Dr. Zack Smith recently gave a presentation detailing some of the current advancements in treatment that may help patients struggling with long-term pain. You can watch the full presentation and Q&A above or on our YouTube channel, or continue reading for a summary.
Many people wait too long to seek help for chronic pain. If pain has lasted more than six months and is starting to interfere with your daily life—whether it’s walking, working, or enjoying time with family—it’s time to talk to a pain management specialist.
When you are seeking treatment for pain, you will likely go through what Dr. Smith refers to as a “ladder” of pain management options.
In the presentation, Dr. Smith focuses on two main treatments for chronic pain that has not responded to other treatments: Radiofrequency Ablation and Spinal Cord Stimulation. Both of these treatments use electricity to help try and treat nerve pain especially, but mechanical pain to varying degrees, but they use it in very different ways.
RFA uses heat to disrupt pain signals in small sensory nerves. It involves using a specialized needle or probe and targeting the sensory nerves that actually tell our brain that we’re having pain and we burn them or “ablate” them. And it uses electricity, similar to how a microwave heats up your food. It actually heats up those little nerve endings and causes those nerve endings to die off.
It’s commonly used for joint or back pain and offers:
SCS is a small device implanted near the spine that interrupts pain signals before they reach the brain. The technology has been around since the 1970s, but recent advancements in SCS have shown great improvements in both the efficacy of the treatment, as well as the type of chronic pain that is able to be treated with it. In addition to being previously recommended for lower back pain, SCS is now FDA-approved for the treatment of diabetic neuropathy, as well as other forms of neuropathy.
Today’s updated technology now allows patients to:
In order to assess if you are a good candidate for a spinal cord stimulator, you will begin with a trial:
SCS who underwent an SCS trial reported:
If you’ve tried other treatments and still live with pain, you may be a candidate for RFA or SCS. Visit pain.com to hear from real patients about their experiences with SCS, or schedule a consultation with Dr. Smith or another pain specialist to explore your options.
*The PainSmith team has reviewed this information. It is intended for informational purposes only, not to replace the advice of your doctor or other health care provider. Please discuss any questions or concerns you may have with your provider.
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08/03/2026
Dear Painsmith Patients,
It has been a pleasure caring for all of my patients over the past several years here in San Antonio. Unfortunately, due to ongoing personal health issues, I will be unable to continue caring for you with the same high level of care you are used to. Because of this, my last date treating patients at Painsmith will be September 5, 2026.
If you have a scheduled appointment prior to this date, we are more than happy to keep that appointment, and will attempt to accommodate other patients who wish to be seen prior to our final date. If you wish to cancel your appointment please contact the office.
Your medical records will remain at Painsmith, and we are happy to forward your records to yourself or a physician of your choosing. Our office staff can assist you with forwarding or obtaining your records.
Thank you,
William (Zack) Smith, MD
