---
title: "Chronic Pain Syndrome"
---
## What Chronic Pain Syndrome Actually Means
If you have been diagnosed with chronic pain syndrome, you may already know that the term does not tell you much. It describes a pattern, pain that has persisted longer than expected, often with multiple contributing factors, but it does not identify what is actually causing your pain or what to do about it.
In some cases, chronic pain syndrome is a legitimate diagnosis describing real changes in how your nervous system processes pain: signals that originally indicated tissue damage continue to fire after the original cause has resolved, the nervous system becomes increasingly sensitized, and sleep, mood, and quality of life are affected. In other cases, it is essentially a placeholder diagnosis used when previous evaluation has not identified a clearer source. The first step in our approach is figuring out which one applies to you, because for some patients a more focused evaluation reveals a specific treatable source, and for others the diagnosis is accurate and the focus shifts to treatments that address nervous system sensitization directly.
## When Chronic Pain Syndrome Has a Specific Source
For some patients labeled with chronic pain syndrome, focused evaluation reveals a more specific underlying condition that responds well to targeted treatment. Examples include facet-mediated spinal pain that has not been correctly identified, sacroiliac joint dysfunction treated as general back pain, specific nerve entrapments or peripheral neuropathies, vertebrogenic pain patterns, and joint or tendon issues that fit regenerative treatment.
When this is the case, the right treatment is usually the one specific to the underlying condition rather than a generic chronic pain approach. We route patients to the appropriate evaluation and discuss this on the related condition pages.
## When Chronic Pain Syndrome Is the Accurate Diagnosis
For other patients, the diagnosis is accurate, and the focus shifts to treatments that address chronic nervous system sensitization directly, working through different mechanisms than standard injections or medications.
Nerve blocks can interrupt specific pain pathways and sometimes produce sustained relief that outlasts the local anesthetic, and successful blocks can also be diagnostic. Radiofrequency ablation disrupts the nerves carrying pain signals from specific structures, providing longer-lasting relief for selected patients. Peripheral nerve stimulation uses small electrical signals to interrupt chronic pain signaling along specific nerves; for patients whose pain has a focal nerve distribution, the 60-day temporary system can produce meaningful relief without the systemic effects of long-term medications. Ketamine infusion therapy acts on a different pathway than most pain medications, with accumulating evidence for chronic pain involving central sensitization, particularly when pain coexists with mood overlap or sleep disruption; PHI administers physician-monitored ketamine in a clinic setting.
## When to See Someone
Consider professional evaluation when you have been managing chronic pain for months or years without lasting relief, when standard treatments have not produced adequate response, when you are tired of the trial-and-error approach with medications, when you want a thorough re-evaluation to see whether a more specific source can be identified, when you are interested in treatments like ketamine infusion or peripheral nerve stimulation that are not widely available, or when you want a clear plan rather than continued symptom management without direction.
## Why PHI for Chronic Pain Syndrome
## Frequently Asked Questions
**Q: Is chronic pain syndrome a real diagnosis?**
Yes, when used appropriately. It describes real biological changes in how the nervous system processes pain, often after months or years of ongoing pain signals. The challenge is that the term is sometimes used as a placeholder when more specific evaluation has not been done, which is why thorough re-evaluation often matters.
**Q: Will I need to take medication forever?**
This depends entirely on your situation. Many patients can reduce or eliminate the need for chronic pain medications when interventional treatments, ketamine infusion, peripheral nerve stimulation, or other targeted approaches address the underlying contributors. Others use medication as one component of a broader plan. The goal is the right level of medication for your situation. PHI does not provide ongoing medication management.
**Q: Is ketamine actually safe for chronic pain?**
Physician-administered ketamine for pain has accumulating evidence and an established safety profile when delivered appropriately. PHI uses subanesthetic doses well below surgical anesthesia, administers infusions in a clinic setting under continuous monitoring, and structures treatment as a defined series rather than open-ended dosing. This is meaningfully different from recreational ketamine use.
**Q: How is peripheral nerve stimulation different from spinal cord stimulation?**
Spinal cord stimulation places leads near the spinal cord to treat broader pain patterns. Peripheral nerve stimulation places leads directly near a specific peripheral nerve to treat pain in that nerve's distribution. PNS is generally appropriate for more focal pain; spinal cord stimulation for more diffuse pain.
**Q: Will I need to repeat treatments?**
This depends on the specific treatment. Radiofrequency ablation provides relief for 6 to 18 months and may be repeated. Ketamine infusions sometimes work as a discrete series, with maintenance sessions for some patients. Your physician will set realistic expectations based on the specific recommendation.
**Q: Should I try interventional treatment if previous injections didn't help?**
Possibly, depending on what was tried and how. Many patients have had injections that were not precisely targeted to the source of their pain, or that were the wrong type for their actual condition. Diagnostic and targeted re-evaluation often identifies whether interventional treatment makes sense and which specific procedure to consider.
**Q: How is PHI different from other pain practices?**
Many pain practices offer one or two treatment types and refer everything else out. PHI offers the full range of interventional, regenerative, and infusion-based treatments under one roof, and we take time for thorough re-evaluation rather than running patients through standardized treatment algorithms.
**Q: Do you take insurance?**
PHI is a concierge practice and is out-of-network with all insurance plans. All pricing is transparently disclosed at consultation.
**Q: Do you accept international patients?**
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.
## Treatments We Offer for Chronic Pain Syndrome
PHI offers evidence-based treatments for chronic pain syndromes. Your physician will recommend the right option, or combination, based on your specific situation, what you have tried, and your goals.
- Nerve Blocks, diagnostic and therapeutic
- Radiofrequency Ablation, 6 to 18 months of relief for selected patients
- Peripheral Nerve Stimulation, the 60-day temporary system
- Ketamine Infusion Therapy, for central sensitization
> Chronic pain: an update on burden, best practices, and new advances. The Lancet.
— [Cohen SP, et al.](https://pubmed.ncbi.nlm.nih.gov/34062143/)
> Ketamine for Complex Regional Pain Syndrome and chronic pain: a narrative review highlighting dosing practices and treatment response. Peer-reviewed via PMC.
— [Lii TR, et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC10688501/)
> Consensus guidelines for the use of peripheral nerve stimulation in the treatment of chronic pain: a Neuron Project from the American Society of Pain and Neuroscience. Peer-reviewed via PMC.
— [Latif U, et al.](https://pmc.ncbi.nlm.nih.gov/articles/PMC12614495/)
## Schedule Your Chronic Pain Syndrome Consultation
A 60-minute consultation will thoroughly re-evaluate your situation, identify whether more specific diagnostic options exist, and walk through the treatment options that match your specific condition. Call (310) 856-9488 or book online now.
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