Treatments that I offer reflect up to date evidence based practice in pain medicine and generally follow national recommendations (NICE guidelines) or relevant local clinical experience.
Chronic lumbar spinal pain
This is the commonest condition that patients present with in pain clinics. Conservative measures such as physiotherapy and simple painkillers are the mainstay of treatment. However, when the pain becomes severe and starts to have an impact on mobility, I will consider X-ray guided pain interventions that include:
Degenerative disc disease
Disc herniation can lead to severe pain and disability in the leg (also known as sciatica) or arm. If physiotherapy and manual therapies do not achieve the desired relief, I can offer X-ray guided epidural steroid injections which are proven to give sustained effective relief in the majority of patients.
I would usually request MRI imaging in this situation if the pain is associated with weakness (e.g. foot drop) or if the response to the first injection is not satisfactory.
Complex regional pain syndrome (CRPS)
Abdominal and pelvic pain
Spinal cord stimulation (SCS)
Joint pain (shoulder, knee and hip)
Facial and head pain
Trigeminal neuralgia: I can offer balloon compression of the trigeminal ganglion if medical and surgical treatments have failed or if you do not wish to undergo surgery.
Occipital neuralgia: This can be successfully treated with occipital nerve blockade and radiofrequency denervation.