Frequently asked questions

Many patients are referred by their primary care physician, surgeon or an emergency department, and most insurance plans in our region prefer or require a referral. Call us at 540-444-5670 and our staff will confirm what your specific plan requires before your visit.

Bring a photo ID, your insurance cards, a complete list of current medications with doses, and any recent imaging reports or discs (MRI, CT, X-ray). Completed new patient forms brought with you will shorten your check-in considerably.

Usually not. The first visit is a full evaluation: history, physical examination and review of your imaging. We want a working diagnosis before recommending a procedure, and we will explain the reasoning behind whatever we suggest.

The skin and deeper tissue are numbed with local anesthetic first, and most patients describe pressure rather than sharp pain. Light sedation is available for many procedures when it is clinically appropriate.

For most injections performed with local anesthetic only, yes. If you receive sedation, you must have a licensed driver with you. Our staff will tell you which applies when your procedure is scheduled.

Medication management is one part of our care, and where controlled substances are appropriate we prescribe them within Virginia's monitoring requirements, including prescription registry review, treatment agreements and periodic testing. Our emphasis is on finding treatments that reduce the need for long-term opioid therapy.

Local anesthetic often gives a few hours of relief right away. The steroid effect generally begins between two and seven days later and builds over the following week. Radiofrequency ablation results usually appear at two to three weeks, after post-procedure soreness resolves.

We participate with most major commercial plans, Medicare and several Medicaid managed care plans. Because networks change, please call 540-444-5670 with your plan details so we can verify your coverage before scheduling.

Please don't send personal health details through the contact form — it isn't a secure channel for protected health information. Call the office at 540-444-5670 or send a message through the patient portal, and a member of the clinical team will respond.

Yes. Our physicians provide hospital consultation and on-call coverage for patients admitted with acute or complex pain problems, and we coordinate follow-up in the office after discharge.

A pain medicine specialist diagnoses the specific structure generating your pain — a joint, a disc, a nerve — and then treats it directly with image-guided injections, nerve procedures, implantable therapies, medication management and coordinated rehabilitation. The goal is restored function, not simply a prescription.

Ask your current provider to fax records to 540-444-5669, or sign a release at our front desk and we will request them for you. Bringing imaging discs with you is the fastest route, since outside reports do not always include the actual images.

Most new patients are scheduled within about two weeks, and often sooner at one of our five offices. Our scheduling staff will offer the earliest appointment across all locations if you are willing to travel.

Yes. We treat hip, knee and shoulder joint pain, peripheral neuropathy, complex regional pain syndrome, post-surgical pain, cancer-related pain, headaches with a cervical origin and abdominal or pelvic nerve pain.

That result is diagnostic information, not a dead end. It usually means the pain generator is a different structure than we targeted, and your physician will re-examine the findings before recommending a different block, a different level or a different treatment path.

Yes. Physical therapy coordination, targeted exercise, behavioral pain strategies, TENS, and lifestyle and sleep changes all form part of a comprehensive plan. Interventional procedures work best when they open a window for those approaches to take hold.