Providing regional interventional pain injections for musculoskeletal pain in a chronic pain patient can prove to be quite challenging. The goal of this presentation is to assess the chronic pain patient in the evaluation of an acute or subacute regional flare and determine if corticosteroid injections are justified or even a consideration. Understanding central sensitization can prove to be difficult and this lecture is intended to provide a framework in which to assess and then determine if regional interventions will benefit or worsen a patient who has chronic pain syndrome.