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Frequently Asked Questions about Chronic Pain Management in Primary Care

Where can I find a new primary care provider?

Many primary care providers within Providence Medical Group are currently taking new patients. To establish care with a new primary care provider, call the PMG main number at 1-855-PMG-TEAM and tell them you need to establish care with a primary care provider.

Will my new primary care provider treat my chronic pain?

You will have to ask this question to any potential new primary care provider. You should be aware that many primary care providers throughout our community have chosen not to treat chronic pain as a part of their primary care practice. Many of these providers would be happy to work with you to manage other health issues, but rather than managing your chronic pain, they will insist on referring you to a pain specialty clinic such as the Montana Spine & Pain Center for management of your chronic pain. When you make your initial call to a new primary care provider’s office, it may be helpful to let the office staff know if you do not necessarily expect the new primary care provider to treat your chronic pain or to prescribe pain medication, and you would be happy to accept a referral to a pain specialty clinic. They will also need to know if you have other health issues such as high blood pressure, diabetes and high cholesterol that you need a primary care provider to manage.

What is the Montana Spine & Pain Center?

The Montana Spine & Pain Center is a multidisciplinary outpatient clinic of Providence Medical Group. The providers at the Montana Spine & Pain Center treat both acute and chronic pain. They have developed a state-of-the-art neurobehavioral rehabilitation program for patients suffering from chronic pain. The neurobehavioral rehabilitation program at the Montana Spine & Pain Center minimizes the use of medication and emphasizes the role of patient behavior change, lifestyle modification and development of enhanced pain-related coping skills.

Will the Montana Spine & Pain Center prescribe pain medications?

First, we need to clarify what we mean by "pain medications." Patients often think the only pain medications are opioid or narcotic medications such as methadone, morphine, oxycodone and so on. In fact, these types of medications are no longer typically used for treating chronic pain. Instead, anti-depressant and antiseizure medications such as Cymbalta or Neurontin are now the more commonly prescribed types of "pain medication." The providers at the Montana Spine & Pain Center most likely will not prescribe opioid/narcotic medications, but may consider prescribing anti-depressant and/or antiseizure medications with pain relieving properties.

What if I am currently taking opioid/narcotic pain medications?

Accumulated scientific research over the past couple of decades has failed to demonstrate any long-term benefit from long-term opioid/narcotic treatment for chronic pain in terms of reduced pain, improved function or improved quality of life. It has become abundantly clear there are multiple risks associated with long-term use of opioid/narcotic medications. Given this background, the providers at the Montana Spine & Pain Center have decided that in most cases the risks associated with the prescription of opioid/narcotic medications outweigh the benefits. Since this is the case, if you are currently taking opioid/narcotic pain medications, the providers at the Montana Spine and Pain Center will most likely recommend you taper off those medications.

How can I avoid going into withdrawal if I can’t find a provider who will prescribe my usual opioid/narcotic medication?

The best way to avoid serious withdrawal symptoms is to reduce the amount of medication you are taking or to decrease how often you are taking it before you run out. Consider talking with your primary care provider or your pharmacist about tapering your medication. Reducing the amount by 25% per day, may result in some withdrawal symptoms, but it is better than having to stop the medication completely when you run out. If you have enough medication, taper off more slowly, such as 10-20% every 1-7 days.

Do not break open extended release tablets or tamper with fentanyl patches, as that can release the entire dose, causing overdose and possible death. Take the entire extended release dose or use the entire patch less often. Please consult a pharmacist if you have any questions about your medication.

What are the symptoms of withdrawal?

Withdrawal can be painful, but it is not fatal. Symptoms include abdominal cramps, anxiety, sweating, diarrhea, nausea, vomiting, goose bumps, high blood pressure, insomnia, tearing, runny nose, muscle twitches, fast heartbeat, fast breathing and increased pain.

Drink a lot of fluid, try to stay calm, and keep reassuring yourself the withdrawal reaction will pass, and you will eventually feel better.

Are there other treatments for pain besides medications?

Yes. At the Montana Spine & Pain Center, our behavioral health professionals can teach you how changes in behavior and lifestyle and enhanced coping skills can help you to reduce pain, increase function and enjoy a better quality of life in which your life no longer revolves around pain but is guided by your most important personal values. Our Pain School Program is designed to provide patients with valuable information about how pain works in the human body and to dispel common misconceptions patients often have about pain, leading to unhealthy behavior which only makes pain worse.

As a part of the Pain School Program, we provide coaching and guidance in developing and pursuing goals to increase physical function and to develop neurophysiological quieting (i.e., relaxation and meditation) techniques which can be helpful in reducing short-term and long-term pain. The Pain School program is usually delivered in a group setting, but our behavioral health professionals can work with patients on an individual basis if this makes more sense. Working with you individually, we can also provide biofeedback therapy.

Learn more about the Pain School Program >>