Q: are your services are covered by OHIP?
A: Consultations conducted with any provider other than Dr. Angela Mailis and Dr. Hadi Shojaei are not covered by OHIP. However, most extended health plans offer a certain amount of coverage. Check with your insurance benefits plan to confirm if you are covered. Braces and certain devices may be covered, while supplements, naturopathic injections and vitamin infusions are not covered by most insurance plans.
Q: Do I need a Family Physician in order to have a Chronic Pain Assessment?
Yes. All patients who would like a Chronic Pain Assessment must be referred by a Family Physician. Our referral form can be obtained here:
Q: What is the difference between acute and chronic pain?
A. Pain is considered chronic if it lasts more than 3 or 6 months. Acute pain usually is due to a specific cause (like a broken leg or a kidney stone): when the cause is removed or healed, the pain goes away. In many cases of chronic pain, the original cause of pain may have gone, but pain continues. Treatments that help acute pain, may not work in cases of chronic pain. In our Centre we will explain to you where the pain comes from and we will offer you several treatments and methods how to control it.
Q: Can my pain be taken away completely?
A: Once pain becomes chronic it is unrealistic to expect it will all go away. This can happen only in cases where the cause is clear and can be permanently removed. For example, in most cases joint replacement for severe knee or hip arthritis may successfully eradicate pain. Removing a tumor that is pressing on a nerve or stabilizing a broken bone that has not fused by using a metal plate, are other examples that can “fix” pain. In most cases, however, chronic pain sufferers should aim to obtain better pain control, so that they can function better and not set their goal on "complete pain elimination".
Q: Should I remain active if i'm experiencing pain?
A. The worry you will harm yourself keeps many chronic pain sufferers from moving and this leads to deconditioning, stiffness, weight gain etc. In our Centre we will explain to you that “hurting” is not the same as “harming” yourself, and we will show you strategies how to control pain while you increase your physical activities.
Q: This pain has destroyed my life. I feel terribly down and some days I feel that it’s not worth living like this. Is there anything that can be done?
A: Of course a lot of things can be done for you. Both your pain and your depression should be treated with medications, psychological management, mindfulness, and physical activation treatments. At our Centre we address all these issues and we feel confident we can make a difference in most people’s life.
Q: I read in the newspapers all these terrible things about abuse of prescription opioids. What is going on?
A: Opioid medications (such as morphine, hydromorph, oxycontin and others) are very strong pain killers and can be useful in cases of both acute and chronic pain. They can also be associated with misuse and abuse and lead to addiction in certain people. Our Centre follows the Canadian guideline for safe and effective use of opioids that was published in 2010. Our director, Dr. Mailis was one of the researchers/clinicians who created this guideline and she has also extensively researched and published on the use of opioid drugs. If we feel you could benefit from them after all other treatments have been exhausted, we will explain why we use them and educate both you and your physician on how to safely take these drugs. On the other hand, if we feel you are not a candidate for opioids, we will use other medications or treatments.
Q. What about Medical Marijuana (MM)? Could it be something I should consider for my chronic pain?
While we do not prescribe MM, if we think you are a potential candidate, we will refer you to a specific clinic with which we collaborate.
Q: My doctor said I should try "nerve blocks" for my neck pain. Can you explain what nerve blocks are?
A: Nerve blocks is a generic term which may mean different things, such as injections into soft tissues or injections into the spine or the nerves (which include local anesthetic and often steroids). If a specialist offers you such "nerve blocks", ask exactly how these injections will be given. Soft tissue and muscle injections can be useful in cases of muscle/soft tissue pain. Injections into the spine or nerves can help in case of sciatica or other causes that irritate nerves. However, injections alone are highly unlikely to take away your pain and a combination with other treatments is strongly recommended. These injections are considered to be effective if they provide you with long lasting pain relief for several days beyond the duration of the local anesthetic as well as improvement in function. If we feel you are a candidate for such injections, we will refer you to a specialized clinic with expertise in such interventions.
Q: I was diagnosed with fibromyalgia. What is this and what can I do to get better?
A: Fibromyalgia (FM) is a condition that has a myriad of triggers characterized by diffuse widespread pain, fatigue, poor sleep and many other symptoms. There is no specific test that can confirm FM, and the diagnosis is based primarily on the symptoms. FM is treated with a combination of treatments (medications, exercise therapy, CBT, mindfulness based treatments, tai chi, yoga, etc).
Q: How does a Naturopathic Doctor differ from other medical practitioners?
A: Naturopathic Doctors (NDs) are trained in the art and science of both conventional and alternative medicines. Every licensed and registered ND has at least 7 years of post-graduate education and has graduated from an accredited Naturopathic College. The primary difference between NDs and other practitioners lies in the naturopathic philosophy to ‘treat the root cause of illness’ and to focus on prevention. NDs integrate standard medical diagnostics and utilize a broad range of natural therapies such as nutritional counseling, herbal medicine, acupuncture, and vitamin infusion therapy to promote healthy and wellness. NDs see their patients as a whole person and carefully consider the physical, mental, emotional and spiritual elements when developing a comprehensive treatment plan.
Q: What is a chiropractic adjustment?
A: A chiropractic adjustment is an evidence-based technique that can help to relieve pain and restore optimal function of the spine and/or extremity joints. It is a highly-skilled and precise movement usually applied by hand. When a joint is adjusted, pressure is released, sometime causing an audible "popping" sound. This release in pressure can help restore joint motion and decrease pain of the affected joint. However, trained chiropractors use also other specialized techniques beyond adjustments to treat soft tissue injuries.