Medical Pain Service

Collaborative care starts here.

Our unique staff, trained in both psychiatry and pain management, are well positioned to treat the complex combination of symptoms common to chronic pain.

Medical Pain Service

Avance Medical Pain Service is dedicated to turning the focus back towards pain patients.  We take the time to listen, to consider all factors that impact your ability to function in the world, and then treat you without fear. We work within a ‘shared decision making’ model, where collaboration with patients and their families is paramount.

Our goal is your optimal function, within your unique limits and abilities, done safely.

Chronic Pain is said to be the most challenging condition in medicine. Though incredibly common (20% of US population currently diagnosed, up to 40% will be at some point in their life) each case is uniquely difficult. Chronic pain can arise from injuries, surgeries, neurological diseases, medications, or even infections (e.g. post-covid). Most patients with chronic pain also struggle with anxiety and/or depression.

The complex origins of pain are confusing for patients and practitioners alike, and the secondary emotional issues it causes (depression, anxiety, substance use) may cause shame and secrecy. With fewer practitioners treating pain, it is difficult to find one with the multidisciplinary training to address this combination of symptoms, leaving chronic pain patients with limited treatment resources.



Though our primary intervention is the use of state of the art pharmacology, we also utilize joint and trigger point injections for musculoskeletal pain, and botox injections for migraine.  We collaborate closely with Avance Psychiatry which specializes in psychotherapeutic techniques for pain treatment.

  • PHARMACOLOGIC TREATMENTS: Our unique staff, trained in both psychiatry and pain management, are well positioned to treat the complex combination of symptoms common to chronic pain. Using a Functional Pharmacology approach, we systematically analyze the effects and side-effects of all medications, working collaboratively to find the correct, yet smallest, combination of medications that are optimal for your individual situation.
  • COLLABORATIVE TX: In response to the opioid crisis, many practitioners abandoned the treatment of pain, or unilaterally decided to reduce medications.  We work conjunctly with our patients in an atmosphere of mutual honesty and transparency to find the most optimal, functional, and safe medication choices.
  • OPIOIDS: We are not biased towards a particular medication or its dose.  As our philosophy notes, optimal function is the most important outcome.  All medications used in pain management are capable of harming, benefitting, or being ineffective.  We work collaboratively, on a case to case basis, to clarify the cost/benefit of all medications used by an individual, while maintaining safety.


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Avance Psychiatry at Centers of Excellence

Steven Prakken, MD

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Open 7-days a week with same-day appointments.