Interventional pain procedures, when performed appropriately and precisely on carefully selected patients provide the best relief of pain to an acceptable level. Most patients are able to do away with medications or reduce the size of dose to the point that they can function and be productive.

From your symptoms and your presentation it appears you have a condition called Reflex Sympathetic Dystrophy. This is a nerve disorder which can be precipitated by minimal injury or a minor surgery, as in your case and needs to be diagnosed and treated appropriately. The sooner you get the appropriate interventional procedure for this condition, the better are your chances for a complete cure and complete restoration of function.

RSD is a result of a nerve disorder affecting specialized nerves that supply the sweat glands and blood vessels of the skin. Under certain conditions, these nerves take over abnormal functions and start shooting off abnormal pain impulses, resulting in tissue changes. If these conditions are diagnosed early, the chances of cure and prognosis are excellent. However, if they are misdiagnosed, and are prolonged, then there will be irreversible damage to the tissues and the chances of cure and prognosis are poor. In your case, if you’re proven to have RSD, then certain procedures that target the sympathetic nerve tracts will need to be performed. These maybe specific nerve blockades of the sympathetic tracts or ultimately a radiofrequency ablation which permanently destroys the troublesome nerve. This is usually combined with physical therapy to restore function.

There are several factors which will determine whether or not help can be provided for your shingles pain. You now have a condition called Post Herpetic Neuralgia. The ideal thing for you when you had your shingles attack was to see a pain management physician and receive certain blocks of the nerves which could have shortened the duration and severity of the attack. Such episodes of shingles, when untreated, may result in Post Herpetic Neuralgia, as in your case. The treatment of Post Herpetic Neuralgia is very complex and involves several therapeutic options. This may include nerve blocks, and some patients may also require spinal electrodes as an ultimate therapy.

Your problem is a generalized condition and arthritis and fibromyalgia need a complex treatment plan which involves  an accurately diagnosing the condition and instituting medical treatment.. Also bear in mind that patients with arthritis and fibromyalgia may also have spinal pain caused by other conditions. So if you have spinal pain or specific pain in certain parts of the spine, those may be amenable to interventional therapy. In the past several years, exciting medications are on the market which can control your discomfort from fibromyalgia. I have successfully diagnosed and treated fibromyalgia and chronic fatigue syndrome with SSRIs, SNRIs, DRIs, etc. restoring quality of life to the suffering individuals.

I would like to clarify that my practice is solely limited to interventional pain procedures. If you feel that your patients have an addiction problem, then they need to see an addiction specialist. I also do not take over pain medication therapy initiated by another physician. However, I would be happy to see them and make some suggestions and give my opinions on the patients to ensure that these patients get the appropriate therapy and reach the appropriate level of functioning and productivity.

It appears that you have suffered from a post traumatic whiplash syndrome, and in such an injury, there is usually an injury to the various ligaments of the neck, the facet joints, and occasionally the discs. It appears that you have not had any specific interventions for addressing your neck pain. You have a very good chance of obtaining substantial reduction of your pain with the appropriate interventions.