Pain Management

Why do we have pain?
Pain can be a sign that something in our body is wrong. There are various types of pain that can differ in the parts of the body that they affect. The intensity of the pain and its duration can also vary. In addition, the way we react to pain is very personal and can vary significantly from person to person.

Acute pain
Acute pain is usually caused by something easily identifiable such as an injury; it occurs suddenly and lasts for a short period of time. Many forms of acute pain indicate an underlying problem and the treatment of this problem will usually relieve the pain. This is obvious in conditions such as broken bones, appendicitis etc.

Appropriate diagnosis and management is the key to relieving acute pain. The drugs that can help acute pain are painkillers like paracetamol, anti-inflammatory drugs like ibuprofen and other drugs like codeine. Severe acute pain may need stronger drugs such as morphine.

Chronic pain
Pain that lasts for three months or more and recurs over long periods is regarded as chronic pain. This can sometimes occur even after the initial acute problem has been properly treated. Chronic pain can occur anywhere in your body; it can range from mild discomfort to very severe pain that can impede your day-to-day activities. Early detection, assessment and appropriate management could prevent much chronic pain. So that we can provide appropriate pain management, it is important that your pain is fully assessed by a practitioner in pain medicine so that the correct treatments can be recommended.

When you experience pain for a long time, it can lead to anxiety and low mood. You may also feel very tired. Lack of sleep and emotional upset tends to increase the pain. Your body’s defence system (the immune system) may get weak, leading to infections and illness. You may be prevented from working and from enjoying your usual recreational activities. 
All of these factors combine to produce a vicious cycle and pain becomes the centre of your life. At this point, you need help to reverse these changes and to start on the road to recovery.

Cancer pain
Although not all cancers are associated with pain, a proportion of people with cancer will suffer from pain to a greater or lesser degree. Your specialist team are fully trained to provide the best management for cancer pain so that your quality of life can be as good as possible.

Common pain conditions
• spinal pain neck pain, thoracic pain and low back pain
• headache and facial pain
• abdominal pain
• pelvic pain
• nerve pain (neuropathic pain)
• pain due to decreased blood supply (vascular pain)
• pain secondary to diabetes
• pain secondary to shingles (postherpetic pain)
• post-surgical and post traumatic pain
• pain after amputation
• joint pain
• chest wall pain
• cancer pain

Many pains involve the musculoskeletal or nervous system. Pain specialists work in close liaison with consultant neurosurgeons and orthopaedic surgeons. They also work with physiotherapists, psychologists and occupational therapists. It is quite likely that your care will be shared between these specialists.

Pain problems related to gastrointestinal tract or cardio-vascular system also occur and again your pain specialists would co-ordinate treatment with these specialties.

Diagnosis and treatment
When you are experiencing chronic pain, the first step is to try to identify the underlying cause of the pain.

Following referral from your GP, your case will be reviewed by the most appropriate Pain Medicine specialist. You will have an initial consultation and a complete physical assessment. You may undergo various diagnostic tests including blood tests, CT and MRI scanning. A treatment plan will then be offered in accordance with the specific cause and symptoms. 

This plan may include:

Injection therapy
There are a wide range of injection therapies available specific to individual complaints; you will be offered these as appropriate. The benefits and potential risks will be fully discussed with you when you are considering your treatment choices.

Stimulation techniques
The simplest of these is a TENS machine; however more sophisticated stimulation devices such as implanted spinal cord stimulators for people with severe and localised nerve pain are available. These techniques may be particularly helpful for spinal pain, pain due to nerve damage, abdominal or pelvic pain and pain due to poor circulation.

Medication therapy
Drugs are mostly given by mouth. Occasionally they are given via patches (the drug is absorbed through the skin). In special situations, sometimes in those with cancer pain, a pump can be implanted into the body to place drugs into the spinal fluid.

Other therapy
Pain specialists work in close conjunction with physiotherapists and psychologists who can be of great benefit in managing pain. Some patients will also benefit from complementary therapy such as acupuncture, massage etc.

Specialists who treat pain
Specialists in pain medicine are experts in managing a wide variety of pain problems. Many pain specialists initially trained as anaesthetists; some also continue to give anaesthesia as part of their job. However, pain medicine is an entirely separate specialty with extensive and rigorous training requirements. The specialists you see will be fully accredited in Pain Medicine and will be Fellows of the Faculty of Pain Medicine of the Royal College of Anaesthetists. Having undertaken this training, they will also have had many years of clinical experience of helping patients with pain problems such as those that you may have.

I would like to see a pain consultant – what do I do?
If you would like to see a consultant in Pain Medicine, you need to visit your GP and ask to be referred privately to Spire Healthcare for an out-patient appointment with a Pain Medicine consultant. Your GP may confirm the appointment for you or may ask you to contact us to arrange your own appointment.

Funding your treatment – with or without medical insurance
Spire Healthcare is open to all patients - with or without private medical insurance.

If you have a health insurance policy, it is likely that your insurance company will cover the cost of your treatment but please check with your insurer first.

If you don’t have health insurance, you can simply choose to have a one-off private treatment and fund it yourself.  Please contact us for a guide price for your treatment.

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