The Skinny On Pain Management


By Jeanni Brosius :: Illustration by Jamison Mosley


More than half of the adults in the United States suffer from one or more chronic health conditions, according the Centers of Disease Control For Disease Control and Prevention.

“Ninety percent of those diseases have one common symptom, and that’s chronic pain,” said Dr. Meraj Siddiqui, pain management physician at White River Medical Center Pain Management Clinic in Searcy.

Siddiqui said more money is spent on chronic pain than diseases, such as diabetes and cancer.

Chronic pain is pain that persists after an injury, surgery or other medical issue. Pain that persists longer than six months and hasn’t responded to typical treatment is considered chronic.


Primary health care providers, who generally don’t specialize in pain management, can recommend a modification; over-the-counter pain relievers; massage, physical or chiropractic therapy; and braces or splints. The patient should ask for a referral to a pain-management specialist.


“We determine the source of the pain through a series of exams,” Siddiqui said. “We either reproduce the pain by provoking it or blocking the pain.”

When it comes to the intensity of pain, the patient must be given the benefit of the doubt because tolerance to pain varies from person to person.

“If a patient has a knife stuck in their leg, well that’s an obvious source of pain,” said Dr. J. Carlos Roman, pain management physician at CHI St. Vincent, Little Rock. “But the patients we see generally do not have an obvious source of pain. Doctors in other specialties will refer patients to us who have already been seen and their cause of pain cannot be determined. The mystery patients end up with us.”

The first course of action is to localize the cause of the pain and determine what has been done.

“Have they had surgeries? What medications are they on? What are they doing to alleviate the pain? We then order objective testing-MRIs, bone scans, etc.”

Pain management is not as complicated as it sounds, said Roman, who also serves as director of Southern Regional Pain Consultants and works regularly with Arkansas Specialty Orthopaedics.

“The term really defines it,” he said. “We help people manage chronic pain. People encounter painful situations that are sometimes curable and sometimes aren’t. We teach patients how to manage conditions that aren’t going away. Examples of these types of patients are amputees, and those with spinal cord injurie or back injuries. We offer interventional treatment as well as medication management.”

Managing chronic pain is an all too common struggle in today’s society.

For some, it’s an uphill climb to reduce pain.


Fixing the source of the pain is always preferable of course, but there are cases where management is the only option.  Treatment can include nerve blocks, epidurals, steroid injections or ablation of nerves.

“We also offer medication management,” Roman said. “One thing we are passionate about is combatting a patient’s opiate addiction. Opiates are wonderful and they can be helpful, but we take a different approach to the management of opiates, to keep people from becoming dependent on them.”

“The first course of action is to localize the cause of the pain and determine what has been done.”-Dr. J. Carlos Roman

Because the CDC sites opiates the number one cause of death in 17 states, Siddiqui urges patients not to rely on opioid pain relievers.

“Medications have a limited role when trying to control pain,” he said. “Narcotics are very dangerous and very addictive.”

Too many patients get their information about how the medicine works from the Internet, according to Roman.

“For example, they might think, ‘If one hydrocodone helps, two would be even better,’” Roman said. “That’s not the way the body works, and that’s not the way pain management works. That’s why medication management is so important.”


“The goal in chronic pain management is to improve mobility and functioning,” Siddiqui said. “Many times chronic pain causes depression and anxiety, and we want to improve the quality of life.”

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