Conditions Evaluated
Chronic Pain Syndrome
Evaluation.
Chronic pain is pain that persists over an extended period and may involve multiple contributing factors. An evaluation for chronic pain syndrome looks systematically at the patient's pain history, functional status, prior treatments, and current clinical picture — with the goal of identifying what remains treatable and what realistic next steps look like.
In Brief
Pain That Persists Over Time
Chronic pain is generally defined as pain that persists beyond three to six months, beyond the expected healing period, or in association with a condition that is ongoing. It is a significant clinical problem that affects function and quality of life.
Evaluation Looks at the Full Picture
A chronic pain evaluation assesses pain duration, distribution, character, functional impact, prior treatments and their responses, current medications, imaging and diagnostic findings, and the overall clinical context.
The Goal Is Identification of Treatable Factors
Not all chronic pain has a fully identifiable structural source, but many patients have treatable contributors that have not been adequately addressed. Evaluation aims to identify those contributors and develop a rational next step.
Overview
Understanding Chronic Pain Syndrome.
Chronic pain syndrome refers to a pattern of persistent pain that has been present long enough to affect function, daily activity, sleep, or overall well-being. Unlike acute pain — which typically resolves as the underlying injury heals — chronic pain may continue or evolve over months and years, with contributions from both structural and neurobiological factors.
It is important to recognize that chronic pain is a real and legitimate medical condition. Patients with chronic pain are not exaggerating their experience. The mechanisms underlying chronic pain are well studied and include ongoing structural contributors, peripheral nerve sensitization, and changes in how the central nervous system modulates and amplifies pain signals over time.
Many patients with long-standing pain have not had a comprehensive evaluation that addresses all relevant factors. Some have seen multiple providers without a systematic approach to identifying what remains addressable. The purpose of a chronic pain syndrome evaluation is to take stock of the full clinical picture and determine what can realistically be improved.
Evaluation
What the Evaluation Examines.
A chronic pain syndrome evaluation is comprehensive. It typically covers:
- Duration and onset of pain — when it began, how it has changed over time, and whether it is continuous or episodic
- Pain distribution and character — location, radiation pattern, quality, and intensity
- Functional impact — how pain affects activity, mobility, sleep, work, and daily life
- Prior treatments and their responses — what has been tried, for how long, and whether it helped
- Current medications and their effects on the pain
- Prior imaging and diagnostic studies — reviewed in the context of the clinical presentation
- Physical and neurologic examination to identify current clinical findings
- Identification of structural pain generators that may have been missed or may have changed over time
Treatment
Treatment Directions That May Be Considered.
Following evaluation, treatment planning is individualized and evidence-informed. Where structural contributors are identified — such as facet-mediated pain, sacroiliac joint involvement, radicular symptoms, or neuropathic components — targeted interventional options may be appropriate for selected patients.
For patients where sensitization or functional contributors are prominent, treatment planning extends beyond procedures and may include medication optimization, physical rehabilitation, and coordination with appropriate specialists. The intent is to identify what is addressable and create a structured plan — not to pursue every possible intervention indiscriminately.
Neuromodulation — such as spinal cord stimulation — may be considered for selected patients with refractory neuropathic or mixed chronic pain when more conservative approaches have been insufficient.
Limitations
Important Limitations.
Chronic pain is often difficult to fully resolve. The goal of evaluation and treatment is to reduce pain meaningfully, improve function, and identify what is realistically achievable — not to eliminate all pain in every patient. Some patients have conditions where complete pain resolution is unlikely, and honest discussion about realistic expectations is part of the clinical process.
A formal clinical evaluation is required to determine the appropriate approach for any individual patient. This page is for general informational purposes only and does not constitute medical advice or create a physician-patient relationship.
Dr. Dardashti sees patients in Mission Hills, California, serving patients from the San Fernando Valley, Santa Clarita Valley, and surrounding Los Angeles communities.