Pain Medicine Clinic

The Pain Medicine Clinic is run by Dr Richard Summerfield and Dr David White, Consultant Anaesthetists who specialise in Pain medicine. They set up a pain medicine clinic at the Royal Hampshire County Hospital 20 years ago which has grown and kept abreast with modern techniques and new medicines. Each year their combined practice sees 700 new referrals and provides care for 1500 patients on an ongoing basis.

Referrals are accepted from General Practitioners, Consultant Colleagues and appropriate professions allied to medicine.

Normally an initial consultation lasts for 30 minutes during which time you can expect a thorough discussion and examination. In some situations it may be possible to perform an injection at the same time, however it is usual that if an injection or other treatment is necessary this will be scheduled for another time.

Follow up visits are usually 30 minutes.

The consultation will involve a review of all your current pain medicines. This may uncover combinations of medicines that may improve pain control. In addition novel routes of administration can be discussed i.e. drug patches that allow constant drug delivery are suitable in some situations.

The next step would be to discuss non-invasive ways of relieving pain. A range of possibilities exist and include physiotherapy, TENS (transcutaneous electrical nerve stimulation), hydrotherapy, and possibly referral to a chiropractor or osteopath.

In some cases in is necessary to recommend a pain relief injection which would normally be carried out as a day case procedure under intravenous sedation.

The range of pain relief procedures offered is comprehensive and includes:

• Epidural injection
• Caudal injection
• Spinal Facet joint injection
• Guanethidine block
• Stellate ganglion injection
• Other specific injections may be tailored to your individual needs.

Epidural Injection

Commonly performed for lower back pain and sciatica, it involves an injection of steroid and local anaesthetic into the epidural space in the lower back. Its full effects are apparent over the weeks after the injection.

Caudal injection

This is similar to the epidural injection but the injection site is lower down the back, and is often performed under Xray control.

Spinal Facet Joint injection

In addition to intravenous sedation this injection is performed using Xrays to guide the injection to the relevant facet joints. A mixture of local anaesthetic and steroid is used and its full effects are noticed over the weeks after the injection. There are two facet joints at each spinal level and it is usual to inject the facet joint on each side and often at more than one level.

Guanethidine block
These are primarily performed for nerve damage pain (neuropathic pain) although there are other indications. Intravenous guanethidine is given in the painful limb while a tourniquet is used to prevent its spread to the rest of the body and to allow it to soak in to the tissues. The tourniquet is usually inflated for about 20 minutes. Repeat guanethidine blocks are commonly required.

Stellate Ganglion injection
This injection is also performed primarily for nerve damage pain. The sympathetic nerves are temporarily blocked with local anaesthetic in the neck which often produces long lasting effects.

Pain Medicine related enquiries:

Tel: 01962 826147
Fax: 01962 840142
Email: jcousins@bmihealthcare.co.uk