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Pain Management/Treatment for chronic pain


Hi Dr. Cappuccilli,

I've had constant chronic pain for almost ten years now; I'm still trying to find out what is exactly causing the pain. Some doctors think I have Fibromyalgia/Myofascial Pain Syndrome, while others think it is nerve-related pain. I do have osteoarthritis of the TMJ for sure, but they don't know what is causing pain throughout my body

Whatever the case, I have tried various pain medications over the years, but they do not even help to reduce the pain. I have decided to stop taking/trying medications; until I find a treatment((s## that I can use in conjunction with medication.Here is my dilemma.

My family means well, but they are frustrated that I've made this decision. I've tried explaining over and over again #based on extensive research and discussions with specialists)that medication alone will not help unless I use it in conjunction with treatment; the underlying problem has to be addressed first.  But, they don't seem to understand/believe that notion.I am not willing to go through side effects from  medication, knowing there is a slim chance it will work. I keep trying to tell them I have mechanical problems that has to be addressed #tight muscles, possible misalignment bones, osteoarthritis of the TMJ,etc.# that cannot be addressed with medication alone.

I was wondering, how can I persuade them that I am not trying to be difficult #which is what I feel, based on their reaction#?  Even though they know what I am relaying to them is from research/doctors, they still want me to take medications/alternative supplements. According to them, "this medication may work this time." But, I don't want to go through uncomfortable side effects, along with symptoms I experience from my condition.  I know in my heart they love me very much #they show it everyday# and want me well. And, I know they are frustrated as well, and they so want to believe there is some "magical" medication out there that will cure/reduce the pain.  I just want them to truly understand I know what I am talking about #in this instance#and to respect my decision.  I apologize for being long-winded, any suggestion would be helpful.. Thank you


First let me say I am sorry for your long term struggle with pain.  I would really need to see a history of your medication uses to be able to determine if the best options have been tried or not.  Certainly if nothing is working for you at all there is no reason to take them - however, I am not aware of a single patient - ever - that was not treatable with the correct medication or medicinal combination.  I deal specifically with chronic pain patients extensively in my practice and would love to see your records and prescription history.  If you are interested in a free review from me message me your address and I will send you a release of information sheet so I can get your history from the people you have seen previously.  I cannot guarantee I can change things for you and I am certain that I can provide some viable suggestions based on history, pharmocolgy and affliction that are specific to your case.

That being said - if the history proves out that there is really no alternative for you I will be glad to send you a responce letter based on my findings for you to show your family.

Pain Management

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Dr. Joshua P. Cappuccilli


I will be able to answer most questions regarding pain management with medications, physical manipulation and trigger point injections.


My current pharmacy practice is specialized to manage challenging patients with chronic pain. I work closely with a number of physicians in the surrounding area to ensure safe and effective pain management while working to minimize the potential from drug abuse, drug addiction and drug diversion. My practice is approximately 40% chronic pain patients on long term therapy.

BA from the University of South Florida 1998 PharmD from the University of Florida College of Pharmacy 2008 AphA certified in Medication Therapy Management

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