How to Start and Run a Pain Clinic

Asian Pain Academy
4h
4 min read

Introduction

Chronic pain is among the leading causes of disability worldwide, affecting millions across all age groups. Despite this enormous disease burden, specialised pain clinics remain scarce in many parts of India and Asia.

For healthcare professionals passionate about improving pain care, starting a dedicated pain management clinic can be a deeply rewarding and impactful initiative. However, it requires far more than space and equipment — it demands vision, structured training, legal compliance, and a multidisciplinary approach.

This step-by-step guide by the Asian Pain Academy is designed to help physicians plan, establish, and successfully operate a modern pain clinic that is ethical, evidence-based, and compliant with all medical regulations.

Step 1: Build the Infrastructure – Location, Layout, and Design to Start a Pain Clinic

Selecting the right infrastructure forms the foundation of a successful clinic. Choose a centrally located, easily accessible site that ensures patient comfort and operational efficiency.

Facility Requirements

Reception and waiting area: Welcoming, well-ventilated, and informative.
Consultation chamber: For detailed clinical evaluation and counselling.
Procedure room: Sterile, well-lit, with radiation safety provisions.
Recovery area: For observation after nerve blocks or radiofrequency (RF) procedures.

Safety and Design Considerations

Maintain adequate spacing between patient and procedural zones.
Provide lead-lined shielding if using fluoroscopy (C-arm).
Ensure fire safety certification, biomedical waste segregation, and air filtration systems for asepsis.

Step 2: Build a Competent, Multidisciplinary Team

Pain management thrives on collaboration. Assemble a skilled and empathetic team to ensure holistic care.

Essential Team Members

Pain Physicians: Trained in interventional and clinical pain medicine.
Anesthesiology or PMR-trained Doctors: With additional fellowship training in pain procedures.
Nurses and Technicians: Skilled in sterile techniques and assisting interventions.
Physiotherapist: For rehabilitation and posture correction.
Clinical Psychologist: For coping strategies, CBT, and chronic pain behaviour modification.
Administrative Staff: For scheduling, billing, and patient coordination.

A multidisciplinary model ensures biopsychosocial management — addressing not only the pain but its emotional and functional impact.

Step 3: Get Proper Training in Pain Medicine

Competency in pain medicine is the most Important investment you can make before starting a clinic.

Pain management involves a deep understanding of neuropathic, musculoskeletal, and cancer-related pain, as well as proficiency in image-guided interventions (ultrasound and fluoroscopy).

Recommended Training

Enroll in a structured pain medicine program or fellowship to gain:

Diagnostic acumen for complex pain syndromes
Procedural proficiency in nerve blocks and RF ablation
Ultrasound and fluoroscopy-guided injection techniques
Safety and complication management

At the Asian Pain Academy, our courses and workshops focus on Ultrasound-Guided and Fluoroscopic Pain Procedures, combining theoretical learning with hands-on cadaveric and live model training.

Step 4: Equip Your Clinic with the Right Technology

The success of a pain clinic depends heavily on precision equipment that ensures accuracy and patient safety.

Essential Equipment

C-arm fluoroscopy unit: For spinal and joint interventions.
High-frequency ultrasound machine: For musculoskeletal and peripheral nerve procedures.
Radiofrequency generator and cannulas: For neurotomy and denervation.
Monitors and crash cart: For vital sign tracking and emergencies.
Sterile instruments, trays, and PPE kits: For aseptic interventions.

Start with a scalable model — upgrade your equipment as your procedural volume grows.

Step 5: Obtain Legal, Radiation, and Imaging Compliance

This is one of the most overlooked yet critical steps in starting a pain clinic. Pain physicians often use radiation-based and ultrasound-guided techniques — both of which require official authorisation.

A. AERB (Atomic Energy Regulatory Board) License

If you use C-arm fluoroscopy, your clinic must:

Obtain AERB approval for radiation installation and safety.
Appoint a Radiation Safety Officer (RSO).
Maintain lead-lined walls, lead aprons, thyroid shields, and dosimeters.
Conduct periodic radiation safety audits and staff exposure monitoring.

AERB compliance is mandatory under the Atomic Energy (Radiation Protection) Rules, 2004 and protects both patients and staff from radiation hazards.

B. PCPNDT (Pre-Conception and Pre-Natal Diagnostic Techniques) License

If your clinic uses ultrasound equipment, even for pain management (not obstetrics), you must:

Register under the PCPNDT Act with your district health authority.
Maintain documentation of machine use, imaging logs, and declaration of non-obstetric application.
Display a visible notice stating that “This ultrasound equipment is used for musculoskeletal and interventional pain procedures only, not for gender determination.”

Non-compliance with PCPNDT regulations can lead to severe legal action, including equipment seizure.

C. Other Regulatory Requirements

Clinic license and medical registration under the local Clinical Establishment Acts.
Biomedical waste management authorisation from the State Pollution Control Board.
Fire safety and building stability certificate.
Professional indemnity insurance for doctors and staff.

Compliance ensures your clinic’s credibility and protects against medico-legal complications.

Step 6: Stock Medications and Emergency Supplies

A well-equipped clinic should have:

Local anesthetics: Lignocaine, bupivacaine, ropivacaine.
Steroids: Triamcinolone, methylprednisolone.
Adjuvants: Hyaluronidase, clonidine, dexamethasone (for specific indications).
Neuropathic pain medications: Gabapentin, pregabalin, duloxetine, nortriptyline.
Opioids: As per NDPS regulations.
Emergency drugs: Epinephrine, hydrocortisone, IV fluids, and anti-allergics.

Maintain strict inventory logs, expiry checks, and storage protocols.

Step 7: Ethical Marketing and Community Outreach

Once your clinic is operational, you need patient visibility — but within ethical and regulatory boundaries.

Build Awareness Through Education

Create a professional website with educational blogs and FAQs.
Maintain an active Google Business Profile.
Share informative posts and videos on social media platforms.
Conduct pain awareness camps, webinars, and referral meets with local doctors.
Publish academic content via Asian Pain Academy’s educational initiatives to establish credibility.

Avoid misleading advertising or promises of guaranteed cures — instead, emphasize evidence-based treatment and compassionate care.

Step 8: Continuous Learning and Professional Growth

Pain medicine is rapidly evolving. Stay updated by attending:

National and international pain conferences (e.g., ISSP, WIP, APS).
Asian Pain Academy’s advanced workshops and cadaveric training in ultrasound and RF interventions.
Research-based webinars and journal clubs to refine clinical judgment.

Our Advanced Ultrasound-Guided Pain Procedures Course (December 2025) will provide intensive training in diagnostic scanning, sonoanatomy, and guided therapeutic techniques for physicians across Asia.

Conclusion

Starting a pain clinic is not just an entrepreneurial step — it’s a commitment to relieving suffering through skill, ethics, and precision.

Invest in structured training, comply with all legal and radiation safety norms, and focus on patient-centred, evidence-based care.

At the Asian Pain Academy, we continue to mentor clinicians who wish to build pain clinics that represent the highest standards of education, safety, and compassion in pain medicine.

Asian Pain Academy