Treatment Philosophy

Excel Pain and Spine is a privately-run practice owned and operated solely by physicians that have trained, taught, and researched at the top pain medicine institutions in the country.

Our physicians are regarded experts in the pain management field and remain involved with teaching new and advanced treatments to practicing physicians, residents, medical students, and fellows across the county.

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Treatments - Opioid Medication Management in Concordance with CDC Guidelines


Does Excel Pain and Spine provide opioid medications?
In select cases Excel Pain and Spine does perform a chronic opioid medication management within the guidelines set forth by the Center for Disease Control. Our Pain Services Center specializes in comprehensive pain, including spine pain, diagnosis and treatment. Our treatment focuses on the management of pain best treated with a multidisciplinary approach that involves an increase in physical activity to prevent deconditioning and worsening of the pain cycle. We always consider interventional pain medicine strategies such as nerve blocks, corticosteroid injections, and radiofrequency ablation; to lower the person's pain so that they may participate in the physical activity that will produce long-lasting pain reductions. We consider non-opioid medication such as NSAIDs, antidepressants, anticonvulsants, topical treatments and others. The goal of the multidisciplinary approach to pain medicine is maximizing pain reduction, improving health-related quality of life, independence and mobility, enhancing psychological wellbeing and preventing secondary dysfunction.

Will I be prescribed medication at my first visit?
It is our policy that we do not prescribe controlled substances (opioid medications) at the first clinic visit.

Having an appointment in the pain clinic does not guarantee that the pain physician will agree with the referring physician’s plan of care and the pain physician may not elect to continue controlled substance therapy.

Further, under this policy, all pain clinic practitioners are required to obtain a urine drug screen prior to prescribing controlled substances; controlled substances will not be written until the confirmatory results are obtained - approximately 2 weeks.

What do I do if I will run out of medications before my second visit?
Please be aware if you are receiving controlled substances (for example opioid pain medications); it is clinic policy that the referring/prescribing physician continues his/her plan of care past the first pain clinic visit. If you have been provided with only sufficient medications to get to the pain clinic appointment date, you will be asked to follow-up with your referring/prescribing physician or your primary care doctor for refills until our urine drug testing has returned.

Does Excel Pain and Spine prescribe benzodiazepines and opioid together?
Please be aware, we do not prescribe benzodiazepines as this class of medication does not provide pain-relief and acceptable non-benzodiazepine medications are available. These medications with opioids have been proven to be dangerous when used together. Examples of these medications are Xanax (alprazolam) and Ativan (lorazepam).

How often do I come for follow-up visits?
All patients on chronic opioid therapy will be followed with frequent clinic visits. These visits are typically every 1-3 months depending on what medication is provided. All patients will have periodic drug screens. Patients must have functional improvement to continue on this class of medications. In addition, they must be low risk for addiction and opioid misuse disorder. Our goal as a clinic is overall to minimize opioids with the use of interventional and adjuvant therapies.

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