Pain injections: when can they help?
Pain injections can reduce symptoms, provide useful diagnostic information or create an opportunity for rehabilitation — but they are not the right treatment for every type of persistent pain. This article explains how different injections are used, what they can realistically achieve and why careful patient selection matters.
Feeling safe in healthcare: why choice and control matter
Trauma-responsive healthcare recognises that previous experiences can influence how safe someone feels during consultations, examinations and procedures. This article explains what trauma-responsive care means in practice, why safety, choice and control matter, and why it should never mean assuming that persistent pain is psychological or caused by previous trauma.
Getting better doesn't always mean zero pain
Getting better from persistent pain doesn't always mean becoming completely pain-free. Recovery can also mean sleeping better, moving more, returning to work or exercise, having fewer or shorter flares, and getting back to the things that matter to you. This article explores why progress is often better measured by what has returned to your life, rather than by a pain score alone — while recognising that pain still matters and should be investigated and treated appropriately.
The window of opportunity: Rehabilitation after a pain injection
A successful pain injection can do more than simply reduce pain — it can create a valuable window of opportunity for rehabilitation. As pain settles, movement may become easier, confidence can return and previously difficult exercises or activities may become possible again. This article explores how to use that period thoughtfully, why gradual rehabilitation matters, and how Wye Sanctuary can work alongside physiotherapists and other practitioners you already know and trust to help turn pain relief into meaningful, lasting improvements in function.
When painkillers aren't helping anymore
Pain medication can be an important part of living well with persistent pain, but treatments that were useful in the past may not always remain helpful. This article explores how to review pain medicines thoughtfully — considering their effect on pain, function and quality of life, as well as potential side effects. The aim isn't simply to take fewer medicines, but to make sure that every medication still earns its place.
Migraine: There are more options than there used to be
Migraine treatment has changed considerably in recent years, and there may be more options available than you realise. From getting acute and preventative medication right to newer CGRP treatments, Botox and selected interventions such as occipital nerve blocks and trigger point injections, treatment can be tailored to the individual. If migraine is regularly taking days out of your life — or treatments you tried in the past haven't helped — it may be worth looking at your options again.
Cannabis-Based Medicinal Products and chronic pain: What are they, what do we know about them, and where might they fit in pain management?
Cannabis-based medicinal products (CBMPs) became legally available for specialist prescription in the UK in 2018 and may be considered for selected patients with significant unmet clinical need. This article explores what CBMPs are, how they may influence pain, the current limitations of the evidence, and where they might fit within thoughtful pain management. It considers potential benefits alongside side effects, safety and the importance of careful patient selection and ongoing review — treating CBMPs neither as a miracle nor something to fear, but simply as medicines that need to justify their place.
When should I refer a patient to a pain specialist — and when should I not?
When does pain specialist input genuinely add value? This article considers when to refer patients with persistent or complex pain — and when completing investigation or obtaining an appropriate specialist diagnosis should come first. It also explores what makes a pain referral useful and how specialist assessment can support rather than replace existing care.
Persistent post-surgical pain: when recovery doesn't follow the expected path
Persistent pain after surgery requires more than escalating analgesia. This article considers when ongoing pain should prompt surgical reassessment, how to recognise neuropathic and other pain mechanisms, and the role of pain medicine in supporting rehabilitation and recovery when healing alone does not resolve symptoms.
Complex Regional Pain Syndrome: recognising CRPS and what to do next
CRPS can be difficult to recognise and is sometimes both under- and over-diagnosed. This article reviews the clinical features and Budapest criteria, important differential diagnoses and the principles of early management, with an emphasis on careful explanation, symptom control and restoration of movement and function.
When chronic pain becomes widespread: beyond the false choice between structural pathology and sensitisation
Persistent widespread pain rarely fits neatly into a single mechanistic category. This article considers how structural pathology, nociceptive and neuropathic input, and altered pain processing can coexist — and how recognising sensitisation can broaden clinical understanding without invalidating a patient's pain or overlooking treatable pathology.
Facet joint pain: steroid injections, medial branch blocks and radiofrequency denervation
Facet joint injections, medial branch blocks and radiofrequency denervation are sometimes discussed interchangeably, but they have different purposes. This article explains their respective roles in assessing and treating suspected facet-mediated pain, and why careful patient selection and integration with rehabilitation matter.
When the MRI doesn’t explain the pain: making sense of discordant imaging and symptoms
MRI findings and pain severity do not always match. This article explores how clinicians can interpret imaging alongside the patient’s history, examination and clinical presentation, recognising that structural changes, nervous system sensitivity and other pain mechanisms can coexist.
Trauma-responsive care in pain medicine: maintaining safety without losing clinical rigour
Trauma-responsive care in pain medicine does not require clinicians to identify trauma or attribute persistent pain to previous experiences. This article considers how principles of safety, choice and control can be incorporated into assessment and interventional practice while maintaining diagnostic rigour, appropriate investigation and a broad understanding of pain mechanisms.