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Chronic pain management Building a plan that keeps you moving
Chronic pain management is a long-term plan, not a single treatment. A pain management doctor finds the main source of pain, then combines active therapy and exercise with targeted treatments, such as an X-ray-guided injection, a nerve treatment or focused shockwave, used to lower pain enough for you to keep moving. The plan is reviewed often and measured by what you can do, not only by a pain score.
When pain has lasted for months or years, the goal changes. Instead of waiting for one treatment to make it disappear, good chronic pain management builds a plan that lowers pain, restores function and keeps flare-ups smaller and shorter. The videos above show pieces of that plan at Precision Care Medical & Sports Performance: focused shockwave, active physical therapy and an X-ray-guided injection. If you are still trying to work out what is causing your pain, start with a full evaluation by a pain management doctor; see what a pain management doctor does at that first visit.
The pieces of a chronic pain management plan
1. Movement and physical therapy
In the second video, our physical therapist explains why active therapy usually beats rest: muscles that are not used get weaker and stiffer, which makes everyday tasks hurt more. The third video follows a patient from exercises on the table to walking the hallway. Therapy builds strength, flexibility and confidence step by step, and it is offered at our Brooklyn and Staten Island offices. See physical and occupational therapy.
2. Targeted procedures
When one structure is driving the pain, a procedure can turn the volume down. The last video shows an X-ray-guided injection in the lower back. Options include epidural steroid injections for nerve pain, medial branch blocks and radiofrequency ablation for facet joint pain, trigger point injections for muscle knots and joint injections for arthritic joints. For a few people with long-standing nerve pain, a spinal cord stimulator trial may be discussed. These treatments open a window for therapy to work; they are not meant to stand alone.
3. Focused shockwave
The first video shows focused high-energy shockwave, which sends acoustic pulses into painful tissue over a short series of sessions. At Precision Care Medical & Sports Performance it is used for back pain, muscle pain, plantar fasciitis and knee pain that have not settled with rest and exercise, and it is performed by a nurse practitioner and physician at our Brooklyn office only. Learn more about focused shockwave therapy.
4. Daily habits
Sleep, stress, activity pacing and general fitness all change how strongly the nervous system reacts to pain. Small, steady changes, such as a daily walk, regular bedtimes and breaking big tasks into smaller ones, add up.
How progress is measured
Pain scores matter, but so does what you can do: walking farther, sleeping through the night, getting back to work or lifting a grandchild. Your clinician sets a few goals with you and adjusts the plan if they stall. For condition-specific plans, see chronic knee pain treatment and chronic neck pain treatment.
A word on medicines
Medicines can be part of a plan, but long-term use of strong painkillers has real risks and often loses effect. Your physician reviews what you take, what is safe for you, and how other treatments may reduce the need for it.
When to see a pain management doctor
See a physician if pain has lasted longer than three months, keeps interrupting sleep or work, or has not improved with the care you have tried. If your plan has stalled, see what to try when chronic pain is not improving. Get urgent care for new weakness or numbness, loss of bladder or bowel control, or pain with fever.
More videos on managing chronic pain
More clips from our YouTube channel @precisioncaremedical about therapy and treatment for long-lasting pain.
Related care at Precision Care Medical & Sports Performance
Chronic pain management near you
If you need a pain management doctor in Brooklyn, our Brooklyn pain management office at 2781 Shell Rd serves patients from Brighton Beach, Coney Island, Marine Park and Gravesend. Ashley Marcus, MD and nurse practitioner Julia Kogan, FNP see patients there, and it is the only office that offers focused shockwave. Brooklyn also has physical therapy with physical therapists Zoya Reznik, DPT, OCS and Maggie (Yi) Zhang, DPT, with physical therapist assistants Dennis Furman, PTA and Leila Nahmoud, PTA. On Staten Island, Jake Stephen, DO leads pain management on Staten Island for patients from New Dorp, Great Kills and Oakwood, with physical therapists Victoria Lynn Kain, DPT and Nicholas “Nick” Ursini, DPT for physical therapy.
For a pain management doctor in Midtown East, Yuri Gordin, MD sees patients at the Precision Care Spine & Pain Center, 150 E 55th St, convenient for patients from Washington Heights, East Harlem, the Upper East Side and Turtle Bay near UN Plaza. Physical therapy and shockwave are not offered at the Midtown Manhattan office. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled. Request an appointment or call the office closest to you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
What is chronic pain management?
It is a long-term plan for pain that has lasted more than about three months. It combines finding the source, active therapy and exercise, targeted treatments such as injections or shockwave when they fit, and daily habits that help, and it is adjusted over time.
What does a pain management doctor do?
A pain management doctor evaluates where pain is coming from, orders tests when needed, performs procedures such as X-ray-guided injections and nerve treatments, and coordinates a plan with physical therapy and your other doctors.
Is rest or exercise better for chronic pain?
For most chronic pain, staying active is better than long rest. Muscles that are not used become weaker and stiffer. A physical therapist can help you increase activity at a pace your body tolerates.
What is focused shockwave therapy?
It is a non-invasive treatment that sends focused acoustic pulses into painful tissue over a short series of sessions. At Precision Care Medical & Sports Performance it is used for back pain, muscle pain, plantar fasciitis and knee pain, performed by a nurse practitioner and physician at the Brooklyn office.
Will injections fix chronic pain?
Injections can lower pain and inflammation for a period of time, which makes it easier to exercise and do therapy. They work best as one part of a plan rather than on their own.
Where can I find chronic pain management near me?
Precision Care Medical & Sports Performance offers pain management in Brooklyn, on Staten Island and in Midtown Manhattan. Physical therapy is offered in Brooklyn and Staten Island and focused shockwave in Brooklyn only.
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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