Why do pain management doctors not manage chronic pain for people who legitimately need medication and surgery will not fix the issue. Even with surgery (spondylolisthesis) you would still need medication. So why have surgery with all the complications and then still need meds. Doesn t it make sense to just take the meds so long as you are managing at a certain level. In this case 5 years. I went to a pain management Dr for the first time and it was a negotiation for meds (I can give you 3 of these and 2 of these or 3 of this and 3 of that but not 4 of anything and you need to wean off x medication. OK I said give me a wean down off schedule and his reply was do it on your own) How is this help or pain management? Obviously not going back to him and will try another Dr but from what I hear this seems to be the same experience many others have also.