Like many pain management places these days, they seem to be moving more in the direction of "interventional" treatments (shots, etc.) and if you've tried all their "interventions" without success, you will probably be invited to go elsewhere, because the name of the game is becoming "intervention" and "procedures". This increasing attitude is not helpful to suffering patients who find themselves being bounced from one place to the other with few alternatives. I would suggest asking them to clearly explain what their goals for you are at the outset, and whether their "pain management" will cease if their interventions don't work. At least then you will know what you're in for and just exactly how much or how little "pain management" you may end up receiving from them long term.