What is a pain clinic and when should you visit one?

A pain clinic — also called a pain center or pain unit — is a medical practice dedicated specifically to the diagnosis and treatment of chronic and acute pain. It is staffed by a pain physician: a doctor with focused training who combines personalized medication management with minimally invasive, image-guided procedures such as nerve blocks, radiofrequency ablation and injections. It is worth seeking one when pain has lasted more than three months, does not ease with common pain relievers, or limits your daily life.

What a pain clinic is

Pain clinic, pain center, pain unit, pain medicine practice: they are different names for the same thing. It is a medical setting where the reason for the visit is not one specific disease but the pain itself, especially when it has persisted over time and the usual treatments have fallen short.

Why does a specialty dedicated to pain exist? Because chronic pain — pain that persists for more than three months — is a biologically different phenomenon from acute pain. When pain continues for months, the nervous system changes: the pathways that carry pain signals become more sensitive, and the pain often stops being a useful signal and becomes a disease in itself. That is why common anti-inflammatories and pain relievers lose effectiveness, and why treating chronic pain as if it were prolonged acute pain is one of the most frequent causes of treatment failure. I explain that difference in detail here →

I am a physician anesthesiologist with postgraduate training in Pain Medicine and Interventional Pain Management, and my practice works exactly like what most people know as a pain clinic. In daily practice I see many patients arrive after years of going from specialist to specialist without an integrated plan: each one looked at their part, but nobody organized the whole. That, to me, is the central role of a pain clinic: putting the pain at the center, locating where it comes from and building a complete strategy — not one more scattered treatment.

What a pain physician does

A pain physician is a doctor with focused training in the diagnosis and treatment of chronic and acute pain, who uses medication-based techniques and minimally invasive procedures such as nerve blocks, radiofrequency ablation and injections. The work has two parts that go together:

• Precise diagnosis. The first step is understanding what type of pain each patient has — nociceptive, neuropathic, mixed — and which structure it comes from. Without a diagnosis, there is no targeted treatment.
• Staged treatment. From medication adjustment and targeted physical therapy to image-guided procedures, moving up only when needed. Chronic pain is rarely solved with a single treatment: it usually requires combining personalized medication, physical therapy, habit management and, when appropriate, percutaneous interventions.

The most frequent reasons for consultation in my practice are chronic low back pain, herniated discs, sciatica, neck pain, osteoarthritis of the knee, hip and hands, shoulder pain, sacroiliitis, lumbar spinal stenosis, chronic headaches and refractory migraine, trigeminal neuralgia, neuropathic pain, chronic post-surgical pain and cancer pain.

What is evaluated at the first visit

The first visit at a pain clinic is different from other medical appointments: above all, it is a long conversation. It typically lasts between 40 minutes and an hour, and has four parts:

Clinical interview

We talk in detail about your history: when the pain started, how it has changed over time, what makes it better, what makes it worse, how it affects your sleep, your work and your mood, what treatments you have tried and what results you had. That history, heard without rushing, already points to much of the diagnosis.

Physical examination

A focused evaluation for your condition: posture, mobility, a neurological exam (strength, sensation, reflexes) and specific tests according to the diagnostic hypotheses.

Review of studies

I look at the images and studies you bring — MRIs, X-rays, electromyograms, lab tests — and put them together with the clinical picture.

Diagnosis and treatment plan

I explain what I believe is going on and why, and propose a plan: medication adjustments, targeted physical therapy, additional studies if needed and, when it makes clinical sense, an interventional procedure. A procedure is generally not performed that same day: if one is indicated, it is scheduled for another date with the corresponding informed consent, so you fully understand the proposal and can decide without pressure.

I devote a full article to how to prepare: The first visit with a pain physician: what to bring, what to expect, what to ask →

What treatments a pain clinic offers

The therapeutic range is broad, and the choice depends on each patient's diagnosis. In my practice it includes:

• Personalized medication management. Not common pain relievers at ever-higher doses, but drugs that act on the mechanisms of chronic pain, including specific medications for neuropathic pain.
• Image-guided nerve blocks under ultrasound or fluoroscopy: facet, epidural, foraminal, peripheral nerve and sympathetic blocks. They serve both to diagnose where the pain is coming from and to treat it.
• Radiofrequency ablation, conventional and pulsed, which interrupts or modulates pain transmission for extended periods (6 to 12 months on average in facet pain).
• Image-guided joint injections (knee, shoulder, hip, spine, sacroiliac joint).
• Regenerative medicine with platelet-rich plasma (PRP) for mild to moderate osteoarthritis and chronic tendinopathies, in selected patients.
• Head and neck blocks for refractory chronic headaches, and treatment of trigeminal neuralgia, including interventional options when targeted medication is not enough.
• Cancer pain management, in coordination with oncology.

I want to be clear about something, because it is where the most overselling happens: nerve blocks, injections and radiofrequency ablation treat the pain — they do not repair the structure. The osteoarthritis or the herniated disc is still there. What we aim for is to lower the pain so you can move, do your rehabilitation and get your daily life back. And surgery is not a rival of the pain clinic: it is one more option within the range, with specific indications; when a case needs it, we work as a team with the surgeon, and my job is to manage the pain well at every stage of the journey.

The full details of each procedure are in Services and treatments →

When to see a doctor

The most frequent signs that your pain warrants an evaluation at a pain clinic:

• Pain that has persisted for more than three months, even after an initial course of treatment.
• Pain that does not ease with common pain relievers or that requires increasingly strong medication.
• Low back or neck pain radiating into the arms or legs, with tingling, weakness or numbness.
• Joint pain in the knee, hip or shoulder that limits mobility or nighttime rest.
• Recurrent headaches or migraines that interfere with work or daily life.
• Post-surgical or post-traumatic pain that never quite resolves.
• You have been taking anti-inflammatory drugs every day for more than a month: that is a signal in itself to seek help.

If you are not sure, the pain self-check is a one-minute guide that can help point you in the right direction.

How the process works at the two locations

My pain medicine practice operates at two locations, both by appointment, coordinated over WhatsApp at +54 9 11 5895-3260:

• Hepta — San Isidro (Av. Fondo de la Legua 577, Zona Norte): I receive patients from San Isidro, Vicente López, Olivos, Martínez, San Fernando, Tigre and nearby areas.
• CIAREC — Villa Urquiza (Av. Monroe 4770, CABA): I receive patients from Villa Urquiza, Belgrano, Núñez, Saavedra, Coghlan and nearby areas.

The process is simple: the appointment is coordinated over WhatsApp, you complete the online medical history before coming in (it takes about 8 minutes and lets me prepare better for your visit), and the first visit is an evaluation. If that evaluation leads to the indication of a procedure, it is scheduled for a separate date with written informed consent. The great majority of procedures are outpatient: you go home the same day, and most patients resume their usual activities within 24 to 72 hours.

I see patients through the main private health plans and obras sociales (Argentine health funds) — OSDE, Swiss Medical, Galeno, Medifé, among others — and also on a private-pay basis. Some procedures — such as regenerative medicine with PRP — are not covered by most health plans; in those cases the costs are discussed in advance and in writing. See detailed coverage here → And if you live far away, a virtual consultation is a real option for the first evaluation: procedures require an in-person visit, but much of the diagnostic process can begin remotely.

Where I see patients: locations in Buenos Aires

I see patients at two locations: Hepta, in San Isidro (Av. Fondo de la Legua 577, Zona Norte) and CIAREC, in Villa Urquiza (Av. Monroe 4770, CABA). I receive patients from across Zona Norte (northern Greater Buenos Aires) and the City of Buenos Aires, and I also offer virtual first consultations to point you in the right direction and organize the next steps. Phone: +54 9 11 5895-3260.

Dr. Mauricio Casarsa

Anesthesiologist. Postgraduate training in Pain Medicine and Interventional Pain Management (UBA — Fundación Dolor; UNLP — CAIDBA). Staff physician at Hospital Alemán de Buenos Aires.

MN 137.756 (Argentine medical license) · San Isidro · Villa Urquiza