Chronic Pain Relief
& Wellness Therapy

Each Patient Has a Unique Story

At Medical Pain & Spine Care, we strive to show patients how much we care about them. Our providers take time to listen to each patient’s story and then provide an individualized treatment plan to produce maximum pain relief.

Although lower back pain is the most common condition our patients are seen for, it is just one of many chronic pain symptoms we help patients overcome and manage. The spinal cord stimulator is one of the most effective pain controlling therapies we have for patients suffering from chronic pain in the spine and upper and lower extremities. Even patients who have undergone multiple back surgeries and started to lose hope for improvement have found wonderful lasting pain reduction through spinal cord stimulator therapy.

No matter what your story, even if you have lost hope in finding pain relief, our team will listen and help you with an effective pain management treatment plan that's right for you.

J Peter Klim, DO


Mark Nielson, MD


Haylee Goad, FNP


Emily Hackett, FNP-C

Nurse Practitioner

Stephen Feehan, DPT


Angie Speer, PTA


At Medical Pain & Spine Care of Indiana, treatment options may include imaging, physical therapy, spine procedures, muscle and joint injections, pain management device implants, medication management, and even medical weight loss which can improve joint and lower back pain

Ketamine has gained significance in treating chronic pain and depression since the 1990s. At our clinics, ketamine infusions are performed in a comfortable, private setting by qualified experts. Our clinicians are members of American Society of Ketamine Physicians, Psychotherapists and Practitioners. We are dedicated to the safe clinical use of ketamine for pain and mental health conditions. If you have been struggling with unsuccessful treatments, ketamine may work for you.

Ketamine is an anesthetic used in the operating room during surgery. It interacts with specific receptors in your brain to decrease pain and your brain's memory of pain. Intravenous ketamine is only FDA-approved for anesthesia and surgical sedation. More recently however, doctors have used low-dose ketamine infusions to alleviate chronic pain conditions, depression, anxiety and other behavioral health purposes.

Ketamine was initially used as an anesthesia medicine in the 1960s. It was administered to soldiers on the front lines during the Vietnam War. Since the 1990s, many clinical studies have found that ketamine is not only useful to relieve pain short term, but can be an effective way to treat certain chronic pain syndromes such as fibromyalgia, migraines and burns. In the 2000s, medical studies showed ketamine was a viable alternative treatment for depression. Today mental health professionals are using ketamine to treat treatment-resistant depression and other mental conditions such as PTSD. Ketamine is also used to treat chronic moderate to severe pain.

If you suffer from chronic regional pain syndrome, phantom limb syndrome, fibromyalgia, chronic back or neck pain, chronic joint pain or neuralgia, Ketamine Infusions may give you the relief you've been missing.
 Side effects of Ketamine include the following: 
  • A dream-like feeling, drowsiness, or a twilight sleep, you may experience drowsiness but stay awake throughout the treatment
  • Double vision or blurred vision
  • Dizziness
  • Jerky muscle movements
  • Vomiting or nausea
  • Loss of appetite
  • Sleep disturbances or insomnia
  • High blood pressure (patients whose hypertension is not well controlled are not eligible for treatment)
If you've completed a Ketamine infusion consultation and are scheduled for an infusion, the length of your ketamine infusion may vary depending on your condition. After your infusion, we  recommend you remain at the office for observation for about 30 minutes and arrange to have someone bring you home.  We also recommend that you take it easy for the remainder of the day. To get the most benefits out of your ketamine infusions, you may need a series of treatments.  
We are IV infusion experts. Ketamine is a dissociative anesthetic, commonly used in the operating room for general anesthesia. Dr. Klim and Dr. Nielson are double board certified by the American Board of Anesthesiology in both anesthesiology and pain medicine. Additionally, both doctors are members of the American Society of Ketamine Physicians, Psychotherapists and Practitioners. Our approach to patient care combines meticulous attention to safety, effectiveness and patient satisfaction.

New PAIN Patient Paperwork

Please complete the attached paperwork prior to your first visit. Bring this paperwork, your insurance card and photo ID, and recent x-ray or imaging reports.

New MAT Patient Paperwork

This paperwork is for new patients seeking medically assisted treatment for addiction. Please print and complete this packet and bring it with you to your first visit.

Release of Medical Records

We have partnered with MediCopy to provide accurate and timely delivery of your medical records. Please complete this form and send to MediCopy via email or fax.

Good Faith Estimate Request

Request an estimate for self-pay or non-covered services.

More people die every year from overdose of prescription drugs than car accidents? The Associated Press reported that in San Francisco, more people died from drug overdose than COVID-19 in 2020.    "A record 621 people died of drug overdoses in San Francisco so far this year, a staggering number that far outpaces the 173 deaths from COVID-19 the city has seen thus far." [12/21/2020]
  • Hydrocodone
  •  Oxycodone (OxyContin)
  • Morphine
  • Fentanyl (Duragesic)
  • Hydromorphone (Dilaudid)
When combined with acetaminophen, hydrocodone and oxycodone are prescribed under the brand names Vicodin and Percocet.  Opioids are available in pills, liquids, shots, patches, and suppositories.

At Medical Pain and Spine Care of Indiana, we offer a comprehensive pain management plan, which will sometimes include prescription opioids for pain relief. 
Opioids are a class of narcotic drugs that are derived from morphine. They work with opioid receptors to disrupt pain signals sent to the brain by the nervous system to offer pain relief.  In general, opioids are most effectively prescribed for short-term, episodic pain relief from injury or illness. Conditions for which opioids may be prescribed include:

  • BACK PAIN -- including degenerative disc disease, ruptured or herniated disc, spinal stenosis, and vertebral compression fractures
  • CANCER PAIN -- especially in late-stage cancer patients
  • HIP PAIN -- with osteoarthritis and fractures as the most commonly treated with opioids
  • INFLAMMATORY BOWEL DISEASE -- such as Crohn’s disease and ulcerative colitis
  • NEUROPATHY -- including diabetic neuropathy and any other types of nerve pain
While some patients benefit tremendously from opioid therapy, recent research into the effectiveness of opioids on chronic pain has shown that opioids may do more harm than good when it comes to treating chronic pain. In 2015, an analysis by the National Institute of Health (NIH) looked at existing studies regarding the effectiveness of opioids for long-term chronic pain and found no evidence that opioids were effective at treating long-term pain. This same study found evidence that indicated a high risk of dose-dependent, serious side effects including abuse and dependence, bone fracture, and myocardial infarction.

As of 2014, an estimated 1.9 million people in the U.S. had a substance abuse disorder involving prescription opioids. From 1999 to 2008, opioid addiction rates and opioid prescription rates rose in parallel with the death rate from overdose increasing 400% during the same period. Opioids are powerful narcotics that change the structure of the brain such that it adapts to the dose and gradually requires more to feel the same pain relief. Even when taken as directed, long-term use can result in dependence.
Opioid-induced hyperalgesia, or increased pain sensitivity, is also a possibility with long-term use of opioids for chronic pain. Previously, opioid-induced hyperalgesia was thought to be a byproduct of opioid withdrawal, but new research has shown that it can occur at any stage of opioid use.

Other lesser-known side effects of long-term opioid use can include:
  •  IMMUNOSUPPRESSION making patients more vulnerable to other health issues. This can be especially difficult for those patients with other chronic, immune-related illness. 
  • DECREASED LIBIDO -- For men, long-term opioid use can result in lower levels of testosterone production (hypogonadism). In women, this same long-term use can disrupt hormone production, causing amenorrhea (lack of menstrual cycle). In both cases, this can result in a decreased sex drive. 
  • OSTEOPOROSIS developing in both men and women. 
We believe the risks associated with long-term opioid use warrant caution and restraint when it comes to prescribing these medications. Our pain management specialists focus on a comprehensive pain diagnosis and management options. To that end, we look at other treatment options before prescribing opioids.
Conventional treatments may include prescription non-steroidal anti-inflammatory drugs, antidepressants, anticonvulsants, and steroids. We may also look at minimally-invasive procedures, such as nerve block procedures, or more invasive techniques such as intrathecal pain pumps, spinal cord stimulation, or radiofrequency ablation. Our pain management specialists believe in a holistic approach to chronic pain and also recommend many complementary and alternative options for pain relief including physical therapy, as well as psychological and behavior interventions available at our office in Noblesville.

While we strive to utilize all other pain-relieving options prior to prescribing opioids, we recognize that for some patients in specific circumstances, opioids may be their best option for relief. Medical Pain and Spine Care of Indiana follows strict prescribing and monitoring guidelines as set forth by the federal government and works closely with patients to resolve their pain in other ways before utilizing opioids.

Part of working closely with our patients includes discussing and signing a pain management agreement form. This form follows the Centers for Disease Control’s updated opioid prescribing guidelines and includes the following provisions:
  1. The agreement acknowledges that opioid therapy is just one part of a patient’s comprehensive treatment plan. 
  2. Patients are to follow all parts of the holistic, comprehensive pain management plan designed with their doctors to include a number of different therapies. This may mean making lifestyle changes as well as undergoing counseling and other complementary therapies tailored to each individual patient. 
  3. Our pain management specialists prescribe the lowest effective dose and will not increase the dose without thoroughly re-evaluating the patient. 
  4. Patients agree to regular follow-up visits, monthly urine screenings, and pill counts within 24 hours if requested by the doctor. 
  5. Doctors and patients work closely together with all other specialists and physicians to avoid over prescription or concurrent benzodiazepine or opioid prescriptions. Each part of this opioid agreement form was designed to protect the patient while undergoing opioid therapy. 
Our goal at Medical Pain and Spine Care is to develop the best possible pain management plan for every patient that improves their quality of life. We work as a pain management team to provide comprehensive diagnostic and therapeutic services. We utilize an extensive array of treatment options specifically designed for each patient. When one of these options is opioid therapy, we provide the support and guidance needed for safe, effective pain relief.

For more information on all of our pain management options, including opioid therapy, please call 317-776-7028 to schedule an appointment.

Happy patients are the best referral sources!