{"id":381769,"date":"2026-01-01T16:19:07","date_gmt":"2026-01-01T16:19:07","guid":{"rendered":"https:\/\/www.newsbeep.com\/ca\/381769\/"},"modified":"2026-01-01T16:19:07","modified_gmt":"2026-01-01T16:19:07","slug":"how-an-ontario-chronic-pain-clinic-is-taking-a-new-approach-for-long-lasting-relief","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ca\/381769\/","title":{"rendered":"How an Ontario chronic pain clinic is taking a new approach for long-lasting relief"},"content":{"rendered":"

Open this photo in gallery:<\/a><\/p>\n

Physician Zameer Pirani at the Afiya Spine & Pain Institute in Toronto in December. The clinic offers treatments designed to allow patients with chronic pain to be seen only once or twice a year.EDUARDO LIMA\/The Globe and Mail<\/p>\n

When physician Zameer Pirani teaches medical students how to treat patients with chronic pain, he ends his lectures by raising three red flags. He says the aspiring family doctors should watch out for patients who make weekly visits to pain clinics, who get frequent steroid injections and who, despite all that, are not getting better.<\/p>\n

\u201cYou\u2019re actually harming a patient by doing things like that,\u201d he said. <\/p>\n

That kind of treatment for chronic pain has also attracted scrutiny as a drain on health resources. The Ontario Auditor-General reported in December that excessive injections for chronic pain were costing the province\u2019s health system an estimated $100-million a year, with 10 physicians billing nearly $60-million between them last year. <\/p>\n

Dr. Pirani believes he has a better way. The clinic he co-founded \u2013 the Afiya Spine & Pain Institute \u2013 offers treatments that mean he will ideally see a patient only once or twice a year once the underlying causes of their pain have been stabilized. <\/p>\n

In addition to giving patients a better quality of life, it also means he\u2019s able to have far more patients on his roster, increasing the efficiency of the health care system<\/a> and leading to fewer billings per person.<\/p>\n

\u201cI would get paid a lot more money to do weekly injections on someone, but I don\u2019t think that\u2019s right,\u201d he said. \u201cAnd none of the doctors here think that\u2019s right. That\u2019s not why we do medicine.\u201d<\/p>\n

Instead, he focuses on procedures such as radiofrequency ablation (RFA), in which instruments guided by special X-ray imaging generate concentrated blasts of heat that disable nerves. It provides pain relief that can last six months to a year. But it requires specialists like Dr. Pirani to do them, and specialized equipment.<\/p>\n

He also encourages physiotherapy and improvements to diet and exercise to reduce discomfort.<\/p>\n

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The road to opening Afiya\u2019s first location wasn\u2019t easy. After Dr. Pirani finished medical school in Ireland, he did a residency in anesthesia at Western University in London, Ont., and a fellowship in pain medicine at the University of British Columbia.<\/p>\n

After coming back to Ontario to be closer to family, he wanted to focus on treating patients with chronic pain. But when he knocked on the doors of academic institutions, they didn\u2019t have room for him. He did some work at community clinics but didn\u2019t feel they were treating chronic pain appropriately.<\/p>\n

So, he connected with another doctor in his professional network \u2013 Ahilraj Siva \u2013 and they decided to start their own practice. He needed bank financing for equipment such as an X-ray machine that cost $200,000. But he found the banks were, at first, skeptical because his business plan didn\u2019t match what they were used to.<\/p>\n

\u201cThe banks were like, \u2018You guys just started your careers. No way you\u2019re going to make this work,\u2019\u201d Dr. Pirani said.<\/p>\n

After revisions to his business plan and further negotiations, he got financing and opened a clinic in downtown Toronto in 2023 while continuing to work as an anesthesiologist at the Scarborough Health Network.<\/p>\n

The early days were challenging. He was one of the clinic\u2019s few doctors and would sometimes finish a 12- or 24-hour shift at the hospital, come to the clinic, sleep a few hours, and then start seeing patients. \u201cI would come here just because I had to pay the staff, right? So, I would see as many patients as I could.\u201d<\/p>\n

He said 95 per cent of their procedures are billed to the Ontario Health Insurance Plan.<\/p>\n

And although his clinics are not equipped to help patients with addictions, he said a benefit of treating chronic pain is to reduce dependence on painkillers.<\/p>\n

\u201cI always tell them, you know, if you\u2019ve been on opioids for two, three, four, five, six years, the opioid is not doing what it\u2019s supposed to be doing,\u201d Dr. Pirani said. \u201cIt\u2019s not treating your pain. It\u2019s preventing you from having withdrawals from addiction.\u201d<\/p>\n

Within two years, Afiya\u2019s Toronto location had 13 physicians on its register and had seen 5,000 patients \u2013 and was looking to expand.<\/p>\n

In April, the team opened a clinic in Hamilton, in partnership with Eugene Maida, medical director of the Michael G. DeGroote Pain Clinic at McMaster University. <\/p>\n

Open this photo in gallery:<\/a><\/p>\n

Dr. Pirani’s clinic focuses on procedures such as radiofrequency ablation, which provides pain relief that can last six months to a year.EDUARDO LIMA\/The Globe and Mail<\/p>\n

Dr. Pirani said that after the first clinic\u2019s success, getting financing again was a different experience. \u201cFor the second location, every bank wanted to lend us money,\u201d he said with a laugh.<\/p>\n

By December, the Hamilton clinic was seeing 300 to 350 patients a week, and Dr. Pirani said they have the capacity to see double that.<\/p>\n

One of those patients is 69-year-old Michael Doucet, who drives in from London for treatment. Mr. Doucet said his experiences with chronic pain began after a car accident in 2003 that left him with shattered bones in his leg and hip. He said he struggled through 14 more months of work at an auto plant so he could qualify for his pension.<\/p>\n

In the years that followed, he tried different things to alleviate the pain. He used opioids for about a decade before quitting. Around 2012, he flew down to Mexico for private stem-cell therapy that worked for a time. <\/p>\n

But in 2019, he got rear-ended while driving. \u201cThat opened everything up again,\u201d he said.<\/p>\n

He paid out of pocket for a hip replacement in 2021. The pain got so bad that last year he started the process of applying for a medically assisted death.<\/p>\n

Then one of Mr. Doucet\u2019s neighbours suggested he reach out to Dr. Pirani, who the neighbour had taught during his residency.<\/p>\n

Mr. Doucet said his treatment at Afiya since May has greatly increased his quality of life and made it easier to spend time with his daughter and two grandchildren. \u201cI enjoy things more in life now than I used to,\u201d he said.<\/p>\n

Dr. Pirani said he hopes to continue to expand his practices and provide more opportunities to physicians who have specialized in pain management. He recently signed an agreement-in-principle with the Scarborough Health Network to partner on a pain clinic there, with the support of donors.<\/p>\n

He said medical school was difficult, but running a business and trying to correct deficiencies in the health system has been a whole other level. \u201cThis is one of the most gratifying things I\u2019ve done,\u201d he said.<\/p>\n","protected":false},"excerpt":{"rendered":"Open this photo in gallery: Physician Zameer Pirani at the Afiya Spine & Pain Institute in Toronto in…\n","protected":false},"author":2,"featured_media":381770,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[49,48,84,392,6347],"class_list":{"0":"post-381769","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-ca","9":"tag-canada","10":"tag-health","11":"tag-healthcare","12":"tag-ne-i"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/381769","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/comments?post=381769"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/posts\/381769\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media\/381770"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/media?parent=381769"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/categories?post=381769"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ca\/wp-json\/wp\/v2\/tags?post=381769"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}