Pain, joints & skin
Pain management
We assess and manage ongoing pain — back, neck, joints, nerve pain and widespread pain. The aim is to identify what is causing it and improve what you can actually do, rather than only chasing the pain score. Treatment usually combines several approaches, because single treatments rarely work alone.
Come in if you have
- Pain lasting more than a few weeks
- Pain limiting work, sleep or activity
- Painkillers that used to work and no longer do
- Burning, shooting or electric pain, or numbness and tingling
- You feel your pain has not been taken seriously
What happens at your visit
- We take a full history and examine you properly. Chronic pain is frequently assessed too briefly.
- We work out what type of pain this is — mechanical, inflammatory or nerve-related — because they respond to completely different treatments.
- We look for treatable contributors, including sleep, mood, and deconditioning.
- We build a plan combining approaches, and we set goals about function, not just numbers.
Identifying the type changes everything
“Pain” covers several quite different mechanisms, and they respond to different treatments:
- Mechanical — worse with movement or load, better with rest. Responds to physical treatment, targeted strengthening, and load management.
- Inflammatory — stiffness worse in the morning, better with movement. Responds to anti-inflammatory approaches and sometimes disease-modifying treatment.
- Nerve pain — burning, shooting, electric, with numbness or tingling. Responds poorly to ordinary painkillers and well to specific nerve-pain medications.
Nerve pain treated with standard painkillers is a common reason people conclude nothing works. It is the wrong tool, not an untreatable problem.
Function over numbers
Asking “what is your pain out of ten?” is less useful than asking what you have stopped doing.
Sleeping through the night, walking to the shop, getting through a workday, picking up a grandchild — those are the goals worth setting, and they are what we track. Pain scores often improve as a by-product.
On opioids
We will be straightforward. For most long-term non-cancer pain, opioids show limited lasting benefit and carry real risks — including tolerance, dependence, and increased sensitivity to pain over time.
That is not a refusal to treat you, and it is not an accusation. It means we will put effort into approaches that work better over the long run, and if you are currently on opioids we will work with you rather than abruptly stopping them.
Movement, carefully
Rest helps acute injury and harms chronic pain. Prolonged inactivity weakens muscles and reduces tolerance, which increases pain, which reduces activity further.
Breaking that cycle needs a graded, realistic plan — not being told to exercise. We will build one that starts where you actually are.
Common questions
- Will you take my pain seriously?
- Yes. Being disbelieved is one of the most common experiences people with chronic pain report, and it is both unkind and clinically counterproductive. Pain that has no visible cause on a scan is still real pain.
- Will you prescribe opioids?
- Rarely, and not as a first approach. For most chronic non-cancer pain the evidence shows limited long-term benefit alongside real risks, including that they can increase pain sensitivity over time. We will be honest about that rather than either refusing outright or prescribing freely.
- Do I need an MRI?
- Usually not, and for back pain especially, imaging often finds changes that are common in people with no pain at all — which can lead to unnecessary worry and procedures. We image when there are specific reasons, and we will explain them.
- Why are you asking about my sleep and mood?
- Because they genuinely affect pain, in both directions. Poor sleep lowers pain tolerance measurably. This is not suggesting the pain is psychological — it is that treating sleep often reduces pain, and ignoring it makes everything harder.
This page explains how we care for this condition at our office. It is general information, not medical advice for your specific situation — please talk to us about your own care.
Ready to get this looked at?
Call us or send a request and we will get you in — often the same or next day.