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Pain Management Unit

Pain Management Unit


Telephone: 01604 545065


The pain management clinic is a multi-disciplinary unit, functioning in accordance with the British Pain Society’s recommendations.

The unit is a vital part of the directorate and deals with approx 5500 patient episodes per year. This unit was started by Dr AT Chmielewski, 20 years ago.

The Pain Clinic treats patients with persistent pain & provides solutions for patients who have complex problems with intractable pain. This is pain that continues despite investigation and intervention. Chronic pain is usually defined as pain which has lasted for three months or longer, beyond the expected period of recovery.

The unit has 4 Medical Consultants, a Specialist Senior Sister, 4 specialist nursing staff, 2 HCA, Secretarial and Admin staff. The unit currently also works with a Psychologist who can provide valuable support.


  • Dr M.Murali-Krishnan, FFARCSI – Lead Clinician
  • Dr B Reddy, FRCA, FFARCSI
  • Dr P Bheemapa, FRCA and
  • Dr S Ramani, FRCA

We have a self contained day unit with 6 beds, an operating theatre with its own image intensifier, radiofrequency machine and clinic spaces. “Nessie” is the state of the art database system holding approximately 16000 patient details allowing ready access to patients past details to help with managing their current problems.

Patients with pain of more than 3 month’s duration can seek referral to this unit after triaging by either their own GP or hospital Consultants when appropriate. Patients are initially assessed to explore the most appropriate direction of treatment, which is discussed with them. This may take the form of individual work with one or more members of the Team, to help patients not only understand but also manage their pain and lead their lives as effectively as possible.

Patients are initially assessed, so that a management plan can be organised and appropriate treatment and support offered. Although the team may not be able to cure your pain, they will be able to offer advice and help with different aspects of your pain and may give you some treatment that could help you to manage your pain more effectively.

There are several treatments and interventions that may help, which include medication, acupuncture therapy, injections and TENS.



Comprehensive Pain Evaluation

  • detailed, pain-oriented history and physical examination
  • psychological screening review of medical records
  • formulation of differential diagnosis and treatment plan
  • communication with referral source

Pain Medication Management

  • single and combination medication trials

Precision, Fluoroscopic Guided Injections for Diagnosis and Therapy

  • facet joint blocks
  • Root Blocks
  • nerve plexus blockade
  • Sympathetic blockade
  • Discography


Nerve Blocks and Nerve Ablation

Epidural Injections

Radiofrequency Nerve Destruction

  • Splanchnic
  • Sympathectomy
  • RFTC Lumbar and Cervical
  • Peripherial nervesTrigger Point Injections

Alternative Medicine Clinic

  • Acupuncture
  • Tens Therapy
  • herbal therapy
  • hypnotherapy and

Rehabilitative Physical Therapy

  • physio therapy coordinated with pain-relieving injections when necessary
  • functional capacity evaluation

Multidisciplinary Chronic Pain Program

  •  Thrice a year

Outcomes Measurement

  • computer programs measure and analyse outcomes for each intervention
  • Outcome questionnaire – sent after each intervention – repeated 6m later
  • Follow-up or repeat procedure

Your appointment

It is important that you keep your appointment or let us know if you cannot or do not want to attend, so we can reallocate the slot to another patient and avoid the slot being wasted.

Your initial consultation with the medical team will usually last approximately 45 minutes. It is advisable to make suitable arrangements for this, such as your transport. Any further appointments are shorter than this. If you wish you can bring a relative or friend with you.

It is important that you bring the questionnaire form sent to you along with the appointment letter. You will be asked to describe your pain in detail and will be asked questions about your sleep, mood, general activity and medication. You may also have an examination of parts of your body in relation to the pain. Your Consultant and Nurses will carry out a detailed assessment, discuss and plan the treatment options available for your painful condition.

It would be helpful if you can bring a list of your current medication with you to clinic, as this could influence the prescription of medications suitable for your condition.

We aim to offer pain relief where possible, and to help you improve your quality of life even if medical treatment has been of little benefit in the past. We will try to explain why you have pain that has lasted for longer than expected.


Some helpful leaflets

Coping with your pain whilst you are in hospital

Epidurals for pain relief after surgery

Pain relief

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