Pain Management

Take action against pain

The pain management team helps to eliminate or decrease patients’ pain and improve the daily function and quality of life of individuals living with persistent, chronic pain. Each provider specializes in in a specific area:

• Edward Kim, MD—Physical medicine and rehabilitation (physiatry) and pain medicine
• Elliot Palmer, MD— Interventional pain medicine
• Jill Faccia, NP—15 years of experience in pain management

Patient treatment is individualized and includes a detailed physical examination; review of medical history, images, and past treatments; and education about their condition. Vancouver Clinic providers partner with physical therapists, psychologists, alternative medicine providers, and other physicians to ensure patients receive the ideal support for their diagnosis and needs. They also help patients manage medications, injections, and other interventions. The goal? Empower patients to return to doing the things that bring them joy and meaning.

What we see:

Pain Management Department physicians are able to help manage nearly every type of pain. Here are some of the most common conditions they see:

• Chronic low back pain
• Chronic neck pain
• Radicular pain (“sciatica” or “pinched nerves”)
• Joint pain
• Muscle pain
• Arthritis
• Peripheral neuropathy and other nerve-related pain
• Postoperative pain
• Fibromyalgia
• Headaches
• Carpal tunnel syndrome
• Spinal cord injuries and spinal disorders
• Tendonitis

What we do:

• Prescription of physical therapy and exercise plans
• Mobility assessments and fall-prevention plans, including prescription of assistive devices
• Electrodiagnostic studies, including nerve conduction studies and electromyography
• Epidural steroid injections
• Diagnostic medial branch blocks
• Medial branch denervation (radiofrequency ablation)
• Facet joint injections
• Spinal cord stimulation—both trials and permanent implantation
• Sympathetic nerve blocks
• Sacroiliac (SI) joint injections
• Major joint injections (knees, hips, shoulders, etc.)
• Ultrasound-guided peripheral nerve blocks
• Occipital nerve blocks
• Trigger point injections
• Botox injections for spasticity and migraines

How do I schedule an appointment?

Patients need a referral in order to schedule with the Pain Management Department. Speak to your primary care provider, or the doctor who is currently managing your pain, to request a referral.

What should I expect during my first visit?

During your first visit you’ll fill out paperwork and have your vitals taken. After that, your provider will meet with you to discuss the details of your pain—be prepared for lots of questions! Your provider will also review imaging and perform a physical exam. At the end, your provider will review possible next steps. These may include obtaining imaging; ordering physical therapy; adjusting medications; or ordering a procedure.

What types of questions will my provider ask?

Common questions include:

• Where is the pain?
• How long has it been there?
• What started it?
• What does it feel like?
• What makes it better or worse?
• Is there numbness or tingling?
• Have you noticed any weakness?
• Is it improving, staying the same, or getting worse?
• What have you tried so far?

Where do procedures happen?

Some procedures, such as knee joint injections and trigger point injections, may happen in the exam room on the day of the appointment.  Other injections are performed in the Ambulatory Surgery Center or in the Radiology Department at Columbia Tech Center. Insurance approval is required for some injections prior to scheduling.

If I need a procedure or surgery, what happens next?

The typical process for arranging a surgery or procedure includes few steps:

• After you and your provider have made the decision to proceed, your provider will submit a request for authorization to your insurance carrier.
• Once authorization is received you will be contacted by our scheduling department to set up a day and time that work for you.
• Once your procedure is scheduled you will receive another phone call from our nurse to go over specific instructions and answer any remaining questions.