The evaluation of chronically painful disorders starts with a clear determination of the underlying condition. Whenever a patient is seen in our practice, the evaluating physician does a careful review of available medical records and, if possible, discusses the case with the referring physician. We review previous studies and determine if further studies are needed.

Once the diagnosis of the underlying condition is clear, a more extensive look at the type of pain the patient is experiencing is explored. Pain is evaluated from several different sources, including nerve pain, referred pain, mechanical pain, inflammatory pain, muscle spasm pain, and central nervous system pain enhancement. Additionally, a careful exploration of the patient's psychological state, past medical history, past psychiatric history, social and family history is developed. We put together all of this information, plus a careful mental status examination to come up with a diagnosis that incorporates the biological, psychological and social issues affecting each of our patients.

Finally we look at the type of problems our patients are dealing with and come up with treatment strategies for reducing pain and repairing damaged lives. One of the most important aspects of our initial evaluation is to determine if the patient can establish a partnership with treating physicians to maximize the possibility of a positive treatment outcome.