First pain management appointment
For your first pain management appointment, bring the imaging, the med list and everything you have stopped doing. We do not need you to edit the story first.
What happens at a first pain management appointment, what to bring, and the honest answer to the question people are afraid to ask: what not to say to your pain doctor. Say everything. This practice does not sort patients by how their story sounds.
What actually happens
No procedure happens on day one. The first visit is for taking a full history and examining you. It is not for deciding in ten minutes what to inject. Expect questions beyond the painful area itself — sleep, weight change, mood, work, and what a typical day looks like now compared with before the pain started. That is not small talk. Pain rarely has a single cause. The questions that seem off topic are usually the ones that matter most to the plan.
What to bring
- Imaging you already have — the actual images on a disc or through a patient portal if possible, not just the radiologist’s summary.
- A current medication list, including anything over the counter and any supplements, with doses.
- A record of what you have already tried — physical therapy, injections elsewhere, and medications that did or did not help.
- A specific list of what you have stopped doing because of the pain — work tasks, sleep positions, activities with your kids. This tells us more than a 0-to-10 number ever will.
- Insurance information and, if this is work- or accident-related, the claim or case details.
What not to say to your pain doctor
The honest answer is that you do not need to leave anything out. A study of chronic pain clinic visits found that patients are often interrupted within the first minute of their opening statement. That happens before they finish describing what brought them in. That pattern is exactly what makes people start editing their own history in the waiting room. They decide which parts sound too dramatic, too vague, or too likely to get them labeled as difficult. This practice does not judge character. We are not listening for the version of your pain that sounds most believable. We need the real one, including the parts you are embarrassed by. Tell us about the medication that is not working the way you hoped, the day you cried in the car, and the fact that you have not told your employer how bad it really is. Editing the story for us costs you time later, when the plan has to be changed because the first version left something out.
Why the full history matters this much
Two biological facts explain why we ask about more than the painful joint or nerve. First, metabolic health — blood sugar, inflammation, weight — changes how tissue heals and how sensitized your nervous system stays. Second, poor sleep on its own lowers the point at which any pain signal feels severe. Neither one shows on an X-ray. The social piece completes the picture. A job that will not allow restrictions, or a home where rest is not really possible, shapes how a treatment plan has to fit your real life rather than an ideal one. None of that shows up if the visit stays limited to “where does it hurt.”
Common questions
Will I get an injection at my first visit?
Usually not. The first visit is diagnostic. If a procedure makes sense, you will understand why before it is scheduled — see what to expect for how later visits are set up.
Do I need a referral to be seen?
Not from this practice. Some insurance plans require one for coverage purposes, which is a separate question — covered in full at referral for pain management.
What if I do not have my old imaging?
We can request records from a previous provider, though it takes longer than bringing them yourself. We can also order new imaging here if your old studies are outdated or incomplete. This is the same imaging that shapes decisions on conditions like a herniated disc.
Should I stop my pain medication before the visit?
Take your medications as normally scheduled and bring the list. Changing your routine right before the visit only makes it harder to see your true baseline. Any needed changes get worked out openly as part of this practice’s approach to opioid stewardship.
What should I ask the doctor at my first pain management appointment?
Ask which structure the doctor thinks is producing the pain, and which exam finding points there. Then ask whether the next step is a test or a treatment, what result would change the plan, and how your current medicines and your sleep fit into it. A doctor who has examined you properly can answer all four in plain words, and here those answers come before you leave, as the first-visit walkthrough describes. Learn more: how a diagnostic block turns a guess into a yes or no.
Related reading
- What to expect
- Referral for pain management
- Pain management vs. interventional pain management
- Metabolic health and pain
We will let you finish the sentence
Come with the records if you have them, and the whole story regardless. Nothing you say here disqualifies you from being heard.
4479 Woodson Rd, Suite 401
St. Louis, MO 63134
Next to St. Louis Lambert International Airport, off I-70 at Woodson Road.
Sources
- Imran A et al. Duration of opening statement of patients attending a chronic pain clinic consultation. Journal of the Royal College of Physicians of Edinburgh, 2019. PubMed 29779089