department of anesthesia and Perioperative medicine

Chronic Pain Management Clinic

Arthur Richard Smith, MD

Ryan Nobles, MD

The Chronic Pain Management Clinic of the Department of Anesthesia and Perioperative Medicine at the Medical University of South Carolina in Charleston is dedicated to serving our community by the treatment of a wide of range pain problems, including acute pain, chronic pain and cancer pain.

The MUSC Pain Clinic offers outpatient services in our Rutledge Tower offices along with inpatient services for treatment of acute post-operative pain and for inpatient consultation.

The emphasis on treatment in the MUSC Pain Clinic is on interventional treatments such as nerve blocks, or steroid injections, but because chronic pain can present complex and challenging problems we feel that a multidisciplinary approach that treats the whole person is often necessary to obtain the best results for our patients. To achieve this we work closely with colleagues in physical therapy and occupational therapy, along with specialists in psychiatry, pain psychology, neurosurgery, orthopedics and physical medicine. Our patient’s primary care physician is an essential participant in the treatment process, and we require all of our patients to have a family doctor.

The MUSC Pain Clinic is staffed by two full time physicians with board certification in Anesthesiology and with subspecialty certification in Pain Management. The acute pain service and inpatient consult service are managed by four full time board certified anesthesiologists with training and expertise in epidural and peripheral nerve blocks for post operative pain management. A pain psychologist is available to work with those patients that have an emotional component to their pain. He also specializes in providing methods of pain relief that do not involve medications or injections, and he provides pre-surgical psychological assessments. Our pain clinic staff also includes four full time registered nurses to assist in patient care before, during and after procedures.

The MUSC interventional pain specialists are dedicated to finding answers for chronic pain through research, diagnosis and treatment using the latest therapies and technologies. We approach each case with an individualized diagnosis and treatment plan based on the patient's medical history, physical examination and specialized studies, so that we are able to treat each patient’s specific needs. Our most important priority is patient care, and by combining state-of-the-art clinical treatment with a compassionate approach we strive to address not only our patients’ medical problems, but their emotional and social needs as well.

MUSC Pain Management offers a wide variety of services to our patients. The following is a list of some of the most common procedures we perform:

  • Trigger point injections
  • Peripheral nerve blocks
  • Sacroiliac joint injections
  • Cervical, thoracic and lumbar epidural steroids injections
  • Facet blocks and radiofrequency rhizotomy for facet pain
  • Stellate ganglion, celiac plexus and lumbar sympathetic blocks
  • Trigeminal nerve blocks for facial pain
  • Occipital nerve blocks for headache
  • Implantation of spinal cord stimulators

For those procedures that require X-ray guidance we have a fluoroscopy suite in the pain clinic. Surgical procedures are performed in the out patient operating rooms in Rutledge Tower.

A comprehensive approach to managing pain often includes medications. Our physicians are knowledgeable in the indications and proper use of a wide variety of drugs that can be used for pain. The policy of the pain clinic is to consult with our patients’ primary care physicians to coordinate medical management. We may prescribe medication long enough to establish what is most appropriate and effective; however we do not have the facilities to manage patients for long term prescribing of medications.   

Arthur R. Smith, M.D.
Ryan Nobles, M.D.

The MUSC Pain Clinic is located on the 9th floor of the Rutledge Tower clinic building at:

135 Rutledge Ave.
Suite 942 R
Charleston, SC 29425
Get directions

Telephone: (843) 792-2500

Parking is available in the Ashley Avenue Parking Garage adjacent to Rutledge Tower.  Valet parking is offered in the drive up circle in the front of Rutledge Tower. 


Patients are scheduled by referral from a specialist or primary care physician.