Conditions we treat

Chronic Pain

Pain that has been there for months or years is one of the four situations patients ask about most, and it is the one the reviews below cover the longest stretches of.

What “chronic” means once it is a definition rather than a complaint, how many people are living with it, and what the research says about how long-standing pain behaves. Then how a visit here works.

5.0 average from 130+ Google reviews3 reviews about thisFirst visit 45–60 minutesWhen to get urgent help
Book onlineText us (616) 747-8462

The condition

What “chronic” actually means

Chronic pain has a definition behind it rather than a feeling. The classification the International Association for the Study of Pain wrote for ICD-11 sets it at pain that persists or recurs for more than three months, and then splits it in two. Where pain is secondary to another disease it is a symptom of that disease. Where it is not — fibromyalgia and non-specific low back pain are the examples the authors give — it is treated as a condition in its own right, which they call chronic primary pain.[1]

It is common. Analysing the National Health Interview Survey, CDC found that during 2021 an estimated 20.9% of US adults — 51.6 million people — had chronic pain, and 6.9%, or 17.1 million, had high-impact chronic pain, meaning pain that substantially restricted their daily activities.[2]

It also behaves differently from a new episode, and that difference is measured. New low back pain improves substantially over the first six weeks on moderate-certainty evidence; pain that has been around a long time improves much more slowly, on very low-certainty evidence. Neck pain has a similar shape — most acute episodes settle, and close to half of people go on to have continuing pain or recurrences.[3, 4]

And for most people there is no single physical cause to find. Low back pain is the leading cause of disability in the world, and only a small number of cases turn out to have a fracture, an infection or a tumour behind them.[5]

Almost everything quoted on this page is about the spine, the neck and the hip, because that is where the good evidence on persistent musculoskeletal pain sits and it is what we see. Chronic pain is far wider than that — nerve pain, headache, widespread pain and pain after surgery each have a literature of their own, and none of it is here. That is a scope limit rather than an oversight.

The standards

What good care for it looks like

Guidelines around the world agree on where care starts, and it is not with a scan or a prescription. The international position on back pain is a first approach without drugs: advice and information that help you manage it yourself, and getting back to normal activity and exercise.[6, 7]

For long-standing back pain the American College of Physicians heads its list with exercise, and prints the grade of evidence beside every option it names. Cochrane’s own account is more measured than a recommendation sounds: exercise probably helps chronic low back pain compared with no treatment, while its advantage over other conservative treatments was small and, in the reviewers’ own words, not clinically important.[8, 9]

One finding is worth carrying away more than any of the rest. Following 609 people with sciatica and back-related leg pain through primary care, one of the strongest predictors of not improving was the person’s own belief that the problem would last a long time. What you are told about your back appears to matter to how your back does — which is a good reason to be wary of anyone who tells you your spine is failing and will need looking after indefinitely.[10]

How we work

What happens when you bring it in

Pain that has been around for months or years starts the same way everything else here does: a full medical history, an orthopedic and neurologic evaluation, and a review of any imaging where that is appropriate. The history has room for what has already been tried and who else you are seeing, and after you become a patient we reach out to your primary care provider to tell them our plan and how you are responding. Nearly every new patient leaves with stretches and exercises for the complaint they came in with. If what we find is not ours to treat, we say so and point you to the provider it belongs with.

  1. A full office visit.

    Your first visit will be roughly 45-60 minutes in duration and involve the following: full medical history, orthopedic & neurologic evaluation, review of imaging (when appropriate), additional referrals & co-management (when needed), and your first homework: lifestyle changes, rehab exercises and pain education to start at home.

  2. Treatment on the same day

    Almost always, we are able to treat on the first visit. If we find any red flags during your examination or another need for a referral prior to treatment, we will let you know and schedule accordingly.

And if it is not ours to treat

One of the biggest differences you’ll notice about our practice is that we are upfront and honest about what we can and cannot help you with. This means that we’ll make sure you’re being co-managed by all of the right providers in all specialties.

The treatments themselves

Which of these we offer comes out of the examination. Each one is described on the services page.

In patients’ own words

What patients who came in with long-standing pain said

Reviews from patients who described pain they had lived with for a long time, quoted whole. The tag comes from what they wrote, not from a chart here.

  • “Can I start by saying THANK YoU SO MUCH !!! You can't even imagine how much better I feel omg I can't explain the difference from before my apt and now it's unbelievable I can't thank you all !! Special shout out to Rebecca and Noah I feel so much relief at this moment it's priceless I've been in pain for years like ten plus years and right now I can move it and I'm not in unbearable pain. I can't never repay you. All thanx a million”
    Staci S.Google review · August 2023Read Staci S.’s review on Google
  • “I love Dr Rebecca, she has helped me so much, I had chronic pain for 7 years, had very little range of motion, after seeing her for few times my pain is gone and I have amazing range of motion.”
    Yana B.Google review · July 2023Read Yana B.’s review on Google
  • “Dr. Rebecca is AMAZING!! I have never received this kind of care and attention from ANY healthcare provider. I was given a comprehensive exam and Dr. Rebecca took the time to discuss what was found, both positive and negative, addressed all my concerns, and created a plan for how to improve. The adjustments were gentle and incredibly proficient. I’ve dealt with pain and movement restrictions in several joints for MANY years, and for the first time I feel confident that I can improve these things and stay active into middle age and beyond. Thank you, Dr. Rebecca!”
    Shane D.Google review · January 2023Read Shane D.’s review on Google
More reviews about chronic painRead all reviews

Worth knowing

When to get urgent help

Pain that has behaved the same way for months is not what this list is about. What matters with long-standing pain is a change in it — and the emergency below, which looks like ordinary back pain when it starts.

Now — emergency department

  • New back pain with any of these: trouble starting to pee, or not feeling the flow; numbness around the genitals, the back passage or the area you sit on; new weakness or numbness in both legs; or new bowel or sexual changes. This is cauda equina syndrome, and it needs emergency diagnosis and surgery to prevent permanent damage.[11, 12]

Soon — get it looked at properly

  • Back pain after a significant injury, or in someone on steroids or immune-suppressing medicines; with a history of cancer or unexplained weight loss; or pain that is there at night and at rest rather than with movement.[13]
  • Numb or clumsy hands together with unsteadiness on your feet, dropping things, frequent falls or bladder changes — especially over 50. That points at pressure on the spinal cord rather than a simple neck problem, and it is commonly missed for years.[14]

These are prompts to look more carefully, not a checklist to diagnose yourself with. Having one does not mean something is seriously wrong — it means it is worth someone checking.[13]

The 14 sources this page cites

Every numbered claim on this page is tied to one of these, and every link goes to the source itself so you can read it rather than take our word for it.

  1. 1.Treede RD, Rief W, Barke A, et al. Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain. 2019;160(1):19-27. DOI 10.1097/j.pain.0000000000001384. PMID 30586067. pubmed.ncbi.nlm.nih.gov
  2. 2.Rikard SM, Strahan AE, Schmit KM, Guy GP Jr. Chronic Pain Among Adults — United States, 2019-2021. MMWR Morb Mortal Wkly Rep. 2023;72(15):379-385. DOI 10.15585/mmwr.mm7215a1. PMID 37053114. pmc.ncbi.nlm.nih.gov
  3. 3.Wallwork SB, Braithwaite FA, O’Keeffe M, et al. The clinical course of acute, subacute and persistent low back pain: a systematic review and meta-analysis. CMAJ. 2024;196(2):E29-E46. DOI 10.1503/cmaj.230542. PMID 38253366. pubmed.ncbi.nlm.nih.gov
  4. 4.Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. 2015;90(2):284-299. DOI 10.1016/j.mayocp.2014.09.008. PMID 25659245. pubmed.ncbi.nlm.nih.gov
  5. 5.Hartvigsen J, Hancock MJ, Kongsted A, et al.; Lancet Low Back Pain Series Working Group. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356-2367. DOI 10.1016/S0140-6736(18)30480-X. PMID 29573870. pubmed.ncbi.nlm.nih.gov
  6. 6.Foster NE, Anema JR, Cherkin D, et al.; Lancet Low Back Pain Series Working Group. Prevention and treatment of low back pain: evidence, challenges, and promising directions. Lancet. 2018;391(10137):2368-2383. DOI 10.1016/S0140-6736(18)30489-6. PMID 29573872. pubmed.ncbi.nlm.nih.gov
  7. 7.National Institute for Health and Care Excellence. Low back pain and sciatica in over 16s: assessment and management. NICE guideline NG59. Published 30 November 2016; last updated 29 July 2026. nice.org.uk
  8. 8.Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530. DOI 10.7326/M16-2367. PMID 28192789. pubmed.ncbi.nlm.nih.gov
  9. 9.Hayden JA, Ellis J, Ogilvie R, Malmivaara A, van Tulder MW. Exercise therapy for chronic low back pain. Cochrane Database Syst Rev. 2021;9(9):CD009790. DOI 10.1002/14651858.CD009790.pub2. PMID 34580864. pubmed.ncbi.nlm.nih.gov
  10. 10.Konstantinou K, Dunn KM, Ogollah R, et al.; ATLAS Study Team. Prognosis of sciatica and back-related leg pain in primary care: the ATLAS cohort. Spine J. 2018;18(6):1030-1040. DOI 10.1016/j.spinee.2017.10.071. PMID 29174459. pubmed.ncbi.nlm.nih.gov
  11. 11.Buell KG, Sivasubramaniyam S, Sykes M, Zafar K, Bingham L, Mitra A. Expediting the management of cauda equina syndrome in the emergency department through clinical pathway design. BMJ Open Qual. 2019;8(4):e000597. DOI 10.1136/bmjoq-2018-000597. PMID 31799444. pmc.ncbi.nlm.nih.gov
  12. 12.Conte A, Lingham A, Nagulendran S, et al. Improving the suspected cauda equina syndrome pathway at a district general hospital: a quality improvement project. BMJ Open Qual. 2025;14(2):e003081. DOI 10.1136/bmjoq-2024-003081. PMID 40441733. pmc.ncbi.nlm.nih.gov
  13. 13.Verhagen AP, Downie A, Popal N, Maher C, Koes BW. Red flags presented in current low back pain guidelines: a review. Eur Spine J. 2016;25(9):2788-2802. DOI 10.1007/s00586-016-4684-0. PMID 27376890. pubmed.ncbi.nlm.nih.gov
  14. 14.Davies BM, Mowforth OD, Smith EK, Kotter MRN. Degenerative cervical myelopathy. BMJ. 2018;360:k186. DOI 10.1136/bmj.k186. PMID 29472200. pmc.ncbi.nlm.nih.gov

This page is general information, not a diagnosis or a treatment plan, and nothing on it is a claim about what our care will do for your chronic pain — read the full disclaimer.

The rest of the list

The other conditions on our list

Pages to read next. We are not saying any of them is connected to chronic pain.

Ask first

Tell us what is going on

If you can’t find a time that works, text us at (616) 747-8462 and we’ll do our best to fit you in. If what you describe is not ours to treat, we will say so and point you somewhere it is.

Somewhere it is — the physical therapists, pelvic floor therapists, counsellors, OB/GYNs and pain clinics we point people to.

Book onlineText us
  • Monday9:00am – 6:00pm
  • Tuesday – Wednesday8:30am – 6:00pm
  • Thursday10:00am – 6:00pm
  • Friday8:30am – 1:00pm
  • SaturdayBy appointment

By appointment only

3888 Lake Michigan Dr NW, Grand Rapids, MI 49534 · Get directions