Pain problem that is not going away? Physiotherapy or Surgery not helped your painful condition fully? Read more about the role of a pain management specialist.
Jolene Sher, from BOOST PHYSIO Hendon, asks Consultant in Interventional Spine & Pain Medicine, Dr Nigel Kellow key questions about Pain Management.
Dr Nigel Kellow MB BS FRCA is a leading specialist in painful spinal, skeletal, and neurological problems and one of his main areas of interest is the use of percutaneous image guided procedures.
Dr Kellow practices privately in London and you can find out more about his practice on his website here: www.kellow.com
1) When is the right time to see a pain management consultant?
A. Pain specialists deal with problems that a) have been caused by surgery, b) can’t be treated by surgery, or c) for which surgery is not indicated. So I see a lot of surgical complications, e.g. .nerve injuries, prolonged or severe postoperative pain delaying recovery or impairing function. I see CRPS whether related to surgery or trauma. I also see patients who are trying to avoid spinal surgery, for whom it isn’t indicated, or where they have continuing pain in spite of, or because of, spinal surgery. In practice this means a lot of patients with back and neck pain, sciatica or brachalgia, of all ages. The right time to refer to a pain specialist is as soon as any of these criteria have been met. With respect to the patients you see it will be anyone with sciatica or brachalgia whose pain is not well controlled; anyone who is not responding to treatment for back or neck pain; anyone with a possible serious problem; anyone for whom you want imaging; anyone with CRPS; anyone who has recently had surgery, whose physio is being impaired by inadequate pain control.
2) What treatments do you offer as a pain management consultant?
A. Triage and diagnostics – Full clinical and diagnostics assessment with advanced medical imaging (MRI, 3D CT, SPECT-CT), bone densitometry, neurophysiology, blood chemistry.
Treatment – medications (eg. anti-nociceptive drugs, anti-neuropathic drugs, muscle relaxants, opioids if necessary), spinal injections, nerve ablation, tumour ablation, spinal cord stimulation.
3) You deal a lot with spinal cord stimulation. What is this?
A. This is the implantation of electrodes and a pulse generator into the spine. Common indications include FBSS (Failed Back Surgery Syndrome – persistent pain in the back or legs after spinal surgery), CRPS, neuropathic pain. See this link.
4) What is the role of Physio in pain management in your opinion?
A. It plays an essential role throughout the spectrum of care of the patient in pain. Patients in pain always suffer from impaired function. It is vital that physios and pain specialists collaborate so I can make sure the patient’s pain has been adequately controlled so you can do your job as effectively as the patient’s MSK system will permit – whether this is following an acute injury, or after surgery.
After I have treated patients it is vital that they have physio during the window of opportunity afforded by any treatment I have done for them.
Jolene Sher, Specialist Physiotherapist
BOOST PHYSIO is a leading private physiotherapy practice with high street clinics across North West London. We have 4 branches in the following areas: . Branches of our physiotherapy practice are in Cricklewood NW2, Hampstead NW3, Hendon NW4 and East Finchley N2.
Our private physiotherapy clinics treat patients from all over North West London and North London. We provide same day physiotherapy treatment for sports injuries, neck and back pain. Appointments are available 8am to 9pm and we even have Saturday and Sunday appointments available.
Patients come for physiotherapy from the following areas: Hendon NW4, Mill Hill NW7, Cricklewood NW2, Hampstead NW3, Kilburn NW6, Queens Park, Finchley Road, Golders Green NW11, Swiss Cottage and Willesden Green NW10. Fortis Green, Muswell Hill, Highgate N6.
If you do have nay issues that need attention please book an appointment at one of our 4 High Street Physiotherapy clinics.
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