PATIENT SPACE - Portland Pain Solutions

• Routine scheduling, questions about the practice, and billing questions - (207) 835-8116, ext 1.
• After hours administrative messages can be left with voice mail for reception as above.
• Urgent referrals from medical providers, call our main number, ext 4 for Dr. Littlejohn.
• Urgent or emergent after hours contact, see the section on after hours care below.
• To contact us for more information on services, please use our contact form here on the website and we will respond shortly, usually within 24 hours. Alternatively, you can email info@portlandpainsolutions.com.

We will post these updates on our Facebook page, which you can find at: https://www.facebook.com/PortlandPainSolutions

We are located at 1945 Congress Street, Building C, on the first floor. The building complex is directly across the street from the entrance to the Portland Jetport. The signage can seem confusing. The largest signs for the building complex are for Clark Insurance and the Elks Lodge, as well as Medical and Cosmetic Centers of Maine (our building). Once you enter the complex, make your first right and Building C will be straight ahead. We are located in the same suite as Northeastern Interventional Pain and Migraine Solutions, which is a different practice from ours, and focuses primarily on headache management and migraine surgery.

Scroll up this page to find the insurance participation roster file to view or download. It's the third file down on the left.

The first step, whether you find us online, or if you are referred by another provider or clinic, is to get you registered as a patient. We'll need your legal name, sex, date of birth, address, cell phone, email, PCP, and insurance info. We'll get a chart started for you and request primary care records, and a referral if needed. Finally, we'll get you scheduled for an appointment. Once an appointment is schedule, you will receive email and text notifications that there are some electronic forms to complete. Please do this as thoroughly as possible, as it saves a lot of time on the day of your appointment. Less time spent on administrative issues means more time with the doctor. We can usually get new patients in within 1-2 weeks.

We have a $15 administrative fee for prior-authorization. Our prior-authorization process is outsourced, and the fee covers the cost of paying for your insurance-required authorization. We decided to do this because prior-auths take a minimum of 20-30 minutes of administrative time, but can stretch out to an hour or more on the phone with your insurance company. We could no longer sustain this as a free, in-house service, so going forward this is outsourced for a fee. You are responsible for the fee even if the insurance company ultimately denies the service.

See our financial policy for the most up to date information. Co-pays are collected at the time of service, and for anyone having an insurance with a deductible, a credit card on file is required to cover what your insurance doesn't pay, as well as incidental fees. For insurance-covered services (particularly with commercial policies) we do not know at the time of service exactly what your bill will be. Every insurance has different contracted rates for services. That information isn't unavailable until your insurance company processes the claim. It's for this reason that we require a credit card on file to cover the remaining bill. If you are unable to provide a credit card on file, we will require a cash deposit prior to certain services.

After hours emergency consultation is available for patients having recently had a medical procedure. Please review the Procedural Policies & Instructions file to get a sense of what's normal, and what's not. We ask patients to use their best judgment regarding phone calls after hours. Dr. Littlejohn is on call for the practice at all times and wants to be called for important care matters. He also has a family. If you believe a problem can wait until the morning, it probably can. Please send a message through the portal, send us a text, or give us a call the next day. If you believe yourself to be having a medical emergency, leave a message on our service, but proceed immediately to urgent care or a hospital emergency department to be seen and examined right away. Some problems can't wait for a returned phone call and are best addressed in a setting where immediate diagnosis and treatment is available.

We are not trained in disability assessment, and do not participate in the process. We are 100% focused on treating your pain, improving your quality of life, and restoring function. If you are looking for help with a disability claim, we suggest you speak to your primary care provider about a referral to occupational medicine, or to physical therapy for a functional capacity evaluation.

The patient portal is a secure online web site that gives you access to your medical records, allows you to manage appointments, gives you a secure way to communicate with the practice, update contact information, and pay bills. Please note, new patient and procedure-only visits will be scheduled over the phone or in-person during a visit.

We will set up your portal access at your first visit. You can find the portal by clicking the link above.

Click the "contact us" button on the menubar at the top of the page and follow the instructions to send us an email. We typically respond within 24 hours and can answer any questions you might have, or get the registration and scheduling process going.

Download THIS FILE to find our medical release form. To be clear, this is the form you SEND TO YOUR PCP to give them permission to send us your records. This form is not for releasing your records here.

See the "practice policies" tab of the FAQ.

If you have urgent needs, we are happy to help get you in quickly. Your doctor will contact us to make arrangements. We’ll call you with a time to come in. If you are an established patient with an urgent need, just call our office, or contact us via the portal. We will make every effort to get you in right away.

We offer a wide array of services. In general these include injection based therapies, heat-ablation therapies, cement stabilization of vertebral fractures, and electronic stimulator placements. These are all performed at our clinic, and are minimally invasive. Recovery periods are short, and pain relief is expected rapidly.

In general, not much. This depends a lot of the nature of the procedure, but also the patient as well. People vary widely in sensitivity. Anesthetic is used for every procedure, but even anesthetic injections can be painful to some people. It’s more common for patients to express surprise at how little they feel from a procedure, than complaints of discomfort or pain. If you handle vaccinations well, injection therapy for pain should be well-tolerated.

Pain with a definitive source, pain that is readily reproducible with mechanical movement of the body, or pain that constant over time. Intermittent, spontaneous, or functional pain is less likely to respond to interventional therapy, but there are certainly instances where it does.

One of the best parts of being a doctor in this field is listening to stories of success every day. Our procedures are very often successful.

Soreness and bruising at an injection site is very common, and can last about a week. Most of our injections include enough anesthetic that you may have some lasting numbness. Procedural anesthetic usually wears off within 6-8 hours, but may persist for 24-36 hours. Significant bleeding is unlikely with any of our procedures. Blood thinner use is more likely to cause some bleeding, but this stops with applied pressure and some time.

Many of our procedures have an immediate local anesthetic effect that can wear off in a day or so. The pain may return for some time. The therapeutic effect of the procedure may take 5-7 days to begin. So try not to worry, give the procedure at least 1-2 weeks to work before seeking re-evaluation.

Epidural procedures can occasionally lead to a headache lasting several days. Injection headaches are usually improved by laying flat, and worse when sitting up. If you have a headache, let the office know. These are not dangerous and are best managed conservatively by staying hydrated (drink lots of fluids), rest, and over the counter analgesics.

Infections are very rare, but possible. In 11 years of practice Dr. Littlejohn has never had a patient with a serious procedure-related infection. A low-grade fever around the time of an injection procedure is almost always an unrelated illness. Procedure-related infections take time to develop, often a week or more. A fever developing at least a week after a procedure, particularly if accompanied by new onset pain at the site injected, and/or drainage of pus from the site would be concerning for an infection. If this is the case, let us know immediately so we can get you in for an exam, blood work, and possibly new imaging. Infections are most common in diabetics, so if you have diabetes, our threshold for investigating a possible infection will be much lower than for a non-diabetic.

True complications are rare, and Dr. Littlejohn has had the good fortune of not having any in 11 years of vigilant, careful practice. Dr. Littlejohn will address potential complications with you prior to your procedure, and answer any questions you might have. There are often ways to mitigate complication risk, and Dr. Littlejohn can explain how we do that if you are interested in learning the details.

See the PDF link above to “Practice Policies”. This contains our full financial policy.

See the PDF link above to “Practice Policies”.

We do not routinely prescribe opiates such as hydrocodone, oxycodone, oxymorphone, morphine, tramadol, etc. We will not "take over" prescriptions originally provided by another medical provider, and we do not have any recommendations on providers who will. The focus of our practice is on liberating patients from dependency on not only medications, but the health care system in general. In rare instances where opiates are appropriate for acute pain control needs, we do prescribe them for short periods until the acute issue resolves or definitive treatment occurs. Acute pain control prescriptions do not lead to long-term prescribing.

You will be assessed a fee outlined in the financial policy. The goal of having this fee is, ideally, to not need to collect it. Medical practices routinely double-book appointment slots to deal with the problem of unexpected no-shows. We prefer not to do that. By using a fee to encourage timely cancellation of appointments that can not be attended, your own appointment is likely to be more convenient and expeditious. We hope you understand the need for this policy.

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