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Acute pain is something we all experience when we cut or injure ourselves or suffer some other form of trauma, such as an operation.  It is also our bodies’ way of warning us when an underlying disease process may be developing, prompting us to seek help.

In the vast majority of people, pain after a trauma settles down as the body's healing processes take effect or when a disease process is brought under control, either naturally or after medical intervention.  However, in some individuals the pain persists beyond the usual or expected time; pain that persists for over three to six months is defined as chronic pain.  The persistence of chronic pain can become a major obstacle in trying to live a normal life.  Pain also has a profound emotional change on us, often leading to depression.  It may come to dominate your life and the lives of those around you.

Pain management specialises in the management and treatment of both chronic and acute pain.  It is aimed at:

• Reducing the intensity of the pain
• Addressing the emotional impact of the pain
• Increasing the level of mobility, activity and overall well-being and function of the individual.

Our service
We see people with a variety of chronic pain problems, including common causes such as:

• Joint, tendon or muscle pain (arthritis, tendonitis and myalgia) 
• Nerve injury (pins and needles, burning pain and shooting pains)
• Back and neck pain - maybe from facet joint disease, disc disease, slipped disc or osteoarthritis of the spine
• Disc disease - leading to back ache and nerve root pain (often called "sciatica" if it is affecting the leg)
• Failed back surgery syndrome
• Headaches - maybe from cervical skeletal problems or damaged nerves
• Chest wall pain
• Shoulder pain - when surgery has failed to help
• Knee pain - when surgery has failed to help
• Complex regional pain syndrome (also known as Reflex Sympathetic Dystrophy or causalgia) - causing swelling, discolouration and stiffness of a limb
• Phantom limb pain - after an amputation
• Abdominal pain - from chronic pancreatitis or following surgery such as gall bladder removal
• Pelvic pain - when gynaecological or surgical intervention has failed to help
• Fibromyalgia (chronic widespread pain syndrome)
• Myofascial pain syndrome.

Treatments
Chronic pain is now being widely studied and there are many effective therapies and a variety of drugs available to treat the above conditions, including:

• Epidural injections of steroid - cervical, thoracic and lumbar area
• Selective nerve root blocks – cervical, thoracic and lumbar area
• Peripheral nerve blocks - e.g. supra scapular for shoulder pain
• Facet joint blocks - cervical, thoracic and lumbar area
• Radiofrequency conventional (CRF) or pulsed ( PRF) - a specialist way of destroying or modulating the activity of a nerve
• Sympathetic Ganglion Block - cervical, thoracic or lumbar area
• Transcutaneous Electrical Stimulation (TENS)
• Spinal cord stimulation - electrodes placed in the epidural space to modulate pain
• Physiotherapy and support
• Psychological therapy and support.

Our consultants
Consultant Physician – Dr C A Gauci
Consultant Physician – Dr V Mehta
Consultant Physician – Dr S Thanthulage

Next steps
To make an outpatient appointment, please call us on 020 8936 1201.