Conditions
Chronic pain has a multitude of causes and can be felt anywhere from smaller, isolated parts of the body all the way up to a diffuse pain felt almost everywhere. Even if the pain is localised, it is commonly felt in a number of locations. For example pain from wear and tear in the back will have a knock on affect often on the hips and knees.
Examples of some of the more common pain conditions treated are discussed below.
Back and Neck Pain
Back pain is probably the leading cause of disability, missed work and impaired quality of life in the world. There are a multitude of causes from a new injury to long term wear and tear, affecting many age ranges in many ways. As a result, a variety of management options exist after careful assessment and involve co-working with skillful physiotherapists and exercise physiologists.
Back and Neck Pain
Back pain is probably the leading cause of disability, missed work and impaired quality of life in the world. There are a multitude of causes from a new injury to long term wear and tear, affecting many age ranges in many ways. As a result, a variety of management options exist after careful assessment and involve co-working with skillful physiotherapists and exercise physiologists.
Nerve Pain
Nerve pain is a frequently distressing pain type, often associated with feelings like electric shock, burning or sensitivity. In addition, the peculiar sensation of pain in an area of numbness is also typical for nerve pain. Whilst frequently poorly treated, pain specialists use well researched management regimes including options such as medications and interventions.
Nerve Pain
Nerve pain is a frequently distressing pain type, often associated with feelings like electric shock, burning or sensitivity. In addition, the peculiar sensation of pain in an area of numbness is also typical for nerve pain. Whilst frequently poorly treated, pain specialists use well researched management regimes including options such as medications and interventions.
Joint Arthritis
All joints in the body can show signs of wear and tear. The load bearing joints of the knee and hip are common sites for pain, but so too are many of the smaller joints of the back and neck. Treating pain from arthritis can reduce the need for a joint replacement surgery and in some cases, can help improve outcome from surgery. In other situations where surgery isn’t possible pain management remains the best long-term option.
Joint Arthritis
All joints in the body can show signs of wear and tear. The load bearing joints of the knee and hip are common sites for pain, but so too are many of the smaller joints of the back and neck. Treating pain from arthritis can reduce the need for a joint replacement surgery and in some cases, can help improve outcome from surgery. In other situations where surgery isn’t possible pain management remains the best long-term option.
Cancer – Related Pain
Pain can occur at any time in a cancer journey and isn’t always due to cancer itself. A number of the treatments used in cancer care can cause pain themselves (eg pain after surgery or peripheral nerve pain after chemotherapy). Living with uncontrolled pain whilst having cancer shouldn’t be accepted as pain affects how people choose and respond to treatments. After cancer, minimising the impact of any pain on living is an imperative.
Cancer – Related Pain
Pain can occur at any time in a cancer journey and isn’t always due to cancer itself. A number of the treatments used in cancer care can cause pain themselves (eg pain after surgery or peripheral nerve pain after chemotherapy). Living with uncontrolled pain whilst having cancer shouldn’t be accepted as pain affects how people choose and respond to treatments. After cancer, minimising the impact of any pain on living is an imperative.
Persistent Post-surgical Pain
Surgeons are enormously skillful, highly trained specialists. Some surgeries though are associated with persistent pain syndromes as nerves are injured by the process of surgery and some damaged nerves behave abnormally. In most cases, post surgical pain doesn’t mean anything has gone wrong.
For example nearly 5% of patients after hernia surgery develop severe nerve related pain, even after such a “minor” surgery. Treating these problems early to prevent them becoming long term is essential.
Persistent Post-surgical Pain
Surgeons are enormously skillful, highly trained specialists. Some surgeries though are associated with persistent pain syndromes as nerves are injured by the process of surgery and some damaged nerves behave abnormally. In most cases, post surgical pain doesn’t mean anything has gone wrong.
For example nearly 5% of patients after hernia surgery develop severe nerve related pain, even after such a “minor” surgery. Treating these problems early to prevent them becoming long term is essential.
Limb Pain
Limb injury, like back and neck pain has a wide variety of causes, from acute trauma to chronic degenerative processes. Treating accordingly and working with orthopaedic surgeons, physiotherapists, hand therapists etc, it is vital to restore as much function as possible as quickly as possible.
Limb Pain
Limb injury, like back and neck pain has a wide variety of causes, from acute trauma to chronic degenerative processes. Treating accordingly and working with orthopaedic surgeons, physiotherapists, hand therapists etc, it is vital to restore as much function as possible as quickly as possible.
Headache and Facial Pain
Distinguishing the causes of headache and facial pain can be challenging. In these situations it is often useful to co-manage the condition with colleagues such as expert neurologists. It is not uncommon in these pain syndromes that other areas of the body refer pain into the head and face, eg wear and tear in the neck can be felt as predominantly headache (for example Cervicogenic Headache).
Headache and Facial Pain
Distinguishing the causes of headache and facial pain can be challenging. In these situations it is often useful to co-manage the condition with colleagues such as expert neurologists. It is not uncommon in these pain syndromes that other areas of the body refer pain into the head and face, eg wear and tear in the neck can be felt as predominantly headache (for example Cervicogenic Headache).
Pelvic Pain
Both male and female pelvic (and abdominal) pain remains poorly treated for a number of reasons. It is a problem area that is under researched and under discussed. It is well recognised to have a knock on affect on relationships, well being and reproductive health. Prior to working with a pain specialist it is important to have been fully assessed by a urologist for males and gynaecologist for females.
Pelvic Pain
Both male and female pelvic (and abdominal) pain remains poorly treated for a number of reasons. It is a problem area that is under researched and under discussed. It is well recognised to have a knock on affect on relationships, well being and reproductive health. Prior to working with a pain specialist it is important to have been fully assessed by a urologist for males and gynaecologist for females.
Complex Regional Pain Syndrome
CRPS is a pain management priority. It is essential to get on top of this condition as quickly as possible, after early recognition. CRPS is an abnormal response to trauma, where the trauma can be in some cases relatively mild. More normally the trauma is more severe, such as fracture and is often experience in the hand or foot. Moving rapidly through treatment options, to get on top of this condition quickly is necessary to optimise the chance of recovery.
Complex Regional Pain Syndrome
CRPS is a pain management priority. It is essential to get on top of this condition as quickly as possible, after early recognition. CRPS is an abnormal response to trauma, where the trauma can be in some cases relatively mild. More normally the trauma is more severe, such as fracture and is often experience in the hand or foot. Moving rapidly through treatment options, to get on top of this condition quickly is necessary to optimise the chance of recovery.
Treatments
Chronic pain often doesn’t have a cure. One of the biggest causes of chronic pain for instance is the wear and tear associated with a busy and active life. So, setting realistic goals to manage this pain and optimise your quality of life is vital from the outset.
In most cases a number of different strategies from the list below will be considered.
At assessment discuss with your pain specialist where you feel the pain and how the pain affects you. Then we can jointly create treatment options unique to your experience. It may be for instance worth treating the less severe pain first if it can get you moving a bit more freely before moving on to the more severe problem.
In addition, it is impossible to underestimate how much chronic pain affects us on all levels so it is best to maintain an open mind to management options.
Medications
Medications for pain management come in many forms such as patches, pills, infusions and creams. There are many considerations when starting someone on a medication for pain management not least what type of pain they have.
In addition the medications used in chronic pain are a significant source of concern for many patients. Many are worried these medications will cause addiction, profound side effects and don’t help long term. Others have concerns that medications will be reduced unnecessarily even if effective.
The medication rationale at Northern Beaches Pain Managment is to use better medications that are more likely to be effective, specific for the pain syndromes experienced. In addition we recommend starting at very low dose to allow careful increase if working. We are not aiming to start a medication for long term use.
In regard to the opioid medications (eg morphine, Endone) at Northern Beaches Pain Management. We aim to minimise opioid medication usage for all of our patients whilst remaining pragmatic. We do this as a result of a great body of evidence showing how opioid medications help in acute pain (in the short term) but in the long term they are not often helpful and can cause profound issues.
At present Northern Beaches Pain Management does not prescribe Cannabis preparations. We are happy to discuss why at further appointment. For further information in the meantime Link to cannabis statement
Medications
Medications for pain management come in many forms such as patches, pills, infusions and creams. There are many considerations when starting someone on a medication for pain management not least what type of pain they have.
In addition the medications used in chronic pain are a significant source of concern for many patients. Many are worried these medications will cause addiction, profound side effects and don’t help long term. Others have concerns that medications will be reduced unnecessarily even if effective.
The medication rationale at Northern Beaches Pain Managment is to use better medications that are more likely to be effective, specific for the pain syndromes experienced. In addition we recommend starting at very low dose to allow careful increase if working. We are not aiming to start a medication for long term use.
In regard to the opioid medications (eg morphine, Endone) at Northern Beaches Pain Management. We aim to minimise opioid medication usage for all of our patients whilst remaining pragmatic. We do this as a result of a great body of evidence showing how opioid medications help in acute pain (in the short term) but in the long term they are not often helpful and can cause profound issues.
At present Northern Beaches Pain Management does not prescribe Cannabis preparations. We are happy to discuss why at further appointment. For further information in the meantime Link to cannabis statement
Interventions
Interventions in pain cover a wide range of procedures from simple injections that can be done in rooms, all the way up to implanted spinal techniques. Before considering an intervention, it is important to remember that not all conditions that cause pain can be helped by interventions. For instance if someone has pain felt throughout their body there is little opportunity to use a procedure to help such a problem.
In addition, an intervention if appropriate must be coupled with other forms of treatment. For example some of the back pain syndromes, can be helped by nerve block and radiofrequency procedures but then the onus is on you to engage with a physiotherapist to start moving and rehabilitating.
Information on the different kinds of interventions for your pain syndromes can be discussed with your specialist.
Types of interventions
- Epidural injections
- Autonomic ganglion blocks
- Diagnostic nerve blocks for back pain
- Joint injections eg Sacroiliac joint injection
- Radiofrequency ablation techniques
- Pulsed radiofrequency techniques
- Pudendal nerve block and radiofrequency
- Spinal cord stimulation
- Intrathecal pump implantation for cancer pain
Interventions
Interventions in pain cover a wide range of procedures from simple injections that can be done in rooms, all the way up to implanted spinal techniques. Before considering an intervention, it is important to remember that not all conditions that cause pain can be helped by interventions. For instance if someone has pain felt throughout their body there is little opportunity to use a procedure to help such a problem.
In addition, an intervention if appropriate must be coupled with other forms of treatment. For example some of the back pain syndromes, can be helped by nerve block and radiofrequency procedures but then the onus is on you to engage with a physiotherapist to start moving and rehabilitating.
Information on the different kinds of interventions for your pain syndromes can be discussed with your specialist.
Types of interventions
- Epidural injections
- Autonomic ganglion blocks
- Diagnostic nerve blocks for back pain
- Joint injections eg Sacroiliac joint injection
- Radiofrequency ablation techniques
- Pulsed radiofrequency techniques
- Pudendal nerve block and radiofrequency
- Spinal cord stimulation
- Intrathecal pump implantation for cancer pain
Allied Health
In almost all situations, your pain wont be managed optimally without involving other highly skilled professionals, such as Physiotherapists, Occupational Therapists and Psychologists, for example. This is because there are many domains to pain management and many effects from living with chronic pain.
It is not surprising to think that someone with long term back pain for example would have impaired mobility and that their mood has taken a hit as a result. When the pain is improved they will require reconditioning from an exercise physiologist and while their mood is affected they will require support from a psychologist.
As a practice we will look to develop our allied health services locally and develop good links with trusted professionals throughout the local area.
Allied Health
In almost all situations, your pain wont be managed optimally without involving other highly skilled professionals, such as Physiotherapists, Occupational Therapists and Psychologists, for example. This is because there are many domains to pain management and many effects from living with chronic pain.
It is not surprising to think that someone with long term back pain for example would have impaired mobility and that their mood has taken a hit as a result. When the pain is improved they will require reconditioning from an exercise physiologist and while their mood is affected they will require support from a psychologist.
As a practice we will look to develop our allied health services locally and develop good links with trusted professionals throughout the local area.
