndrome (Reflex Sympathetic Dystrophy –  RSD)
  • Herniated discs and degenerative disc disease (discogenic pain)
  • Neck pain
  • Shoulder and knee arthritic pain (osteoarthritis)
  • Myofascial (Muscular) pain
  • Post surgical pain
  • Cancer pain (pancreatic, colorectal, lung, breast, bone)
  • Pain from peripheral vascular disease
  • Anginal pain (chest pains)
  • Post-herpetic neuralgia (shingles pain)
  • Nerve entrapment syndromes
  • Spastisticy related syndromes/ pain
  • Spinal Cord Injury (central pain)
  • Pelvic pain
  • Thoracic outlet syndrome

When should a person seek a pain medicine physician?

You should seek a pain management expert when pain does not respond to the usual and customary treatments within a reasonable period of time. All too often, people see pain management as a last resort for pain. If pain persists — contact your doctor or an accredited pain management expert immediately.

What to expect when you begin treatment?

If you have acute (or recent) spine or extremity pain you can usually expect a limited number of simple medications, physical therapy and pain injections (interventional therapy such as epidural steroid injections or facet joint blocks).

The majority of chronic (persistent) pain patients, the sensation of pain will NOT be eliminated. BUT, with treatment you can drastically change how much the pain affects your life. Chronic pain is a disease that can be managed effectively. You should expect your pain management team to work with you and your primary care provider to effectively manage your chronic pain condition with all of the expertise and tools available as long as you need help.