If you are being referred out for pain management, this means chiropractic therapy is no longer working for you and results that your pain is more severe and needs to be looked at by orthopedics. Yes, sometimes medication and therapy alone are not enough to treat your pain.  In most cases to ease the pain our Orthopedic services will perform injections. This is where local anesthetics, often combined with corticosteroids, would be injected into the pained areas to relief irritation, swelling, and muscle spasms.