Dr Mark Alexander-Williams
Acute and chronic pain are two different conditions. Acute pain will normally last for a short amount of time and resolve on its own. Chronic pain does not go away on its own and can have a severe impact on your ability to live life to the full.
Chronic pain can be referred to as a biopsychosocial phenomenon - it has layers. Diagnosing the exact cause involves a comprehensive assessment of multiple factors in your life, looking at you as a whole person and not just one specific condition.
Your pain management specialist will go through these with you to gain an understanding of your pain, so that an effective course of treatment can be put in place.
During your consultation, your pain management specialist will ask questions to gain a real understanding of who you are, what you do and what is going on – so they understand best how to manage the problem.
They will take a full medical history, carry out a physical examination and complete appropriate investigations to make a treatment plan.
Chronic pain is a persistent pain, which continues after healing or is the result of ongoing damage.
This includes spinal pain, post-traumatic pain (e.g. after amputation or surgery), pain involving the central or peripheral nervous system (e.g. post stroke pain, complex regional pain syndrome, diabetic neuropathy, post herpetic neuralgia and sciatica) and pain associated with other chronic diseases such as angina, arthritis, migraine, endometriosis, headache and pancreatitis.
While acute back pain most often goes away without treatment, if you have experienced ongoing pain for over 3 months, it is essential you seek specialist advice and treatment as soon as possible.
Symptoms you should watch out for include:
If left untreated, chronic pain can have a severe impact on your everyday life. If it affects your sleep, your relationships, your career or your ability to complete even simple tasks it is essential you find treatment.
Early diagnosis and treatment of chronic pain is the best way to get back to your normal life. Our pain management specialists at Schoen Clinic London are experts in treating all aspects of pain, and passionate about getting you back to enjoying life again.
The majority of patients are managed with good physiotherapy and in some instances, osteopathy or a chiropractor.
For most patients presenting with chronic back pain, all that is required to relieve the symptoms is a combination of movement based therapy and lifestyle modifications. There are five main modalities when treating chronic pain and which of the five will be used to treat each patient will differ dependant on how the patient is presenting.
Our aim is to resolve the pain by addressing the negative biopsychosocial factors uncovered during the consultation and these vary from patient to patient.
As sedentary lifestyles have a large role to play in the impact of chronic pain, exercise is one of the first treatment methods which should be employed.
Our pain management team in London work closely with our physiotherapists to formulate a unique physical therapy plan tailored to target your specific pain.
This physiotherapy plan can involve:
There are many different types of psychotherapy but the aim is to help you gain control of your life by learning about your thoughts and behaviours.
As chronic pain is long lasting it can have an impact on your mental health as well as your physical health, so a multifaceted approach to tackling it is beneficial.
Psychotherapy can help you to manage the emotional aspects of chronic pain, ranging from mood swings and depression to stress and anxiety.
Anti-inflammatory medications, muscle relaxants and other medications for pain relief can be used in cases of chronic pain.
It is important to note that while they can provide relief for pain symptoms, they do not resolve the underlying issue and should be used in conjunction with other methods (e.g. physiotherapy) to combat the root cause of your chronic pain.
There are a number of different injection therapies that can be useful in treating the symptoms of chronic pain.
Nerve blocks, nerve ablations and epidural steroid injections can help to relieve pain symptoms if the source of the pain is known, but they do not resolve the cause of the pain and should not be used as a long term solution alone.
Neuromodulation can be non-invasive or minimally invasive through external or implanted devices. This form of therapy is designed to deliver stimulation to specific nerves to provide pain relief and restoration of function.
Your diet could be a contributing factor to your chronic pain.
Processed foods or foods high in trans fats or sugar can be inflammatory. Being overweight can put strain on your body and have a negative impact on your joints increasing your risk of heart disease, diabetes and many other associated health problems.
Maintaining a healthy weight can assist in reducing the levels of pain you experience. Making changes to your lifestyle is key to addressing some cases of chronic pain too.
Listening to your body and taking breaks to rest when you need to is also essential. Activities which aggravate your pain should be minimised and understanding what those activities are is an important part of your treatment plan.