Patients tell us the hardest part of starting pain care is not knowing what the first visit involves. Below is exactly how the initial evaluation runs at our Silver Spring office, whether you come on a Tuesday morning or a Sunday afternoon.
Before you arrive
You complete an intake form with your history, current pain, prior treatments, and insurance or self-pay preference. Filling it out beforehand means the clinician has read your story before you sit down, and the visit is spent on examination and planning rather than paperwork.
Bring or upload anything you already have: prior imaging reports, physical therapy notes, a list of medications and doses, and the names of clinicians you have already seen. Old records shorten the path considerably.
The history
The first portion of the visit is a structured pain history. Where is it, when did it start, what makes it better or worse, what does it stop you from doing, and what has already been tried. We pay particular attention to function — whether you can sleep, drive, lift a child, or stand through a shift — because function is what a plan is built around.
We also screen for the findings that change the plan: numbness, weakness, symptoms in both legs, unexplained weight loss, fever, or a history of cancer. These are the features that push an evaluation toward imaging or a referral rather than straight to treatment.
The examination
The physical exam is focused on the region involved and the nerves that serve it: range of motion, strength testing, reflexes, sensation, provocative maneuvers, and gait. For a low back complaint that means straight-leg testing and hip assessment; for a neck complaint it means shoulder and upper-limb neurological testing.
The plan
You leave with a written, individualized plan. Depending on your findings, it may include guided physical therapy, a steroid or trigger-point injection, acupuncture, laser therapy, StemWave shockwave sessions, imaging, a specialty referral, or — where clinically appropriate and consistent with Maryland law and CDC guidelines — monitored medication management. Treatment plans are set only after clinical evaluation, and no outcome is promised.
You also leave knowing the follow-up interval and how to reach us if things change. Most patients are seen again within two to three weeks, frequently by weekday evening telehealth.
What $175 means
$175 is the self-pay price of the initial evaluation itself. It is stated plainly so nobody has to guess. Procedures, injections, imaging, therapy sessions and medications are separate and are discussed with you before anything is scheduled. If you use insurance instead, your cost depends on your plan's benefits, and most major carriers are accepted.