Welcome to the Newport Pain Management Blog: Why We've Spent 30 Years Treating Pain Without Leaning on Opioids

By H. Rand Scott, MD — Medical Director, Newport Pain Management

When I opened Newport Pain Management in 1996, the prevailing wisdom in American medicine was heading in one direction: more opioids, for more patients, for longer. Pain had just been declared "the fifth vital sign," and physicians everywhere were being told that under-treating pain was the real danger.

Our practice took a different path. From the beginning, we built Newport Pain Management around a simple idea: chronic pain is a disease in its own right, and treating a disease means understanding it — not just quieting it. Thirty years later, that idea has been vindicated. The medical world has spent the last decade working its way back from the opioid era, and the non-opioid, multimodal approach we've practiced since the 1990s is now the national standard of care.

This blog is where we'll share what we've learned along the way — practical, honest information about living with and treating chronic pain. For this first post, I want to explain the philosophy behind everything we do.

Chronic pain is defined as pain that persists beyond the normal expected healing time. When pain outlasts the injury that caused it, something has changed in the nervous system itself. That's why chronic pain affects everything — sleep, work, mood, relationships — and why treating it like a lingering symptom ("take this and rest") so often fails.

Treating pain as its own disease changes the entire approach. It means a real diagnostic workup, because different pain mechanisms respond to entirely different treatments. Nerve pain, muscle pain, joint pain, and centralized pain syndromes like fibromyalgia are different problems that happen to share a symptom.

No single therapy fixes chronic pain. But several therapies, each doing part of the job, add up. That's the multimodal approach:

• Interventional procedures — epidural steroid injections, nerve blocks, and trigger point injections that treat pain at its source
• Non-opioid medications — including nerve-pain medications like gabapentin, which our practice was among the first in the country to use for pain management
• Physical therapy — restoring the movement and strength that pain takes away
• Ketamine infusion therapy — for depression and certain pain syndromes that resist other treatment
• Counseling and behavioral support — because pain and the brain are inseparable, and treating one without the other shortchanges both

Each of these might improve your pain 15 or 20 percent. Together, the result is often the difference between a life organized around pain and a life where pain is one manageable factor among many.

We are not an anti-medication practice. Opioids have a legitimate role, particularly in acute and post-surgical pain, and for some patients they remain part of a carefully monitored plan. But three decades of evidence is clear: for most chronic pain, long-term opioid therapy delivers diminishing relief at increasing risk.

Much of our work today involves helping patients who arrive on long-term opioid regimens that no longer serve them. If that's you, know two things: we will not judge you, and we will not abandon you. Safe, gradual transition to more effective strategies is one of the things this practice does best — we've developed protocols for it and taught them to physicians across the country.

In future posts, we'll dig into individual topics: what actually happens during an epidural steroid injection, what the research says about ketamine, how to sleep when pain won't let you, and how to talk to your doctor about tapering. If there's a topic you'd like us to cover, tell us at your next visit or through our contact page.

Help is a phone call away. If you or someone you love is living with chronic pain, call us at (949) 759-8400. We've been here in Newport Beach since 1996 — and we'll be here for whatever comes next.