Top London pain management experts

With the very rare exception of those born with a congenital insensitivity to pain disorder, everyone has experienced pain at some point in their lives. Stubbing your toe, getting a paper cut, breaking a bone - these are all typical instances in which you are likely to feel pain. Pain is your body’s way of telling you that something is wrong. When the cause of your pain heals, your body stops sending pain signals and you stop hurting.

If your pain persists longer than three months and is having an impact on your ability to carry out your everyday life, you are likely to be experiencing chronic pain.

Our pain team work closely with other specialists as part of a multidisciplinary team to provide a holistic approach and optimal outcome to chronic pain, whatever the cause. The techniques used in pain management will depend on the nature and severity of the pain but our consultants all have special expertise in spinal interventional procedures for back pain.

Diagnosing chronic pain

Acute pain and chronic pain are two entirely different conditions. Acute pain will normally last for a brief amount of time and resolve on its own accord. 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 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.

  • Biological factors: medical history and genetic predisposition to physical injury. Is the physical  pain radiating from a specific location?
  • Psychological factors: following initial stress from an injury, has it had an impact on your emotional or mental wellbeing? Have emotional factors resulted in fear avoidance, changes in behaviour or altered your perception of pain?
  • Social factors: getting to know your lifestyle, your working habits, your overall socioeconomic behaviours. Do you live a sedentary life or an active one?

During your consultation, your pain speciailst will ask questions to gain a real understanding of who you are, what you do and what is going wrong – so they can know how to fix it. To do this they take a history, carry out a physical examination, and complete appropriate investigations to then make a plan.

Common causes of back pain

There are a wide variety of possible causes when it comes to back pain, from muscle strains to structural problems or simple everyday activities to do with posture or movement. Diagnosing the cause and understanding how it impacts your everyday life is a key component in effectively treating it.

Symptoms of chronic back pain

While acute back pain most often goes away without treatment, if you have experienced ongoing pain for over 3 months then it is essential you seek specialist advice and treatment as soon as possible. Symptoms you should watch out for include:

  • Ongoing pain or ache
  • Inflammation or swelling in the back
  • Persistent pain with rest or activity
  • Ongoing pain that radiates down the legs
  • Numbness or tingling
  • Persistent pain following injury
  • Persistent pain with no injury noted

Treatments for chronic back pain

Get back to living life to the full

In cases of chronic back pain the vast majority of patients do not require surgery. The only instances where surgery would be required would be in structural cases like slipped discs or in severe cases, such as the removal of cancer. The majority of patients can be treated conservatively, without the need for any surgical intervention.

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 specialists at Schoen Clinic are experts in treating all aspects of pain, and passionate about getting you back to enjoying life again.

Conservative management of chronic back pain: surgery is almost never necessary

The majority of patients are managed with good physiotherapy and in some instances, osteopathy or through 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 we employ when treating chronic pain. Which of the five will be used to treat each patient will differ dependant on what patient is presenting. The aim is to resolve the pain by addressing the negative biopsychosocial factors uncovered during the consultation and these will always vary from patient to patient.

Physical therapy: Movement to manage pain

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 works closely with our physiotherapists to come up with a unique physical therapy plan tailored to target your specific pain. This physiotherapy plan can involve:

  • Retraining your posture
  • Aerobic exercise
  • Strengthening your core
  • Flexibility and stretching
Psychotherapy: Changing your behaviours and introducing mindfulness

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.

Pain management medication: Getting your pain under control

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.

Neuromodulation & Injections: Targeted relief

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.

Diet & lifestyle modifications: You are what you eat and you feel what you do

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 and increase 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 a key player in addressing some cases of chronic pain too. Listening to your body and taking breaks to rest when you need to is essential. Activities that aggravate your experience of pain should minimised and understanding what those activities are is an important part of your treatment plan.

Pain management - our team

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Our specialised hospital for pain management in London

Schoen Clinic Orthopaedic and Spinal Hospital London
66 Wigmore Street
London W1U 2SB