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Pain management

Expert management and treatment for chronic pain

Pain Management is a specialist area of medicine involved with managing chronic (long-term) pain.

Pain Management Specialists are doctors who are specially trained, qualified and revalidated so that they can offer integrated, expert assessment and management of pain using their own unique knowledge and skill set, usually within the context of a multidisciplinary team (MDT).

The vast majority of Pain Medicine Specialists will have undertaken Pain Medicine training as a part of the Fellowship of the Royal College of Anaesthetists (FRCA) and the Certificate of Completion of Training (CCT) in Anaesthesia award by the GMC. A doctor who specialises in this field is known as a Consultant in Pain Medicine and Anaesthesia.

At The Alexandra Hospital, our leading consultants help manage a wide variety of chronic pain conditions and symptoms for people aged 18+. They would be delighted to help you too.

Fortunately, many of us will only ever experience pain that is fairly mild or short-lived. For example, we may catch an arm or leg on a piece of furniture, or accidentally bang a finger with a hammer while hanging up a picture. This type of pain will usually resolve itself with a few days. At worst, we may need to take a painkiller for a while to help relieve the pain. Even if we have a more significant injury, like a broken arm or dislocated shoulder, the initial pain will often be horrible, but it will usually go away over time and with the proper treatment and rehabilitation.

Longer-term (chronic) pain can be much more challenging to cope with. If you are experiencing pain every day, and possibly even being woken up at night by your pain, it can have a hugely detrimental effect on your physical, mental and emotional health, as well as on your work and relationships.

If you have pain that is not being adequately controlled, our specialists in pain management can help review your current treatment plan and determine the most appropriate way to get your pain better managed.

Pain can be felt in a number of different ways. For example, it may be:

  • Sharp or dull
  • Localised (in one specific place) or spread more widely
  • Intermittent or constant
  • Triggered by certain things (bright lights, food, drink, activity etc.)

There are many ways people can experience chronic pain. The people who visit The Alexandra Hospital in Manchester for help are often struggling with one of the following conditions or symptoms:

  • Headaches
  • Migraines
  • Facial pain
  • Neck pain
  • Back pain
  • Abdominal or pelvic pain
  • Sciatica - pain in the leg or arm
  • Joint pain
  • Nerve pain – including post-operative pain, phantom pain and pain after shingles
  • Fibromyalgia – a long-term condition that can cause pain all over the body

Any type of pain that is affecting your daily life can be incredibly hard to cope with. Long-term, unmanaged pain can very easily cause depression, frustration and anger, and will often cause relationship difficulties. While loved ones will want to support you, it can be hard for them to truly understand what you are going through.

There are different ways pain may be managed. Depending on your specific condition, your consultant may use medication or interventional procedures (or often a combination of both) to help ease and manage your symptoms.

Pain management

Managing chronic pain involves comprehensive assessment of the patient, including:

  • Physical examination
  • Review of investigations
  • Ordering of new investigations
  • Formulation of a management plan

It deals with:

  • Communicating with all relevant healthcare professionals and carers
  • Onward referral to other healthcare professionals if appropriate
  • Prescription of medication
  • Performance of interventional procedures
  • Referral for physical or psychological technique
  • Appropriate discharge and follow-up plans.


Medicines that relieve pain can work in a number of ways, and this will determine where they are most effective. For example, if your pain is being caused by inflammation, an anti-inflammatory drug or a combination of paracetamol and an opioid (a strong painkiller with a similar effect to morphine) will often be the most effective treatment. Pain caused by a nerve problem will most likely need a different type of medicine that desensitizes the nerves, such as a capsaicin patch.

While there are a great number of medicines available to help relieve pain, the skill of an experienced consultant is in knowing which one(s) will be most suitable for your specific condition, and what dose and frequency will be most effective for you.

An epidural involves an injection of an anaesthetic into the epidural space around the spinal cord. It is commonly associated with pain relief during labour and childbirth but can be helpful for other pain relief, including post-surgery.

Pain management – interventional procedures

Interventional procedures available at The Alexandra Hospital include:

  • Nerve blocks
  • Nerve root blocks
  • Facet joint injections
  • Radiofrequency denervation
  • Trigger point injections
  • Ultrasound guided nerve blocks

Nerves transmit electrical impulses around the body in order to generate a specific response. A nerve block deliberately interrupts the signal in certain nerves in order to help relieve pain. For example, an occipital nerve block is an injection made into the occipital nerves in order to relieve pain from headaches and migraines.

A nerve root block involves injecting an anaesthetic and steroid at the precise point the nerve leaves the spinal cord (this is known as the nerve root). The anaesthetic numbs the pain while the steroid helps to reduce inflammation and swelling. A nerve root block is normally targeted at one particular nerve, with X-ray guidance used to ensure precise positioning of the injection.

Facet joints are small joints in the spine that join the vertebrae (bones of the back) together. A facet joint injection involves injecting an anaesthetic and steroid into a facet joint. As with the nerve root block (described above), the anaesthetic numbs the pain while the steroid helps to reduce swelling and inflammation.

Radiofrequency denervation (also known as rhizotomy or RF ablation) uses radiofrequency waves to interrupt the function of the nerve. It is commonly used to relieve pain in the back or neck.

Because of the complexity of interventional pain management and its overlap with so many other areas of medicine, your consultant works closely with other experts like spinal and orthopaedic surgeons, neurologists and neurosurgeons to ensure you see the most appropriate specialist at all times.

When you first meet with your consultant at The Alexandra Hospital, they will take a detailed medical history and ask you to describe your pain and any other symptoms you have. They will want to know:

  • What symptoms you have
  • How long you’ve had these symptoms for
  • Where your pain is and how you would describe it
  • How your symptoms are affecting you on a daily basis
  • Whether you already have a pain management plan

It can often be quite challenging to talk with somebody about chronic pain and the effect it is having on you. Your consultation gives you an extremely safe place to talk through these things in a relaxed environment with somebody who understands and appreciates the effects chronic pain can have on people.

Your consultant will review your current medication and treatment plan and discuss alternative options or possible changes with you.

Depending on your symptoms, they may refer you for additional diagnostic investigations. With X-ray, CT, MRI, Nuclear Medicine and ultrasound all available on-site, any of these can be easily and quickly arranged when needed. Dedicated radiologists provide a prompt reporting of any of these tests so that your consultant can start planning the best treatment for you sooner.

In some cases, particularly for more complex conditions, your consultant may discuss treatment options within a multidisciplinary team meeting, with input from specialists like spinal surgeons, neurologists, rheumatologists and psychologists.

It is important to know that pain management is not usually a one-time “fix”. Chronic pain may flare up again for no obvious reason, or symptoms may no longer be adequately managed with the current treatment.

Successful pain management involves close collaboration between you and your consultant. If treatment needs adjusting, such as altering the strength or frequency of a medication, this can be easily done by your consultant when appropriate.

Not all types and causes of pain can be successfully treated, but your consultant will make sure your treatment gives you the best symptom relief possible. They will always explain treatment options to you so that you can make an informed treatment choice.

Many people who visit The Alexandra Hospital for help with pain management have been referred to us by their GP, physiotherapist or another specialist such as a spinal or orthopaedic surgeon. Others are sent to us by their private medical insurance provider.

We treat private medical insurance and self-pay patients.

When you visit us, you will benefit from:

  • Quick access to an expert – Any type of pain is unwelcome, and you will appreciate being able to see somebody as soon as possible. As the largest private hospital in the country outside London, we have leading pain management consultants available to see you and can schedule a consultation for you without delay.
  • Remote consultations available – Consultations are usually carried out in person, but we can also provide remote consultations by telephone or video call if required.
  • Tailored treatment – Pain management requires a tailored approach, with regular review and adjustment as necessary to ensure you receive the pain relief you need. If you have any questions or concerns at any times, it is very easy to book an appointment to see your consultant again.
  • A multidisciplinary team – Your consultant has easy access to experts in other fields, including neurologists, spinal surgeons, orthopaedic surgeons, radiologists and physiotherapists. This multidisciplinary team ensures you will always see the most appropriate specialist for your particular needs at all times.
  • Recommended by patients - In an independent survey, 97.3% of the people we treated at The Alexandra Hospital said they were likely or extremely likely to recommend us to their friends and family.

If you would like to meet with an experienced consultant to discuss your pain and to explore suitable treatment options, why not book your appointment online now. 

Specialists offering Pain management

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Dr Mowafak Abdelghani

Consultant Pain Medicine & Anaesthesia


The Highfield Hospital 1 more The Alexandra Hospital

View profile Book online

Dr Jonathan Rajan

Consultant in Pain Medicine and Anaesthesia


The Alexandra Hospital

View profile Book online

Dr Joshua Adedokun

Consultant in Pain Management


The Highfield Hospital 3 more The Alexandra Hospital The Beardwood Hospital The Beaumont Hospital

View profile Book online

Dr Salmin Aseri

Consultant in Pain Medicine & Anaesthesia


The Highfield Hospital 2 more The Alexandra Hospital The Beaumont Hospital

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Mr Shafqat Bukhari

Consultant Neurosurgeon

MBBS; FRCSEd(Surgery); FRCSEd(Neurosurgery); FRCS(Surgical Neurology)

The Highfield Hospital 1 more The Alexandra Hospital

View profile Book online

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