Chronic Pain


What is pain? 

Pain is the body’s natural response to harm. Pain occurs when special pain receptors at the end of the nerves, called nociceptors, are turned on because of an illness or injury or because chemical changes within the body indicate that tissues are being damaged. When a nociceptor is turned on, a signal travels through the spinal cord to the brain, which recognizes the signal as pain.

When does normal acute pain become abnormal chronic pain?

When pain lasts a long time, it is called chronic pain. This type of pain is often caused by an illness or injury. Some doctors consider pain to be chronic when it lasts one month longer than expected, but the general medical definition of chronic pain is pain that has lasted for six months or longer.

Chronic pain can be one of two types: nociceptive and neuropathic. Each type differs based on what causes it, what it feels like, and what types of treatments may relieve it. Of the two, neuropathic pain can often be managed by a therapy called neurostimulation, also known as spinal cord stimulation (SCS). Dr. Hanna is experienced treating neuropathic pain using SCS and emerging experimental approaches such as IV Ketamine.

What increases your risk of developing a chronic pain condition? 

Risk factors are things that increase your chances of getting sick or having a problem. Risk factors for chronic pain include:

  • Aging. Older adults are more likely to have certain health problems that can lead to chronic pain, such as arthritis, diabetes, and shingles.

  • Certain health problems. These include:

    • Existing health conditions, such as fibromyalgia, shingles, arthritis, depression or anxiety disorders, or phantom limb pain.

    • Past health problems, such as joint injuries or past surgeries.

    • Overall general health. You may have a weakened immune system, which can lead to frequent infections or illness.

  • Lifestyle, such as not eating healthy foods, not exercising regularly,smoking, or having a drug or alcohol problem.


Other risk factors include stress, relationship problems, or a history of physical, sexual, or emotional abuse.

You Have Options

We have seen that a number of clinics focus on one or two modalities for treatment. The problem is that pain is neurological and that means "it's complex". There are a wide variety of therapies, products, at-home activities, procedures and medicines that can be used and we believe there's a place for all. Determining which (or combination thereof) is right for you is a process for you and your Pain MD to work together on.

Those could be laser ablation, spinal cord stimulation, Ketamine infusions, Platelet Rich Plasma, Steroid injections, Stem cell therapy, Botox, trigger point injections and much more!   

Laser Ablation
Spinal Cord Stimulation
Peripheral Nerve Stimulation
Sacral Nerve Stimulation
Peripheral Field Stimulation
Superion/Vertiflex Interspinous Spacer
Ketamine for Pain & Depression
Facet Joint Injection
Pulsed Radio Frequency Ablation
Platelet Rich Plasma Injections
Stem Cell BMAC
Ultrasound Guided Joint, Ligament or Tendon Injection
Sacroiliac Joint Injection
Amniotic Stem Cell and Wharton's Jelly
Epidural Steroid Injection
Diagnostic Facet Block/Medial Branch Block
Diagnostic Selective Nerve Root Block
Knee, Hip & Shoulder Ablations
Botox for Migraines and Dystonia
Trigger Point Injections
Discogram Diagnostics
Kyphoplasty Surgical Procedure
Spinal Disc Decompression
And Much, Much More!


When should you see a doctor?

Make an appointment with Dr. Mukalel about chronic pain if:

  • Your pain has lasted more than 3 months without a clear reason.

  • You are feeling down or blue or are not enjoying the activities or hobbies that you have enjoyed in the past. You may have depression, which is common with chronic pain.

  • You can’t sleep because of the pain.

  • You had an illness or injury that healed, but you still have pain.


Book an Appointment for an Evaluation.

Dr. Mukalel is a top-rated interventional pain doctor.  He has treated thousands of patients and in many cases, his patients are referred to him as a last resort when conventional pain therapies have failed to produce adequate pain reduction.  Click the “Make an Appointment” button to schedule an appointment. Otherwise, contact us for more information or to make an appointment over the phone.


Jessen Mukalel MD
3786 FM 1488, Suite 150A
Conroe, TX 77384
Phone: 346-291-2226
Fax: 281-781-2540

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