Combined Rheumatology and Pain Management

It is rather unusual for a Rheumatologist to combine practice in both “medical” rheumatology and “Interventional” pain management, though most rheumatologists will have a good understanding of the medical (ie drug or psychologically based treatment) of chronic pain.

The term, Interventions refers to that range of treatments between conservative care with pain killers, excercise and physical therapy and major surgery, usually employing “percutaneous” techniques. Percutaneous means accessing deep structures such as spinal nerves without opening the tissues surgically to gain direct physical contact. In general this is done with needles or electrical devices under direct visualisation with continuous X-ray screening called fluoroscopy. I summarise this as “stabs and jabs” and describe myself as doing “anything with a needle, nothing with a knife”.

Over the years I have pursued training in the evolving specialty of interventional pain management by joining the  American International Spinal Intervention Society (ISIS) group and have engaged in their well-developed interventional training programme.  I continue to believe that the ISIS technical standards are the best evolved and most scientifically rigorous. I now have the pleasure of helping to organise the European “chapter” of ISIS and teaching on their courses.

I now have a well developed range of techniques for the treatment of acute and chronic spinal pain problems and can deliver all of these from KIMS hospital. I can also use some of these treatments at other Private hospitals (The London Bridge Hospital) and at the Horder Centre for NHS patients, though not all of my possible treatments are provided by the NHS nor available in each private hospital.