Dr Mark Alexander-Williams
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.
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.
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.
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:
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.
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.
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:
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 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.