September is Pain Awareness Month

Pain Awareness Month

Pain Awareness Month is a time when various organisations work together to raise public awareness of issues in the area of pain and pain management. The initiative was introduced by the American Chronic Pain Association under the Partners for Understanding Pain banner in 2001.

This year, the International Alliance of Patient Organizations and International Pain Management Network joins the initiative to bring pain to the forefront of the international community. Raise awareness by getting involved. Talk to your family, friends and healthcare team and help create greater understanding of pain.

neuropathic pain

What is neuropathic pain?

neuropathic pain

Neuropathic pain commonly presents as burning, pins & needles, numbness, electric shocks or itching. It has multiple causes including nerve injury, spinal cord damage and complications from shingles. Neuropathic pain can also arise following a surgical procedure.

Around 7–8% of adults experience pain that can be described as neuropathic, as well as one in four people with diabetes.  Managing neuropathic pain can be challenging. It is associated with impaired quality of life and is often poorly managed, partly because neuropathic pain is often unrecognised by healthcare practitioners.

At Metro Pain Group, we regularly treat patients with neuropathic pain. We offer advanced and evidence-based treatment measures in conjunction with multidisciplinary care.

For more information, please fill out the form below.

 

References:

Costigan, M., Scholz, J. and Woolf, C.J., 2009. Neuropathic pain: a maladaptive response of the nervous system to damage. Annual review of neuroscience32, pp.1-32.
Dworkin, R.H., O’Connor, A.B., Kent, J., Mackey, S.C., Raja, S.N., Stacey, B.R., Levy, R.M., Backonja, M., Baron, R., Harke, H. and Loeser, J.D., 2013. Interventional management of neuropathic pain: NeuPSIG recommendations. PAIN®154(11), pp.2249-2261.
Freynhagen, R. and Bennett, M.I., 2009. Diagnosis and management of neuropathic pain. Bmj339(b3002).
International Association for the Study of Pain. Epidemiology of neuropathic pain: how common is neuropathic pain, and what is its impact? Washington: IASP; 2014.
Smith, B.H. and Torrance, N., 2012. Epidemiology of neuropathic pain and its impact on quality of life. Current pain and headache reports16(3), pp.191-198.

 


Neuropathic pain inquiry

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

Has a workplace injury left you in chronic pain?

workplace injury

Living with pain is not easy. Chronic pain can prevent a person from participating in work, daily tasks or other activities. When battling pain resulting from a workplace injury, one may experience frustration and disappointment, particularly when their usual healthcare team is at a loss in finding effective strategies in managing their pain.

At Metro Pain Group, we understand the strain that chronic pain can place on our patient’s lives.  Our expert team will assess a patient’s symptoms and then provide options to best alleviate the pain. We have a multidisciplinary approach to treating pain as we recognise that being in pain can impact all areas of our patient’s lives.  Our team consists of:

  • Pain Doctors
  • Psychologists
  • Physiotherapists
  • Physician Associates
  • Rehab Coordinator

Our dedicated team works with our patients in ensuring that they get the best possible outcome.  Our highly experienced admin team liaise with insurance companies and legal firms on a regular basis and can act on your behalf when requesting approvals and other matters.

Our goal is to help manage your pain, give you back control of your life and enable you to live better.

If you are experiencing persistent pain following a workplace injury and would like more information, please fill out the form below:

Workplace Injury Inquiry

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

Advanced treatment for chronic headaches and migraines yields positive results

headaches and migraines

People who experience daily headaches and migraines often find that the pain hinders their day to day living. Their work, family and social life can also be affected when their pain is not well managed.

While there are many conventional treatments for headaches and migraines, some patients unfortunately do not get relief.  At Metro Pain Group we offer patients several options to alleviate headaches and migraines such as medications, physical and psychological treatments and procedures.

When conservative treatments have been unsuccessful, patients may seek alternative options.

In a long term study of 60 cases, Peripheral Nerve Field Stimulation (PNFS), a type of neuromodulation, has shown encouraging results. [i] Almost 70% of patients who underwent the procedure reported significant pain relief (>50%). [i]  Medication use was reduced for the majority of patients (83%) who were previously taking pain relief or prevention medication. Additionally, reductions in disability and depression were reported allowing patients to return to normal activity. [i]

As with any procedure, PNFS carries possible risks and side effects, however the treatment is reversible and can potentially bring relief to patients who have unsuccessfully tried other therapies.

If you are experiencing ongoing headaches and migraines and would like more information, please fill out the form below.

___________________

[i] Verrills P., Rose R., Mitchell B., Vivian D., Barnard A. 2013. Peripheral Nerve Field Stimulation for Chronic Headache: 60 Cases and Long-Term Follow-Up. Neuromodulation 2013; e-pub ahead of print. DOI: 10.1111/ner.12130

 

Headaches and migraines - more information

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

Would you like to find out more about the latest in pain treatments?

latest in pain treatments

Metro Pain Group has a wholly owned research subsidiary, Monash Clinical Research (MCR), who run clinical studies together with our doctors to help find new or improved treatments for patients suffering from chronic pain.

MCR is currently running several clinical trials, with more due to start later this year.

Some of the conditions being investigated include:

  • Failed Back Surgery Syndrome
  • Chronic Lower Back Pain
  • Chronic Leg Pain
  • Shoulder Pain

 

WorkCover/TAC/DVA and uninsured patients can also participate in some of these studies.

To find out more about our clinical trials, please fill out the form below and one of our research coordinators will be in touch.

 

Find out about the latest in pain treatments

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

Can Radiofrequency Neurotomy be repeated?

radiofrequency neurotomy

Radiofrequency Neurotomy (RFN) is a treatment used to bring relief to neck or back pain caused by facet joints. 1,2 The procedure is performed under fluoroscopy under sterile conditions in an operating theatre using mild sedation and local anaesthetic. Using a radiofrequency generator, the procedure involves placing a probe alongside the affected nerve. The probe is heated to 90 degrees Celsius. Pain signals are interrupted as a result which can bring pain relief for a long period until full nerve function recovers.

A small portion of patients may find that their pain is gone for good; however most patients may find that the effects are temporary and that the pain could return 6 to 18 months following the procedure. In such cases, the procedure can be repeated. Studies have found that patients who have previously responded well to the treatment are usually successful when they undergo subsequent treatments. 3

If you have previously had radiofrequency neurotomy and find that your pain is returning, please fill out the form below for more information.

References:
1 McDonald GJ, Lord SM, Bogduk N. Long-term follow-up of patients treated with cervical radiofrequency neurotomy for chronic neck pain. Neurosurgery 1999:45: 61-68
2 Dreyfuss, P., Halbrook, B., Pauza, K., Joshi, A., McLarty, J., & Bogduk, N. (2000). Efficacy and validity of radiofrequency neurotomy for chronic lumbar zygapophysial joint pain. Spine, 25(10), 1270-1277.
3 Husted, D. S., Orton, D., Schofferman, J. and Kine, G. (2008), Effectiveness of Repeated Radiofrequency Neurotomy for Cervical Facet Joint Pain. Journal of Spinal Disorders & Techniques, 21(6):406-408. doi: 10.1097/BSD.0b013e318158971f.

 

Repeat RFN Inquiry

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

Are you taking the right medication for your pain?

multidisciplinary team

Patients suffering from chronic pain often take codeine-based medications to relieve their pain. But do the side effects outweigh the positives?

Codeine-based medications which include Nurofen Plus, Panadeine Forte and Mersyndol are classified as an opioids. In Australia alone, opioid dispensing has surged 15-fold from 1992 – 2012. With this number, opioid-related hospitalisations and deaths have also increased. 1 While an effective short term treatment, taking opioids for several days or more can lead to physical dependence, abuse and overdose. 2 Patients with a physiological dependence suffer many withdrawal symptoms such as nausea, muscle aches, chills, diarrhoea and others. Some studies have also found that prescribing opioids as a long term treatment as simply ineffective. 3

It is a common misconception that opioids are the sole answer to chronic pain when in fact opioids can cause more harm than good. At Metro Pain Group, we offer alternatives to opioid based treatments. Our highly trained and experienced doctors adopt a comprehensive integrated approach and will work with you to find the treatment that is right for you.

 

References:
1Blanch, B., Pearson, S. and Haber, P. S. (2014), Prescribed opioid use in Australia. Br J Clin Pharmacol, 78: 1159-1166. doi:10.1111/bcp.12446.
2Volkow, N., McLellan, A. (2016), Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies. N Engl J Med 2016; 374:1253-1263 DOI: 10.1056/NEJMra1507771
3Rosenblum A, Marsch LA, Joseph H, Portenoy RK. Opioids and the Treatment of Chronic Pain: Controversies, Current Status, and Future Directions. Experimental and clinical psychopharmacology. 2008;16(5):405-416. doi:10.1037/a0013628.

 

If you would like to make an appointment, please fill out the form below.

Book an appointment

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

Dr Paul Verrills presented with the highly esteemed Best Research Paper Prize

multidisciplinary team

Dr Paul Verrills from Metro Pain Group has been announced as the prestigious winner of the Best Research Paper Prize for his presentation at the 87th Annual Scientific Congress of the Royal Australasian College of Surgeons in the section of Pain Medicine. The Congress was held on 7 – 11 May 2018 in Sydney, Australia.

The title of the research paper was “Investigating the Efficacy of High Frequency Spinal Cord Stimulation at 10 kHz for Treating Chronic Abdominal Pain: Interim Results from a Multicenter Feasibility Study”. Dr Paul Verrills in collaboration with a wider international team, presented the research findings from a spinal cord stimulation study which aims to assess the safety and effectiveness of HF10 Spinal Cord Stimulation (HF10-SCS) in the treatment of chronic abdominal pain. Unlike other spinal cord stimulation systems, HF10-SCS provides pain relief by producing wave forms at 10 kHz without paresthesia 1. HF10-SCS has previously established its ability to provide relief for chronic back and leg pain 2, and more recently for chronic abdominal pain, as presented by Dr Verrills at the Congress.

 

For more information on spinal cord stimulation, visit our website.

 

References:
1 Verrills P, Sinclair C, Barnard A. A review of spinal cord stimulation systems for chronic pain. Journal of Pain Research. 2016;9:481-492. doi:10.2147/JPR.S108884.
2 Leonardo Kapural, Cong Yu, Matthew W. Doust, Bradford E. Gliner, Ricardo Vallejo, B. Todd Sitzman, Kasra Amirdelfan, Donna M. Morgan, Lora L. Brown, Thomas L. Yearwood, Richard Bundschu, Allen W. Burton, Thomas Yang, Ramsin Benyamin, Abram H. Burgher; Novel 10-kHz High-frequency Therapy (HF10 Therapy) Is Superior to Traditional Low-frequency Spinal Cord Stimulation for the Treatment of Chronic Back and Leg Pain: The SENZA-RCT Randomized Controlled Trial. Anesthesiology 2015;123(4):851-860. doi: 10.1097/ALN.0000000000000774.

The involvement of a multidisciplinary team in managing your pain

multidisciplinary team

At Metro Pain Group, our integrated approach to pain encompasses the recognition and management of biopsychosocial factors through the collaboration of our multidisciplinary team comprising of doctors, physician associates, nurses, psychologists and a rehab coordinator. Having a team involved in addressing specific aspects of pain optimises outcomes for our patients. Where appropriate, we refer patients to a Physiotherapist, Psychologist, Exercise Physiologist, Dietitian or other appropriate therapist. We are always developing our list of preferred providers, and will direct the patient to the person we believe will deliver the best care in the closest location to their home.

 

For more information, fill out the form below.

 

Find out more

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

What is pelvic instability?

Pelvic Instability

Pelvic instability can present at any age, but tends to decline with aging, due to stiffening of ligamentous tissues. Our pelvic bones bear the weight of our upper body and distribute it through the hips and legs. The pelvis consists of the hip, sacrum and pubic bones all held together by ligaments. If ligaments are injured or overstretched, the pelvis loses its stability and begins to move excessively with physical activities.

Pelvic instability often presents in young females who are involved in sport that requires a high degree of mobility (such as dance or gymnastics). It can also present during pregnancy or post-partum, especially whilst still breastfeeding as the hormone, relaxin (which relaxes the pelvic ligaments in preparation for childbirth) is still circulating in the system.

There may or may not be a history of injury that causes the pain. Often pain will commence insidiously and be associated with prolonged postures rather than moving or physical activity. The underlying cause of pain is deformation of structures in the spine and pelvis (joint and ligaments) due to excessive range of motion without the necessary muscular control. The joints are held at or near their end range of motion, which stresses and stretches the retaining ligaments.

Symptoms include pain in the sacral-iliac joints, lower lumbar spine and pubic pain. There may be radiation of pain to the groin or hip. Pain when rolling over in bed, climbing stairs, and getting out of the bath are highly suggestive of the condition.

As with most chronic pain conditions, a conservative approach for patients is recommended. Patients may be advised to wear a brace for a period of time until their muscles are strong enough to hold the pelvis in place. Simple analgesia, taping and exercises may also help manage the pain. If conservative therapies are unsuccessful, prolotherapy may be an option. Prolotherapy, an injection based therapy which has been used for over 60 years, works by prompting the body’s natural repair mechanisms to heal injured or weakened joints, ligaments and tendons. 1

Most studies on prolotherapy were carried out for low back pain in general, with inconsistent findings 2-5. However, there is good evidence supporting the specific use of prolotherapy around the sacroiliac joint, with one study reporting a functional improvement in 78% of treated patients. 6

At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain management, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. Our treatment pathway involves exploring our comprehensive array of available conservative and interventional treatment options. Our goal is to reduce your pain and improve your quality of life, enabling you to Live Better.

 

References

  1. Hackett GS. Joint stabilization through induced ligament sclerosis. Ohio.Med 1953;49:877-84.
  2. Klein RG, Eek BC, Delong WB et al. A randomized double-blind trial of dextroseglycerinephenol injections for chronic, low back pain. J Spinal Disord. 1993;6:23-33.
  3. Dechow E, Davies RK, Carr AJ et al. A randomized, double-blind, placebocontrolled trial of sclerosing injections in patients with chronic low back pain. Rheumatofogy (Oxford) 1999;38:1255-9.
  4. Ongley MJ, Klein RG, Dorman TA et al. A new approach to the treatment of chronic low back pain. Lancet 1987;2:143-6.
  5. Yelland MJ, Glasziou PP, Bogduk N et al. Prototherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial. Spine 2004;29:9-16.
  6. Cusi M, Saunders J, Hungerford 8 et al. The use of prolotherapy in the sacroiliac joint. Br.J Sports Med 2010;44:100-4.

 

 

If you suffer from pelvic instability and would like to make an appointment, please fill out the form below.

Book an appointment

  • DISCLAIMER

    At Metro Pain Group, we assess each patient’s condition individually. As leaders in pain intervention, we aim to provide advanced, innovative and evidence-based treatments tailored to suit the patient. The suitability of our procedures varies from patient to patient. If you would like to find out if this or other treatments are suitable for your specific condition, please speak to one of our doctors at the time of your consultation.

  • This field is for validation purposes and should be left unchanged.

Keep up to date with all our latest news and information.

Join Our Mailing List

Subscribe to our mailing list