Pain management

Pain Management is a specialist area of medicine involved with the treatment of chronic pain.  

Many of us only experience pain that is relatively mild or short-lived. This type of pain tends to go away over time, and at worst may require some type of painkiller for a day or two to ease symptoms. In more serious cases of acute trauma, such as a broken leg or dislocated shoulder, the initial pain may be incredibly severe, but it will usually improve over time and with the correct treatment.

Longer-term (chronic) pain can have a much more significant, debilitating, and potentially life-changing, impact. If you’re living each day in constant pain, and even woken up by your pain, it can affect every aspect of life; work, relationships, as well as physical, mental, and emotional health. 

Long-term pain can be exhausting to live with. Sleep can be disturbed, exercise tolerance (or any physical activity) lowered, and the effects of trying to cope with pain over an extended period can take a heavy toll physically, emotionally, and mentally.

Depression, sadness, frustration, and anger can all result from long-term pain, and close relationships can be more challenging. While your friends and family will want to support you, it can be hard for them to truly understand the effect your pain is having on you.

If your pain is not being managed or controlled properly, it can be helpful to get help from a specialist in pain management. A doctor who specialises in this field is known as a Consultant in Pain Medicine and Anaesthesia.

At Bishops Wood Hospital, experienced Pain Management Consultants help manage a variety of chronic pain conditions and symptoms for people aged 18+. They would be delighted to help you too. 

Chronic pain can affect people in different ways, and in many parts of the body. Common reasons people visit Bishops Wood Hospital for help include:  

• Neck pain 
• Back pain 
• Leg pain (including sciatica) 
• Headaches 
• Facial pain 
• Nerve pain - this may include post-operative pain, phantom pain, and pain after shingles 
• Fibromyalgia – a long-term condition that can cause pain all over the body 

A Consultant in Pain Medicine has a variety of treatment options available that may help to relieve your pain symptoms. These include physiotherapy, acupuncture, chiropractic treatment, medication, and interventional procedures.

Pain management – medication 

Different pain medicines can help manage different types and causes of pain. If your pain is being caused by inflammation for example, treatment may be with an anti-inflammatory drug or a combination of paracetamol and an opioid (a strong painkiller with a similar effect to morphine). Where a nerve issue is being caused by pain, a different type of medication that desensitizes the affected nerve may be more appropriate. 

An epidural is an injection an anaesthetic into your back (specifically, it is injected into the epidural space around the spinal cord). It is often used for pain relief during labour and childbirth and may be used for some operations.  

Pain management – interventional procedures

Interventional procedures available at Bishops Wood Hospital include: 

• Nerve blocks 
• Nerve root blocks 
• Facet joint injections  
• Therapeutic infusions 
• Trigger point injections 

Nerves are the body’s messenger system, transmitting electrical impulses from one part to another. A nerve block interrupts the electrical signal in specific nerves to try and relieve pain.  

A nerve root block involves the injection of an anaesthetic and steroid into the nerve root (the point a nerve exits the spinal cord). The anaesthetic has a numbing effect on the pain while the steroid helps to reduce inflammation. It is usually given under X-ray guidance. 

Facet joints are small joints in the spine that join the bones of the back (vertebrae) together. A facet joint injection involves injecting an anaesthetic and steroid into a facet joint. 

Injections can be given for diagnostic reasons, to help confirm the cause of your pain. Alternatively, they may be given therapeutically, to treat the pain. 

It is important to know that not every type and cause of pain can be successfully treated. Your Consultant will make sure any treatment you receive is tailored to your specific condition and provides the most effective pain relief possible. 

When you first meet with your Pain Management Consultant at Bishops Wood Hospital, they will take a medical history and talk with you in detail about your pain and any other symptoms you have. They may ask you questions like: 

• What symptoms do you have? 
• How long have you had these symptoms? 
• Where exactly is your pain and how would you describe it? 
• How is your pain affecting daily life? 
• Are there any things you are no longer able to do because of your pain? 
• Do you have a management plan already / are you currently having any treatment? 

Your private appointment is a safe place to talk through the reality of the challenges your pain is causing you. 

Your Consultant will review any current medication and/or treatment plan and discuss potential alternatives or changes with you.  

Additional investigations are often needed. These may include blood tests, CT, SPECT-CT, MRI, ultrasound, and nerve conduction tests. While some of these can be carried out on-site, others will be arranged for you off-site (often at our sister hospital, The Clementine Churchill Hospital in Harrow).   

In some cases, your Consultant may discuss treatment options with specialists like spinal surgeons, neurologists, rheumatologists, and psychologists.   

Pain management is a collaboration between you and your Consultant. They will explain possible treatment options to you and will be very happy to talk through any questions or concerns you may have during your private appointment.

It’s important to know that pain management is not usually a one-time “fix”. Chronic pain can sometimes flare up at seemingly random intervals, and a treatment that has been effective may suddenly become less so.   

Regular review allows treatment to be adjusted as needed, so that your pain continues to be managed as well as possible. 

Many of our patients have been referred by their GP, physiotherapist, or another specialist such as a spinal or orthopaedic surgeon. Others self-refer after being recommended to us by a friend or family member. 

We are ideally located for people living in and around Northwood, and good travel links means we see people from places like Harrow, Hillingdon, Bedfordshire, and Brent.   

When you choose to visit Bishops Wood Hospital for help with your pain, you will benefit from: 

• Fast access to an expert – When you’re struggling with ongoing pain, you won’t want to be waiting weeks (or months) for an initial appointment. We can arrange a private appointment for you with an experienced Pain Management Consultant, at a time that is convenient for you, meaning you will be able to get the help you need sooner.  
• Flexible appointments – Pain Management consultations are typically carried out in person at the hospital, but we can also provide remote consultations by telephone or video call if required (and where clinically appropriate).   
• Consultant-led, always – Regular review and calibration of treatment can be invaluable at managing long-term pain. You will always see the same Consultant and will never have to worry about being treated by a junior doctor. This ensures excellent continuity of care. 
• Access to other specialists – Your Pain Management Consultant works closely with specialists in other field of medicine, including neurologists, spinal surgeons, orthopaedic surgeons, radiologists, and physiotherapists. Where additional input or support is needed, it is easily (and quickly) arranged for you at Bishops Wood Hospital.  
• Recommended by patients – In an independent survey, 94.1% of the people we treated said they were likely or highly likely to recommend us to their friends and family.  
• Location - Bishops Wood Hospital is a 42-bed acute care unit, located within the grounds of Mount Vernon Hospital. It is easy to travel to us and our on-site car park has free parking for visitors.  

We look forward to welcoming you to Bishops Wood Hospital and helping you to get your pain under control and managed as well as possible.