Injections and Procedures
Historically, Pain Medicine as a specialty developed out of the use of injections and other procedures to try to interrupt or modify the activity of the nerve pathways that carry pain. It is for this reason historically that the vast majority of doctors working in Pain Medicine in the UK have come into this specialty through Anaesthetics - Anaesthetists are very accustomed and skilled at doing procedures to numb nerves as part of our work. Professionally, the Faculty of Pain Medicine is still within the Royal College of Anaesthetists although Pain is becoming recognised as a specialty in its own right.
Over the years the specialty has become much broader in its approach, as well as learning that injections in isolation are limited in what they will do for pain and that destroying nerve tissue can itself lead to problems and indeed pain. It will be evident from this site that pain is now a multiprofessional specialty with invaluable involvement of nurses, physiotherapists, psychologists and other specialist staff.
Nevertheless, within an overall rehabilitation and multidisciplinary setting, procedures that can be done for pain still have an important role. In particular, they may help to provide a "window" of pain relief that will facilitate mobilisation and rehabilitation and help to break the cycles of immobility, nervous system sensitisation and other factors that maintain pain and its associated problems.
What procedures can be done?
In the pages in the menu on the right we will discuss some of the procedures we use.
Where do the procedures happen?
When you receive your appointment for a Pain Clinic procedure the letter should give details of where it will happen. At Cheltenham General Hospital the procedures happen on the Chedworth Suite, on the first floor at the back of the Centre Block, and at Gloucestershire Royal Hospital they happen in the Orchard Day Surgery Suite.
Please bring your medications or a list with you. If you are taking warfarin, clopidogrel or othr drugs to thin the blood please ensure that the staff looking after you are aware of this: this should have been discussed with you by the Consultant in the clinic. If there is any chance of your being pregnant please ensure that the staff are aware of this.
If you think that the Pain Team are not aware of your being on blood-thinning drugs or that you might be pregnant we would be very grateful if you could ring us before the appointment.
What happens afterwards?
Normally, after the procedures that we do on the Day Units, people stay afterwards for a short time to ensure that they have no early ill-effects, and in the case of some procedures to ensure that they have not developed any leg or other weakness from the local anaesthetics. Following this, people leave the hospital and go home. For your safety (and because in the event of an accident your insurers might not cover you) we ask you not to drive home or in the first 24 hours and that you go home accompanied and have someone with you for the first few hours, and ideally overnight, so that if you did become unwell you have someone to call on. If there is any numbness, be very careful not to place the affected area against hot things like radiators.
We normally ask patients to phone back afterwards to report progress, which most patients find is much easier for them and saves travel and time. The Trust's generic information sheet on what to do after attending the Day Unit can be downloaded here
The Faculty of Pain Medicine have produced an information booklet called "What is a Pain Medicine Doctor" which you can download here
This site complies with the HONcode standard for trustworthy health information:
Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
Page updated 19/02/2016