TOPS Institute generally does not prescribe opioids for chronic pain. Here is what we do instead — image-guided procedures, regenerative therapy and rehabilitation that treat the source.
If you have lived with pain for months, you have probably been offered medication more than once. You may also have been told that stronger medication is the only option left. That is not how we practise.
At TOPS Institute, our approach focuses on identifying and treating the underlying source of pain rather than masking symptoms with long-term medications. For this reason, we generally do NOT prescribe opioid (narcotic) medications for chronic pain.
This article explains what we offer instead, and why targeting the source tends to produce better long-term results.
Opioids reduce the *perception* of pain. They do not repair a compressed nerve root, calm an arthritic facet joint, or restore a degenerated disc. When the underlying problem is structural, medication alone leaves the cause untouched.
Long-term use also brings well-known trade-offs: tolerance, dependence, and side effects that interfere with sleep, mood, work and driving. Patients often describe feeling foggy but still sore.
The more useful question is not *how do we turn the volume down?* but *what exactly is generating this signal, and can we treat it directly?*
Pain is a symptom, not a diagnosis. The same symptom — lower back pain radiating into the leg — can come from a herniated disc, spinal stenosis, an arthritic facet joint, or the sacroiliac joint. Each responds to a different treatment.
Our evaluation may include:
Diagnostic blocks matter more than most patients expect. If numbing a specific nerve reliably relieves your pain, that tells us the pathway is genuinely involved — and it tells us whether a longer-lasting treatment aimed at that nerve is likely to work.
For selected tendon, ligament and joint conditions, High-Dose PRP uses a concentrated preparation of your own platelets to support the body’s healing response. It is not appropriate for every injury, and a full evaluation is needed to judge whether the tissue is likely to respond.
For certain patients with chronic neuropathic pain that has not responded to conservative care, Spinal Cord Stimulation and Peripheral Nerve Stimulation can modify pain signals before they reach the brain. Patients trial the system before any long-term decision.
Choosing an opioid-free practice does not mean choosing to live in pain. It means the plan is built to change the underlying condition rather than to keep you medicated around it.
Most patients we see have already tried rest, medication and time. What they have often not had is a precise diagnosis — and that is usually where meaningful progress begins.
Our board-certified physicians will find the source of your pain and build a plan around it.
Our approach to pain care focuses on identifying and treating the underlying source of pain rather than masking symptoms with long-term medications. For this reason, we generally do not prescribe opioid (narcotic) medications for chronic pain. Instead, we offer advanced, image-guided procedures and other non-opioid treatments designed to provide meaningful, lasting relief and help patients return to normal function.
Treatment depends on the diagnosis. Options may include anti-inflammatory medication where appropriate, physical therapy, image-guided injections, nerve blocks, radiofrequency ablation, regenerative therapy such as PRP, and neuromodulation. Your physician will recommend what fits the structure causing your pain.
Local anaesthetic is used, and light sedation may be available for selected procedures. Most patients describe pressure or brief discomfort rather than significant pain.
Severity alone does not determine the right treatment — the source does. Targeted procedures often work well for severe pain precisely because they address the structure generating it rather than dulling the perception of it.
You should consider seeing a pain specialist if your pain lasts longer than several weeks or months, interferes with daily activities, limits mobility, or has not improved with conservative treatments.
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640 South San Vicente Blvd., Suite 389, Los Angeles, CA 90048
Interventional pain management for Los Angeles & Beverly Hills — image-guided care that treats the source, not just the symptom.
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