Pain Medicine

Pain Medicine continues to expand and advance across UCSF Health and beyond.

Inpatient pain care continues through our three separate Acute Pain Service (APS) lines and our one Chronic Pain Service (CPS) line, collectively covering Parnassus, Mount Zion, and Mission Bay. Presently, there are 22 anesthesia faculty attending on the APS and 12 anesthesia faculty attending on the CPS. Notable service changes in 2025 include the use of a new regional follow up note, used by the APS, to document and facilitate follow up of any complications which may occur from regional anesthesia. We also now have a director of the Inpatient Chronic Pain Service, the inaugural position for which is held by Heidi Reetz, MD.

Institutional pain care is also advanced by the work of the pain committee, with considerable efforts from APS Director Dr. Matthias Behrends and Certified Nursing Specialist Marilyn Bazinski. Work has included the establishment of new guidelines and nursing practices for the management of indwelling catheters for pain management. This work, along with a pivot to a new securing device for epidural catheters, has dramatically decreased our rate of premature epidural dislodgement. The Pain Committee has also spearheaded the creation of multiple UCSF protocols to address the problem of diversion of controlled substances in inpatient settings.

Outpatient care is anchored at our beautiful new clinic in the new Bayfront Medical Building. In our state-of-the-art new facility, we continue to grow. There are 22 physician faculty members working at the department’s outpatient practice, the UCSF Center for Pain Medicine. Among our new faculty is Dr. Jeff Merz-Herrala, an Emergency Medicine-trained physician bridging many gaps with his work on the APS, in clinic, and emergency medicine (Bayfront UC and ZSFG ED). Another point on the expansion front is the creation of a Department of Anesthesia faculty pathway for pain psychologists, as exists at peer institutions, which has allowed us to expand our pain psychology roster. We now have 5 pain psychologists. Other provider staff include two ambulatory pharmacists, one physical therapist, and two nurse practitioners. The training and credentialing of our NPs in performing certain procedures (e.g., trigger point injections, occipital nerve blocks, capsaicin patch application, ketamine/lidocaine infusion oversight) has allowed our physician faculty to focus their efforts on an increasing volume of fluoroscopic and advanced ultrasound-guided procedures. The result has been an ever-increasing utilization of our procedure rooms. As of early 2026, there are about 140 scheduled patients a day across all our sites: Mission Bay, Marin, Berkeley, Walnut Creek, and most recently Santa Cruz, with the latter staffed by Dr. Lawrence Poree and Dr. Linda Wolbers. Approximately 40 new patient referrals are processed daily, and the clinic continues to operate on an increasingly positive margin for the FPO. This interest in our clinical services comes from highlights of our faculty in high-impact publications (CNN, NYT, WSJ), high impact journals (JAMA Neurology, and more) and the day-to-day impact of our clinicians on patients experiencing pain.

As always, we're looking forward to what the next year will bring.

Chris R. Abrecht, MD
Chief, Pain Medicine
Medical Director, Center for Pain Medicine