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Pain management

Treatment to help you with chronic pain

Pain Management is a specialist area of medicine (Pain Medicine is a speciality on its own. It requires special training and qualifications).

Most of us will experience chronic pain at some point in our lives, but this will usually go away over time. At worst, we may need to take a painkiller for a few days to relieve symptoms.

Longer-term (chronic) pain can have much greater impact on life. When you are in constant pain, even woken up by it sometimes, it can affect your mood, energy levels, work, and relationships.

If you are struggling with pain, it can be invaluable to get expert guidance and treatment from a specialist in pain management. A doctor who specialises in this field is known as a Consultant in Pain Medicine and Anaesthesia.

Some of the common reasons people visit our consultants for help are:

  • Head pain
  • Headaches or migraines
  • Facial pain
  • Neck pain
  • Back pain
  • Joint pain
  • Leg pain - including sciatica
  • 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
  • Herniated discs
  • Persistent post-surgical pain
  • Reflex sympathetic dystrophy (Complex Regional Pain Syndrome)

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

Pain can be experienced in different ways. For example, it may be

  • Dull or sharp
  • Spread throughout a wider area or localised (in one specific place)
  • Intermittent or constant

Chronic pain can be incredibly hard to cope with and can take a heavy physical, mental and emotional toll. It can easily lead to anger, depression, frustration and close relationships can be affected. While loved ones will usually try to support you to the best of their ability, it is often incredibly hard for them to understand and appreciate the reality of what you are going through and the effect it is having on you. This can often end up putting quite a strain on close relationships.

A Consultant in Pain Medicine may use different treatments to help relieve your pain. These can be split into two categories – medication and interventional procedures.

Pain management – medication

Effective pain relief medications can be helpful for many people, but it needs to be at the correct dose and frequency to provide the best results. A Consultant in Pain Medicine will be able to investigate the different combinations and dosages available in order to formulate the best treatment plan for you.

Different types of pain medicine work in different ways. For example, pain caused by inflammation will often respond best to an anti-inflammatory drug, or a combination of paracetamol and an opioid (a strong painkiller with a similar effect to morphine). Pain caused by a nerve problem will most usually require medication that desensitizes the affected nerve.

Pain management – interventional procedures

Interventional procedures may be carried out for certain symptoms and conditions, or if pain medication isn’t able to adequately manage symptoms. Interventional procedures include:

  • Nerve blocks
  • Nerve root blocks
  • Facet joint injections
  • Epidural

Nerves can be thought as the messenger system of the body, transmitting electrical impulses around it. A nerve block deliberately interrupts the signal in specific nerves to try to help relieve pain. This can be done with medication or surgery.

A nerve root block involves injecting an anaesthetic (and usually a steroid) at the point a nerve leaves the spinal cord (this is known as the nerve root). The anaesthetic relieves the pain, the steroid reduces inflammation. A nerve root block will usually be done under X-ray guidance.

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

These injections can be diagnostic, to help confirm the cause of your pain, or therapeutic, to treat the pain for a longer time.

Pain management is an extremely important area of medicine. It is important to know that some pain cannot be cured, but your consultant will ensure you receive the most effective treatment for your specific condition to deliver the best possible pain relief

Because of the complexity of pain management, it often overlaps many other areas of medicine, like neurology and orthopaedic surgery. Your consultant works closely with other experts like orthopaedic surgeons to ensure you receive treatment from the most appropriate specialist.

When you first meet with your consultant in Pain Medicine at The Manor Hospital, they will take a medical history and then discuss 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 you currently taking any medication?

It can often be difficult to talk with another person about your chronic pain and the effect it is having on you. This consultation provides a safe, relaxed environment for you to talk openly and honestly with somebody who understand and appreciates the effects of long-term pain.

Your consultant will review your current treatment plan and discuss potential alternatives or changes with you. For example, they may suggest a change of medication, or a change of dose in your current medication.

Depending on your symptoms and the type of pain you’re experiencing, you may be referred for additional investigations. This may be X-ray, CT, MRI or Ultrasound. Some of these investigations can be carried out on-site, others will be arranged off-site if required.

Once any results are back, your consultant will start formulating a treatment plan for you. They may discuss treatment options within a multidisciplinary team meeting, with input from specialists like neurologists and rheumatologists.

Chronic pain can often flare up, and a treatment that has been working well up to this point may suddenly become less effective. Pain management is a collaboration between you and your consultant. With regular review, the results of any treatment can be carefully monitored, and treatment easily adjusted if required to better manage your pain.

Many people are referred to us by their GP, physiotherapist or another consultant such as a spinal or orthopaedic surgeon. Others are directed to us by their private medical insurance provider.

We treat people with private medical insurance and self-pay patients.

Some people live close to the hospital in Bedford, while others travel from other parts of Bedfordshire, or even further afield, to get help from an experienced pain management specialist.

When you choose to visit The Manor Hospital for help with your chronic pain, you will benefit from:

  • Fast access to an expert – When you’re suffering with chronic pain, you’ll appreciate being able to get quickly. We can easily arrange an appointment for you with an experienced Consultant in Pain Medicine, so that you can access the support and help you need, sooner.
  • Remote consultations available – Pain management consultations are usually carried out in person at The Manor Hospital, but we can also provide remote consultations by telephone or video call when required (and where clinically appropriate).
  • Tailored treatment – Pain management requires a tailored approach, with regular review and adjustment as necessary to ensure you receive the pain relief you need. Your consultant will oversee every aspect of your treatment and will work closely with you to ensure your pain continues to be managed as well as possible.
  • Multidisciplinary team – The hospital provides easy access to specialists in other fields, including neurologists, orthopaedic surgeons, radiologists and physiotherapists. This multidisciplinary team approach means you will also see the most appropriate person for your specific needs.
  • Recommended by patients - In an independent survey, an incredible 99.1% of people treated at The Manor Hospital said they were likely or extremely likely to recommend us to their friends and family.

If you would appreciate meeting with an experienced pain management specialist to discuss treatment options, or to review your current treatment plan, why not book your appointment now?

We very much look forward to welcoming you to The Manor Hospital soon and helping get your pain under control and better managed.

Specialists offering Pain management

Dr Nofil Mulla

Consultant in Integrated Pain Services


The Manor Hospital 1 more Three Shires Hospital

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