Chronic Pain Treatment & Diagnosis | Pain Spa, Bristol, UK

Genitofemoral Neuralgia

Genitofemoral neuralgia is a cause of neuropathic pain that is often debilitating in nature. It is characterized by chronic neuropathic groin pain that is localized along the distribution of the genitofemoral nerve. Genitofemoral neuropathy has been attributed to iatrogenic nerve injury occurring during inguinal and femoral herniorrhaphy, with cases developing after both open and laparoscopic techniques. Diagnosis of genitofemoral neuralgia can be challenging, due to the overlap in sensory distribution the nerve shares with the ilioinguinal and iliohypogastric nerve.

Dorsal Scapular Nerve Entrapment Syndrome

Dorsal scapular nerve (DSN) entrapment syndrome is an under-recognized cause of neck and shoulder pain. DSN injuries can be the origin of a well-defined chronic pain syndrome, often referred to as DSN syndrome. DSN syndrome is often characterized by a dull ache along the medial border of the scapula. The dorsal scapular nerve may be injured in the neck (at the scalenes) or in the thoracic back at the level of the rhomboids.

Supraorbital Neuralgia

Supraorbital neuralgia is characterized by persistent pain in the supraorbital region and forehead with occasional sudden, shocklike paresthesias in the distribution of the supraorbital nerve. Supraorbital neuralgia is the result of compression or trauma of the supraorbital nerves as the nerves exit the supraorbital foramen.

Ilioinguinal Neuralgia

Ilioinguinal neuralgia is one of the most common causes of lower abdominal and pelvic pain encountered in clinical practice. Ilioinguinal neuralgia is caused by compression of the ilioinguinal nerve as it passes through the transverse abdominis muscle at the level of the anterior superior iliac spine. The most common causes of compression of the ilioinguinal nerve at this anatomic location involve injury to the nerve induced by trauma, including direct blunt trauma to the nerve, as well as damage during inguinal herniorrhaphy and pelvic surgery. Rarely, ilioinguinal neuralgia can occur spontaneously.

Morton’s Neuroma

Morton's neuroma is a benign fibrotic thickening of a plantar interdigital nerve that is a response to irritation. Also known as Morton's metatarsalgia, Morton's entrapment, interdigital neuroma, intermetatarsal neuroma, and interdigital nerve compression syndrome, it is not a true neuroma, as the condition is a degenerative process rather than a neoplastic process. The mean age at presentation is 55 years. It is 4-15 times more common in women than in men.

Post Herpetic Neuralgia

Post-herpetic neuralgia occurs when the pain associated with shingles becomes chronic. Definitions of post-herpetic neuralgia differ in terms of the time of onset and duration of pain, and this has resulted in difficulty estimating the prevalence of the disease. One source estimates that approximately 20% of people older than 50 years will develop post-herpetic neuralgia, despite antiviral treatment beginning within 72 hours of rash onset.

Occipital Neuralgia

Occipital neuralgia is defined as a paroxysmal shooting or stabbing pain in the distribution of the greater or lesser occipital nerves accompanied by diminished sensation or dysesthesia in the affected area. The pain originates in the suboccipital region and radiates over the vertex. A suggestive history and clinical examination with short-term pain relief after infiltration with local anesthetic confirm the diagnosis.

Diabetic Peripheral Neuropathic Pain (DPNP)

Diabetes is a worldwide epidemic, and associated neuropathy is its most costly and disabling complication. Painful diabetic neuropathy is a common condition that will only increase as the diabetes epidemic grows. All physicians need to be aware of this under-recognized condition. Given the rising prevalence of painful diabetic neuropathy, it is increasingly important that we understand the best ways to diagnose and treat this condition. Diagnostic tests in this field are evolving rapidly.

Intercostal Neuralgia

Intercostal neuralgia refers to a neuropathic condition involving the intercostal nerves, manifesting as intense dysesthetic pain, e.g., sharp, shooting, or burning in quality. The pain is localized to one or more of the intercostal spaces. Because the pain can span the chest or upper abdomen, afflicted patients may become alarmed about the possibility of having an underlying serious condition from a visceral origin, e.g., myocardial infarction or gallbladder-related pain, and thus may be apt to solicit medical attention.

Phantom Limb Pain

Phantom-limb pain is a common sequela of amputation, occurring in up to 80% of people who undergo the procedure. It must be differentiated from non-painful phantom phenomena, residual-limb pain, and non-painful residual-limb phenomena. Central changes seem to be a major determinant of phantom-limb pain; however, peripheral and psychological factors may contribute to it.

Lumbosacral Plexopathy

Lumbosacral plexopathy is an injury to or involvement of one or more nerves that combine to form or branch from the lumbosacral plexus. This involvement is distal to the root level.

Meralgia Paresthetica

Meralgia paresthetica is a painful mononeuropathy of the lateral femoral cutaneous nerve (LFCN), presenting as unpleasant paresthesia, pain, and numbness in the anterolateral thigh.

Pudendal Neuralgia

Pudendal neuralgia (PN) is defined as the existence of pain in the distribution of the pudendal nerve. Pudendal neuropathy can occur in both genders. Entrapment of the pudendal nerve can give rise to perineal pain involving the penis, scrotum, labia, perineum, or anorectal region. Three sites of entrapment of the nerve have been described. These can occur along its path between the sacrotuberous and the sacrospinous ligaments (interligamentous plane), through Alcock canal, or as the nerve passes through a tight osteofibrotic canal at the entrance to the base of the penis.

Trigeminal Neuralgia

Trigeminal neuralgia is a rare, episodic facial pain that is unilateral, electric shock-like, and provoked by light touch. At first, it is often mistaken as a tooth problem owing to its presentation in the two lower branches of the trigeminal nerve. Patients may undergo unnecessary and sometimes irreversible dental treatment before the condition is recognised.

Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is a poorly characterized disease entity with a wide differential diagnosis. First coined in 1956 by Peet et al, TOS can be categorized as vascular (arterial or venous) or neurogenic (NTOS). Although vascular-related TOS pathology is intuitively easier to understand and document because of more definitive imaging findings and symptoms, there remains significant controversy as to even the existence of NTOS.

Scar Pain

Post Surgical Pain

The incidence of chronic post-surgical pain (CPSP) is at an increase, with increase in the number of surgeries being performed. The first publication that identified surgery as a risk factor for chronic pain appeared in 1998. This finding led to a dramatic increase in interest on this subject.

Neuropathic Pain

Neuropathic pain is a multidimensional entity that continues to present a challenge to medical professionals with regards to its diagnosis and management. In recent years there has been an emphasis on the use of pain descriptors to aid diagnosis, but the lack of pathognomonic terms and overlap of descriptors between neuropathic and nociceptive pain conditions means that neuropathic pain continues to be poorly recognised and under-treated.

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