chronic pain management

The goal is to improve function through decreased suffering.

1 in 5 Canadians live in chronic pain. The Canadian Pain Society states " Evidence supports that chronic pain is  not just a symptom of underlying illness or injury, but it is a disease  in its own right, with significant changes in complex biological, and  psychosocial functions." - Accessed March 2018.

Medication management is a trial and error process, and can be very frustrating. But it is well worth the trials to find a combination that works for you. Dr. Holowaty also performs joint injections, trigger point injections, acupressure, acupuncture, dry needling and  botox injections for chronic migraine.  If deeper injections or lidocaine/ketamine infusions seem beneficial, Dr. Holowaty will refer you to appropriate physicians for further treatments.  

Dr. Holowaty's philosophy is that pain cannot be treated without addressing total suffering. There is the physical component, but because of the plasticity of the nervous system, and the the shared wiring with mood and the stress response, these must also be mastered in order to manage pain and reduce suffering. Most of this work needs to be done by the patient, unfortunately! But it also means that you have control of most of your healing. Please see below for some excellent resources as well as checking out PainBC for their amazing website and free tools.

vertebrae with a disc

vertebrae with a disc

Understanding Pain

Lorimer Moseley takes complex ideas in pain and explains them so everyone can understand them. 

self Management resources

Knowledge is Power

Pain is not simple. In fact, its very complex. The more you know about it, the more you can do about it, and take charge of your life again. 

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Physical Therapy

Physical movement improves almost everything! Even if it hurts at the beginning, as your body gets stronger from its injury, movement will feel better and better.

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Attitude is Everything

It may sound trite, but a positive attitude and an openness to try new things and push yourself are important for physically feeling better. 

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Mindfulness has been shown to be an incredibly powerful tool for dealing with mental health issues, stress, chronic pain and trouble sleeping. 

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Opioid De-Prescribing

Opioids are no longer indicated for treatment of chronic pain. In fact, we know opioids can make you feel worse - lowering testosterone, depressing mood, and making pain worse. 

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Sleep is when your body and your mind are able to repair and rejuvenate themselves, and so is very important. There are easy routines to get into to ensure that you have a good nights sleep.

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Interventional treatments available


Acupuncture and Dry Needling

Acupuncture has been shown to have a good effect on chronic pain.  Dry needling places acupuncture needles at trigger point sites.   J Pain. 2018 May;19(5):455-474. doi: 10.1016/j.jpain.2017.11.005. 

Trigger point Injections

Trigger points are tight muscle bands that you can feel under the skin. They often cause pain at not only their own site, but at body parts that radiate farther away.  This is a very common cause of pain.

Botox for Chronic Daily Migraine

If you have tried "everything" for chronic migraine headaches, and yet you still suffer from 15 headaches per month, 8 of which are migraine, you may qualify for botox injection coverage for this through the Ontario Drug Benefits Program. However, the injecting process itself is not covered. Dr. Holowaty charges only $100.00 for the injection process, which is performed every 12 weeks. 

You can read more about these injections and other migraine treatments at

If you think this may be an option to explore, please have your health care provider complete the referral form for Botox below.