My Philosophy

Through years of treating patients with chronic pain, I have an understanding of how each patient is a person with individual needs. Every patient is entitled to an explanation of what is causing the pain. This is called a diagnosis. Sometimes this explanation is easy to find, for example, scarring in the spine after an operation to remove a bulging disc (Failed Back Surgery Syndrome/ Post Laminectomy Syndrome). Sometimes the explanation is more difficult for example increased pain sensitivity in the nerves supplying a limb that has been injured (CRPS Chronic Regional Pain Syndrome). Or chronic widespread pain due to increased pain sensitivity (Central Sensitization and Wind Up).

A diagnosis is made with a combination of listening to a patient's story (history including medical questionnaires, referral letter and letters from other treating clinicians eg GPs, specialists, physiotherapists), physical examination and appropriate investigation.

I will do my best to provide you with a diagnosis and treatment. Treatment may be advice, medication, injection therapy (intervention), referral to other clinicians eg other specialists, physiotherapy or a psychologist. Self Management and Exercise is very important. Living healthily, eating well, exercising and maintaining psychological health are the key to getting better. This takes effort, especially when you have pain. In many cases being afraid of moving due to pain creates a cycle of deconditioning and reduced physical function. With chronic pain, it is vital to focus on improving function instead of just on reducing pain. Daily exercise is my best advice.

Appropriate medication and intervention can give good relief to many patients with chronic pain. Particularly when combined with pain management which includes physiotherapy/exercise and psychological therapy.

I will not prescribe strong morphine-based medication except in very exceptional circumstances. Strong morphine medication (strong opioids) has no evidence of benefit in chronic pain and are harmful. I will not repeat steroid injections if they are not working for a prolonged period.