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Vincent is a 54-year-old artist who has made significant contributions to the world of art in the recent past. About 9 months ago, he was involved in a fight at a local bar and an assailant stabbed him in the left shoulder. Although the injury was deep, he underwent immediate surgery and his shoulder injury was repaired without much problem. He had an uneventful recovery. However, after discharge from the hospital, he continued to suffer from pain in the left shoulder, which slowly started to involve his left arm. He was under the care of his primary care physician who prescribed him various analgesics, physiotherapy, TENS, and even suggested acupuncture. Unfortunately, he failed to respond to all these therapeutic measures. He was then referred to the pain physician who found that Vincent's initial injury had healed well, and noted a few trigger points over his left shoulder which he treated with injections. He yet again failed to respond. He was then started on gabapentin without any improvement; in fact, he became depressed. His misery was compounded by the fact that he used his left hand to hold the brush while he painted. Now he has opted to undergo the pain management program and is here to consult you as a pain specialist.

Do you think this referral is appropriate?

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