They offer many interventions and pain management programmes to provide pain relief and help patients to return to normal life. They will endeavour to determine the source of your pain to enable them to prescribe the best treatment and advice for your individual circumstances. They will also encourage you to take an active role to control your pain.
Our pain medicine consultants work as part of a multi-disciplinary team that includes consultant neurosurgeons, orthopaedic surgeons, physiotherapists, psychologists and occupational therapists.
The pain relief options we offer include: lumbar epidural injections, nerve blocks and facet joint injections (medications to stop the transmission of pain and reduce inflammation), radiofrequency denervation or ablation (nerves supplying painful facet joints are selectively destroyed by heat produced by radio waves), and spinal cord stimulation (small electrical fields are delivered to the spinal cord to change pain messages and reduce pain).
Pain relief is often combined with other treatments such as physiotherapy. The pain relief often allows patients to recommence activities that were otherwise too painful without, and to engage in an exercise program to further enhance their recovery.
Lumbar epidural injections are a common non-surgical treatment option for low back pain such as a slipped disc and sciatica (leg pain). A lumbar epidural injection involves injecting drugs (steroids and local anaesthetics) into the epidural space in your lower spine. The steroid decreases inflammation and the anaesthetic reduces pain.
The effects of these injections tends to be short term. They can provide pain relief for up to a year. Lumbar epidural injections allow you to move around more easily and are often combined with a comprehensive rehabilitation program, such as a stretching and exercise program, to offer maximum benefit. If a patient finds these injections effective, they may be offered them again to help relieve their pain.
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A transforaminal epidural injection is the newest type of epidural steroid injection.
It involves injecting steroid into the epidural space through the bony opening of the exiting nerve root, known as the foramen. It numbs your nerve, offers temporary pain relief and reduces inflammation.
Transforaminal epidural injections are done with a more diagonal approach than other epidural injections so that the affected nerve can be better treated. They allow the medication to be placed nearer to the area where the nerve is being pinched. They only target one side of your spine.
These injections are also known as transforaminal epidural blocks.
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A dorsal root ganglion block is a spinal injection that contains local anaesthetic and often a small dose of steroid used for back pain due to irritated spinal nerves.
The dorsal root ganglion is a small swelling of nerve cells on the spinal nerve that connects to your spinal cord. It sends impulses from your spinal nerves to your spinal cord. A dorsal root ganglion block works by reducing or blocking pain sensation impulses.
This procedure is also known as a paravertebral block, transforaminal epidural or nerve root block injection.
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A facet joint injection is a combination of local anaesthetic (to reduce pain in the short-term) and corticosteroid (to reduce pain and inflammation longer term) that is injected into a targeted facet joint that is inflamed or irritated. It is performed under x-ray guidance to ensure the injection goes in the correct place.
Your facet joints are small joints on either side of your spine which link each adjacent bone (vertebrae) to each other. They stabilise your spine, whilst allowing movement.
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