At UCLH pain management centre we manage a wide range of pain conditions:
Most pain can be treated in primary care. The British Pain Society has provided care pathway for the assessment and treatment of pain.
Low back pain
Back pain is unfortunately very common and most can be treated in the community or local pain clinic. Early management of low back pain is accessed through your GP and may involve exercise and medications:
Low back pain and sciatica
The NICE guidance is not yet completed but in anticipation of this the Pain Management Centre is able to offer root nerve blocks for in suitable patients with a herniated intervertebral disc with acute radicular symptoms.
Complex spinal pain
The Pain Management Centre is happy to receive referrals for:
- Patients who have already been treated by other pain specialists and may need specialist intervention or
- Camden and Islington patients who are being referred by their GP after triage or treatment in the community pathway.
Treatments in the Pain Management Centre may include facet joint denervation or spinal cord stimulators if the NICE guidance criteria are fulfilled, or a specialised pain management programme.
Abdominal and pelvic pain
The Pain Management Centre has pioneered the multi-professional treatment of pain perceived in the pelvis or abdomen. Four consultants and a senior nurse specialist form the initial assessment team and have close links to gynaecologists, urologists, gastroenterologists and colorectal surgeons within UCLH. We offer a comprehensive assessment and investigation where necessary which may include urodynamics, pelvic MRI neurography, plus diagnostic and therapeutic injections such as Xray, ultrasound and CT guided injections. Our close relationship with UCLH Endometriosis Centre means that women with painful endometriosis can move seamlessly from gynaecological care to pain management.
Our world leading pain management programme named Link is specific for those with abdominal and/or pelvic pain and runs three times a year for women and twice for men. Patients may be considered for a trial of sacral nerve stimulation for bowel and bladder dysfunction with our uroneurology or colorectal colleagues or for pain if indicated and within in context of our multidisciplinary team.
A guide to the assessment and early management of chronic pelvic pain can be found in the link below:
Palliative care and pain following cancer
Our consultants liaise closely with the palliative care team and can assist with difficult to manage pain in cancer such as with intrathecal pumps, catheters and specific injections.
Patients who have survived cancer but have residual pain such as following some chemo- or radio- therapies can be seen in the Macmillan centre by one of our consultants who has trained specifically in the management of these types of pain.
Neuropathic (or nerve) pain
The experience of pain inherently affects the nerves as it is the nervous system that receives and processes information. However certain types of conditions manifest especially in the nerves such as Multiple Sclerosis (MS) or other neurological conditions or injury. The PMC has neurology and pain consultants with many years’ experience treating neuropathic pain.
A guide to the assessment and early management of neuropathic pain can be found in the link below:
Complex regional pain syndrome (CRPS)
CRPS is a specific neuropathic pain condition which warrants particular therapy when diagnosed in the early stages. People with CRPS have persistent pain in an arm or leg, usually after trauma such as a fracture. The limb can also feel swollen, hot, cold, sensitive or have changes in hair growth. In the past it was called reflex sympathetic dystrophy (RSD) or Sudeck’s atrophy. Our dedicated team uses the latest techniques and is contributing to the research to help manage this syndrome.
Patients with pain affecting the face have the benefit of diagnosis and treatment at by orofacial and pain physicians the Eastman Dental hospital as well as specific multidisciplinary pain management programs such as ‘About Face’. There is specialist clinic with our neurosurgical colleagues for those with trigeminal neuralgia.
2013-2014 is the International Association for the Study of Pain (IASP)’s global year against orofacial pain and the PMRC has contributed with a range of talks and seminars.
Pain associated with a Rheumatological condition/Joint Hypermobility Syndrome
Conditions affecting the joints and soft tissues are often painful and are skilfully assessed by our rheumatology colleagues. Occasionally there are specific interventions that the pain management team can also help with. Patients can also be referred directly by UCLH rheumatology consultants to our pain management programme, COPE, or to our programme for those with Joint Hypermobility Syndrome.
Headache is usually assessed and treated by neurologists within NHNN but having a neurologist with a special interest in headache and pain in the Pain Management Centre enables our patients with other chronic pains to have holistic treatment. We also hold a joint clinics with our headache neurology colleagues.
Pain associated with sickle cell disease
Patients with sickle cell disease have pain during crises and may also have long term pain. Many have not had access to pain services in the past and will benefit from treatment from our multidisciplinary team. We run a pain clinic alongside UCLH’s sickle cell service to improve access for our patients.