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What happens during your appointment in the clinic?

A Consultant in Pain Medicine will evaluate your chronic pain condition and discuss a management plan with you. This may be a combination of long-term medications and pain management injections. You may be put forward to be reviewed by Specialist Chronic Pain Physiotherapists and Psychologists (Springboard team) for support and guidance to help you live well with persistent pain.

This will also be an opportunity to ask any questions you and your family might have about the management options, such as: benefits/risks/alternatives or doing nothing differently from what you are already doing, which is sometimes the correct thing to do.

The appointment lasts up to 1 hour, and during this time we may offer a pain management procedure (an injection) there and then. Some treatments cannot be performed on the same day, so you will be added to the hospital day surgery waiting list. Our admin team will contact you to offer you a date for the procedure in due course – our waiting lists are long and we apologise that you may not get seen as quickly as we or you would like.

Following this appointment, you might be discharged back to the person who referred you to us (often your GP), or another follow up plan might made. You will need to stay for 30 minutes after your procedure in the waiting room to ensure that you are safe to go home.

We ask that you attend with someone who can stay with you and that you do not drive to and from your appointment.

Please bring a list of all your current prescription medications, any emergency medications (such as GTN spray or inhaler); and medical letters from other clinics you may have visited outside Frimley Health NHS Foundation Trust, as we will not have access to these.

Pain procedure explanation

  • You will be asked to sign a written consent form outlining the explanation, benefits, risks, alternative treatments by the clinician who reviews you.
  • You will be awake during the procedure.
  • The procedure will be performed under a local anaesthetic (the area being treated will be numbed with an injection of local anaesthetic).
  • The injection into the painful area will contain local anaesthetic and steroid medications.
  • We use ultrasound to guide our injections into the correct place.
  • We may also use radio waves (pulsed radiofrequency denervation) to create a current which heats a small area of nerve tissue. This can help regulate the way the nerve impulses pass through the nerve, decreasing the pain signals sent through the nerve from the painful areas of the body to the brain.
  • We use steroid medications and pulsed radiofrequency denervation to prolong the potential pain relief benefit you might experience from the injection.
  • Steroids (corticosteroids) are commonly used in managing chronic pain but are licensed for specific routes of administration only. Some routes of administration to treat pain are not on license. This is referred to as off-label use. The manufacturer of the medicine may not have applied for a specific licence to extend its usage. MANY medicines used in pain medicine are used off-label. Your doctor will be able to discuss this with you further.

Proposed benefits from the procedure

  • Increase in function and mobility.
  • A drop in your usual pain levels of 30% or more.
  • A reduction in the amount of pain medications that you usually take.
  • Your pain may be worse after your injections, but this should settle down in a few days.

Possible risks and side effects from the procedure

Common:

  • No noticeable pain relief or only short-lasting pain relief.
  • Mild local tenderness and/or bruising at the site of the injection. This usually settles over the first few days.
  • Flare up (worsening) of pain after the procedure (in the first 2 weeks).
  • Muscle weakness.

Rare:

  • Infection. This is rare. You should seek medical help if there is local warmth or redness over the site of injection with tenderness and/or you feel hot and unwell. This may require antibiotic treatment.
  • Bleeding/vascular injury (damage to a blood vessel).
  • Problems emptying bladder (passing urine).
  • Headache.
  • For some procedures around the neck/chest there is a risk of Pneumothorax (bubble of air in the lining of the lung that might need placement of a chest drain to treat and/or further invasive treatment).
  • Adverse drug reaction (including local anaesthetic toxicity); side effects related to steroids such as weight gain, osteoporosis, diabetes exacerbation.

Very rare:

  • Nerve or tissue damage (very rare; but can be significant, with temporary or permanent loss of function including paralysis - extremely rare).
  • Other viscus injury (bowel, kidneys etc).
  • Catastrophic side effects - loss of limb/organ, death.

To get the best out of your pain relief injections you should

  • Continue with your usual medication, including the pain relief medication.
  • Generally, keep active - but within your comfort levels (pace yourself).
  • Re-introduce previously painful activities gradually over the next few days.
  • Maintain any exercise routine a physiotherapist may have given you.

Alternatives treatments

Contact details if there are any problems in the first 24h after the procedure

  • Surgical contact numbers:
    Frimley Park Hospital Surgical Assessment Unit 0300 6136960;
    Wexham Park Hospital & Heatherwood Hospital 0300 6154636.
  • Please contact your GP
    if you have any new symptoms causing you concern, and if there is unusual redness or swelling at the injection site and/or your temperature is 38°C or greater.
  • Chronic pain nursing team 0300 6136700.
    Available to leave a message on 24/7. Calls are returned in business hours within a maximum of 3-4 working days (usually sooner). This isn`t a crisis line but is for clinical queries from/about patients we have seen before.

Other contact details

Outpatient/chronic pain admin team: 0300 613 4201

Contact us

If you have any queries relating to this information, please contact the Pain management service.

About this information

Service:
Pain management

Reference:
B/075

Approval date:
15 September 2023

Review date:
1 September 2026

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Important note 

This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.