Pain management in Stirling

When you need help with pain relief, it’s vital to get fast access to effective treatments tailored to you. 

At The Kings Park Hospital in Stirling, our conscientious and caring Pain Management Consultants will listen to you, assess your problem, provide you with a diagnosis and create an individual treatment plan, all within your first consultation.

Pain can come from all areas of the body, and since there is an extensive list of potential causes, it sometimes takes a pain specialist to get to the nub of the problem. 

Our consultant pain management specialists are trained Anaesthetists, so they have a vast knowledge of medicines, analgesics and injection therapies that can improve your pain and quality of life.

The hospital serves Forth Valley and further afield and is easy to get to from the M9, A905 and A91.

Pain management is a medical sub-speciality provided by Anaesthetists – specialist doctors who provide pain relief to patients during surgery and beyond.

As a speciality branch of medicine, pain management covers a broad range of problems, including persistent back, abdominal and joint pain.

Our pain management specialists can diagnose and treat your pain in various ways, including medication and injection therapies. They’ll provide you with a range of treatment options and will discuss the pros and cons of each to help you make an appropriate decision.

The conditions we treat at Kings Park Hospital include:

• Chronic lower back (lumbar) pain
• Headaches and migraines
• Neck and shoulder pain
• Slipped (herniated) discs
• Buttock and lower back (facet and sacroiliac joint) pain
• Muscular pain (including piriformis syndrome)
• Nervous system (neuropathic) pain
• Persistent post-surgical pain
• Complex regional pain syndrome
• Spinal pain and sciatica

Some of the most common treatments are spine and joint injections to both diagnose and significantly reduce pain. These injections are minimally invasive, with a short recovery time, and are aimed at improving pain and restoring function in as short a time as possible. Some injections involve numbing (blocking) a nerve with local anaesthetic and reducing inflammation with steroid. Some injections aim to inactivate a painful nerve long term. This type of procedure is called denervation. This means that the nerve supply to a painful joint caused by an injury or degeneration is blocked to make you feel more comfortable. Denervation can be used to treat back, shoulder, hip, and knee pain often in circumstances where surgery is not suitable or has not been successful. 

Other common interventional procedures for pain management include trigger point injections into specific areas of muscle pain and spasm. If the painful muscle lies deep within the body, sometimes an ultrasound-guided muscle injection is required.

Your pain management consultant can review and prescribe medication, analgesics and topical treatments, for a wide range of nerve and musculoskeletal problems amongst other things. They can also change your pain relief at any stage of your journey should you experience side effects.

Pain management specialists can help you manage your pain, reducing it to a level where you can function better and get back to your daily life.

You can expect a comprehensive service including assessment, investigation and treatment when referred to our pain management consultants by your GP or specialists such as a neurosurgeon, neurologist, or orthopaedic consultant.

We are also happy to accept self-referrals but request some details of background history, including when your condition started and management and treatment options you have previously tried. If you can, it’s a good idea to bring any details of correspondence from GPs or hospital specialities, investigations and reports should you decide to self-refer.

On the day of your consultation, you should check in at reception and sit in our outpatient waiting area. Your consultant will collect you from the waiting room and take you into a private consulting room where your consultation will take place.

Your consultant will look through your paperwork and ask you about your condition. They’ll want to go back to the start – the onset of your pain, medical history, and development. They will look at associated symptoms, explore systemic problems that may not have been picked up, identify other illnesses, review your current medication, past drug treatments and all the remedies you’ve tried. They may also ask you about the effects pain is having on activities of daily living and sleep.

Your consultant will then perform a complete physical examination. They may ask you to move in certain positions to determine the source of your pain. Your consultant may then make a targeted examination of the painful area and surroundings to try and identify the possible source and nature of pain you are experiencing.

Should your consultant suggest further investigations to help them determine a diagnosis and treatment plan, these will often take place at a later date. They may request an x-ray of the area that you experience pain. This happens at Kings Park Hospital and x-rays are performed within a few days. Should your consultant advise that you require an MRI (magnetic resonance imaging) scan, ultrasound scan or nerve conduction studies, these will take place at our sister hospital, The Ross Hall Hospital in Glasgow. You would then return to Kings Park Hospital for your follow up appointments.

At Kings Park Hospital, our pain management specialists have access to various equipment to help diagnose and treat your pain. This includes fluoroscopy (which provides real-time images of the skeleton), guided x-ray and ultrasound injection equipment and Radiofrequency denervation machine for inactivating peripheral nerves.

The use of each one depends on what they think the cause of your problem may be. For example, x-rays would be used to diagnose hip, knee and shoulder joint pain, MRI for spinal pain, ultrasound for suspected muscle and tendon tears, and nerve conduction tests to ascertain the function and of peripheral nerves.

The most common procedures that our consultant pain specialists perform include:

• Lumbar facet joint steroid injection
• Lumbar medial branch block
• Lumbar facet joint denervation
• Lumbar epidural steroid injection
• Selective nerve root block
• Sacroiliac joint injection
• Denervation of hip, knee and shoulder joints
• Ultrasound-guided intramuscular injections
• Selective peripheral nerve blocks
• Trigger point injection
• Botox for muscle pain and spasm

Some headaches and neck and shoulder muscle pain can be alleviated in minutes in the clinic with simple nerve blocks and trigger joint injections when local anaesthetic is injected into the painful muscles.

Some very active people, or following an episode of back pain, can develop tight muscles deep within the buttock. This can cause localised pain that can be painful to sit on and sometimes mimic the symptoms of sciatica. An ultrasound-guided injection is a standard treatment for this.

A lot of patients with back pain actually experience pain coming from their sacroiliac joints in the back of the pelvis; this can often be successfully treated with an x-ray or ultrasound guided steroid injection. Many patients experience sciatica (leg pain coming from the lower back) that either cannot be operated on or who wish to avoid surgery or where surgery has not improved their pain. In these situations an epidural injection or selective nerve root block with steroid to target the specific nerve in your back causing sciatica can be very effective.

If your consultant suggests a new type of medication or a change to your current medicine, they will issue you with a new prescription. If an interventional procedure such as an injection is required, your consultant will do this procedure themselves at the hospital.

Many persistent pain problems relate to dysfunction in the nervous system and do not require injection treatments. These pains are often best managed with medication. There are many medical options available to modify and dampen down pain regardless of the cause. One of the primary aims of management is to reduce pain but minimise any side-effects that you might experience from drug treatment.

Some specialist treatments such as Qutenza patch application and lidocaine infusions can only be done in a hospital setting as they require close monitoring for possible side-effects.  All our interventional procedures are performed as day-case treatments requiring only a short visit to hospital.

Patients attending our pain clinic have often tried a variety of treatments to manage their pain symptoms and come with a mix of expectations. Our consultant pain specialists will work with you to determine the appropriate treatment, and should you not see an improvement, your treatment plan can be altered.

Our pain consultants take the time to listen to you; you’ll receive a thorough review of the problem, with relevant assessments and investigations and a comprehensive range of treatments, with referral to physiotherapy and other specialists if required.