Patients with any of the clinical presentations/conditions listed below are excellent candidates for referral to the pain medicine specialists of Utah Pain & Rehab for appropriate, ethical and comprehensive evaluation: Treatment-based "trigger points" for referral to pain medicine: Any time the physician feels uncomfortable with the patient's clinical progress or medication use. Patient on stable opioid analgesic pain medication who states it is no longer effective, or patient requiring a medication switch. Lack of response to physical therapy after 4-6 visits or 30-45 days. Consider referral to UP&R for confirmatory diagnosis and evaluation prior to physical therapy. Condition-based "trigger points" for referral: Radicular arm or leg pain from the neck or low back, if associated with extremity sensory or motor changes consider immediate referral. Residual pain after neck or low back surgery, regardless of when the surgery occurred. Neuropathic pain, particularly of the upper or lower extremities. Pain that limits function and activity, including headache, vertebral compression fracture, spasticity, and non-malignant cancer pain. New-onset weakness/sensory deficits in upper or lower extremities. Time-based "trigger points" for referral: New (acute) pain lasting more than one month, or still not resolving at follow-up visit. Pain that requires short-acting opioid for longer than 1-2 months.