Is This the Right Time for a Pain Procedure? How to Make a Thoughtful, Evidence-Informed Decision About Advanced Pain Treatments
When you’re living with chronic pain, it can feel like you’re running out of options. Maybe medications haven’t helped. Maybe physical therapy stalled. Or maybe the stress and exhaustion have become just as difficult as the pain itself.
And now—your provider is recommending something more advanced:
Spinal cord stimulation.
Nerve ablation.
A pain pump.
So how do you know if this is the right next step?
Let’s walk through how pain procedures fit into the broader landscape of care—and how to decide when they make sense for you.
Understanding Stepped Care for Chronic Pain
The stepped care model, recommended by organizations like the International Association for the Study of Pain (IASP) and U.S. Department of Health and Human Services Pain Management Best Practices Inter-Agency Task Force, is a tiered approach to pain care. It starts with the least invasive, lowest-risk options and escalates only if earlier steps don’t offer sufficient relief.
Healing is a process.
Each phase can open the way to the next—gently, intentionally, and in your own time.
Step 1: Foundational Pain Management
Education about pain and how it works
Physical therapy or movement-based approaches
Behavioral interventions (e.g., CBT, ACT, pain coping skills)
Non-opioid medications
Lifestyle changes (sleep, nutrition, stress)
This is often where pain neuroscience education and mind-body therapies like Empowered Relief™ are introduced. They teach people how to reduce pain interference by changing how the brain processes pain signals.
Step 2: Intermediate Treatments
Trigger point injections
Nerve blocks
TENS units
Multimodal rehabilitation programs
Opioid therapy (in select, carefully monitored cases)
These interventions can be helpful when pain is localized, movement is restricted, or Step 1 approaches have been exhausted.
Step 3: Advanced or Invasive Procedures
Neuromodulation therapies, such as spinal cord stimulators (SCS), dorsal root ganglion (DRG) stimulators, and peripheral nerve stimulators (PNS)
Interventional procedures like radiofrequency nerve ablation
Implantable pain devices such as intrathecal pain pumps
These are considered when pain is severe, disabling, and unresponsive to less invasive methods.
According to the American Society of Regional Anesthesia and Pain Medicine (ASRA) and the North American Neuromodulation Society (NANS), these procedures may offer relief—but they also come with risks, costs, and complex decision-making.
Is It Too Early—or Just the Right Time?
There’s no one-size-fits-all answer. But here are a few important considerations:
1. Have you fully explored lower-risk options?
Advanced procedures should not be first-line treatments. If you haven’t yet tried behavioral interventions like pain coping skills, you may benefit from doing so—either as an alternative or a complement to a procedure.
The CDC and IASP recommend behavioral pain treatments as part of core, early interventions—not just last resorts.
(CDC Clinical Practice Guideline for Prescribing Opioids, 2022; IASP Global Roadmap for Pain)
2. Do you understand what the procedure involves?
Many procedures have trial phases, possible complications, or long-term maintenance needs. You deserve to know:
What are the success rates?
What are the common side effects or limitations?
What’s the recovery process?
An informed decision is a powerful one.
3. Are you emotionally and mentally prepared?
Stress, anxiety, depression, and trauma can all increase post-surgical pain and reduce outcomes. In fact, research shows that mental readiness predicts surgical success just as much as physical readiness.
This is where a single-session class like Empowered Relief can help. It offers research-backed tools to reduce pain, manage flare-ups, and clarify your decision.
You Deserve Time, Support, and Clarity
Saying “yes” to a procedure is a big decision. Saying “not yet” is a valid one too.
You might not be ready. You might want more tools. You might be looking for reassurance that you’ve done everything you can.
Whatever you choose—it should feel aligned with your goals, your values, and your full self.
Whatever path you're on, you're not walking it alone.
Empowered Relief™ is here to help you feel more prepared—emotionally, mentally, and physically—as you navigate your next steps.
Whether you're just exploring or ready to sign up, thank you for being here.
P.S. Curious about the research?
Empowered Relief™ was developed at Stanford and has been shown to reduce pain intensity, emotional distress, and pain interference—with results that last up to six months after just one session.
Looking for more support?
Below, explore therapy options, meet Dr. Kalianivala, or keep reading more about pain and healing.
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