Management of Chronic Pain
Service contact information
Spinal cord stimulation, lesions – open cordotomy and Dorsal Root Entry Zone lesioning.
Chronic neuropathic pain; chronic non-malignant pain, including refractory low back pain
Cancer pain – Treatment for the primary condition, lesions and intrathecal drug delivery systems.
Outcomes are viewed as critically important and over the years the neurosurgical service has several publications to attest to this.
Trigeminal neuralgia and other facial pain
There is a major interest in the management of trigeminal neuralgia, and The Walton Centre has an international reputation for this, evidenced by many publications on the subject.
Trigeminal neuralgia is managed by the neurosurgeons who will deliver microvascular decompression as first line treatment, medical management and foramen ovale procedures. There is a further interest in other neuralgic pain due to compression syndromes, including hemifacial spasm, tinnitus, otalgia, glossopharyngeal neuralgia.
A joint facial pain clinic is run with neurology, pain medicine for cases of diagnostic difficulty; for trigeminal autonomic cephalgias, including cluster headache, occipital nerve stimulation is provided, and for some difficult facial neuropathic pains deep brain stimulation may be appropriate. They can also be supported by a facial pain management programme in most challenging to manage facial pain.
Many of these techniques involve implanted devices – these are supported on a day to day basis by a team of specialist nurses and physiotherapists working for the neuromodulation service with close support and supervision from the pain and neurosurgical service. There is an intrathecal drug delivery system pump refill clinic, spinal cord stimulator clinics and deep brain stimulation clinics
The Walton Centre - Main Hospital Building
This building hosts many of our in-patient services, including wards and theatres, and some outpatients services.
Lower Lane, Liverpool, L9 7LJ
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This is a specialised pain control procedure. Pain is transmitted by nerves so it may be possible to reduce pain by blocking signals from affected nerves.
“Epidural injection” is the name given to an injection into the epidural space. The epidural space lies inside the bony spine. The spinal cord and spinal nerves lie within the epidural space surrounded by a thin skin (dural membrane). A cervical epidural is an injection of steroid mixture into the epidural space in the lower part of the neck.
The 8% capsaicin patch contains a synthetic form of capsaicin which is the compound that gives chilli peppers their heat sensation. The capsaicin acts on pain-sensing nerves in the skin, making them less sensitive to pain. The effects of the 8% capsaicin patch are expected to last for many weeks (on average 3 months or more).
Using saddle neurolytic block for pain relief
Trigger point injections - what they are
Management of Chronic Pain Consultants
Dr Andreas Goebel is a Consultant in Pain Medicine at The Walton Centre since 2007.
Page last updated: 23 June 2021