Low back pain refers to pain most commonly in the lumbar spine. The lumbar spine provides a stable column connecting the upper body to the pelvis. One of its important functions is to provide structural support though interconnected vertebral bodies, intervertebral discs, ligaments and muscles. Low back pain can originate from a number of structures or joints in the lower spine. It can also be a product of nerve injury or compression resulting in typically nerve related (neuropathic) pain, weakness or other changes in sensation.

Neck pain occurs in the upper part of the spine, clinically known as the cervical spine. The cervical spine provides structural support to the head, allows complex movements and protects the spinal cord as it travels from the brain to the rest of the body. Neck pain can originate from irritated and inflamed structures causing pain with a sharp or aching nature. Quite often patients present with a combination of symptoms.

Complex regional pain syndrome is a condition where there is a mismatch between what is happening in an area of the body and what the body feels in that area. It most commonly affects limbs, and can be triggered by trauma to the area including nerve injury and fractures.

Nerve pain can be severe, and often feels like an electrical or burning sensation. It can be caused by a specific nerve injury, or multiple nerves such as happens with diabetes or some diseases of the immune system. It can occur by itself, or along with other symptoms such as weakness or numbness.

Hip and knee pain is often degenerative, and due to arthritis. The chance and severity of this is a combination of genetic vulnerability, anatomy, patient age and use. The process, once started, is often usually age related and progressive. Hip and knee pain alter the body’s biomechanics, and often trigger pain in other areas such as the feet or the lower back.

Headache is a complex symptom, with a variety of causes from mild to catastrophic. Diagnosis can be difficult, and is focussed on excluding progressive or severe causes. Once this has been done, symptom treatment is often the priority. Treatment is usually in conjunction with a neurologist or a general practitioner. Neck pain can commonly cause head pain, known as cervicogenic headaches.

Radiofrequency neurotomy denervation is a technique utilising specially insulated needles placed next to the small nerves that supply the facet joint. The needles emit an energy that heats the tissues and interrupts the small sensory nerve fibres to the joint. This results in a significant reduction or complete resolution of the pain from the joints. The procedures are performed under sedation to ensure minimal discomfort to the patient. The procedures are guided by mobile image intensifier x-ray guidance and are performed under clean antiseptic conditions.

The epidural space surrounds the dura; a fibrous layer of tissue surrounding the spinal cord. Using this space, we can deliver medications to the intervertebral disc, the spinal cord, or to the exiting nerve roots. For this reason, this procedure is useful in treating pain originating from these locations. Using x-ray guidance, a fine gauge or touhy needle is used to access the epidural space once the skin has been anaesthetised. Local anaesthetic and steroid is then carefully injected to conclude the procedure.

Spinal Cord Stimulation is a technology providing stimulation of the spinal cord inside the vertebral column to reduce pain. This occurs with electrodes positioned in the epidural space in the spine that modify the pain signals travelling to the brain. Spinal Cord Stimulation has been used in the treatment of pain since 1967. With advances in technology, there are now a number of types of stimulation available. Your pain specialist will be able to assess if this technology is appropriate for your pain management.

An intrathecal pump is a battery-operated device which delivers medication directly into the spinal canal. The system uses a small pump that is surgically placed under the skin of your abdomen. The pump delivers medication through a catheter to the area around your spinal cord. By delivering the medication via this technique, side effects of oral medication are eliminated, and symptoms can be controlled with a much smaller medicinal dose compared to the use of oral medication. The pump is programmed to meet your specific needs and can be adjusted as required with the oversight of your pain specialist.