Get professional help when pain becomes a burden.
We can help with pain diagnosis, pain relief treatment, personalised support and advice how to best help and manage yourself.
For arranging a Consultation go to our Appointment request page
Or contact us on 01983 526699 or appointments@saps-medical.co.uk to book an appointment
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Why does it (continue to) hurt?

Most of us are familiar with and usually accept short-term pain - after, say, an injury or operation. We assume that pain serves a purpose (as a warning sign) and that it will disappear soon as part of the healing process.
Unfortunately, this doesn't always happen. It is not so rare for pain to persist for much longer than the causing problem. An example is post-herpetic neuralgia after shingles, when pain or unpleasant sensitivity is felt long after the skin lesions have healed. Another is ongoing wound or scar pain after an operation.
Other causes are chronic conditions such as structural wear and tear or arthritis. There is no full cure for these problems and they can continue to cause pain and related problems over long periods of time
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Central sensitisation

Independent of the original cause, there are other factors contributing to chronic pain.
Constant pain changes neural pathways. With persisting pain nerve receptors, brain cells and the “messenger” neurons in the spinal cord get sensitised over time. This is called central sensitisation as is happens mostly in the central nervous system.
Research has identified various mechanisms at spinal cord level (e.g. wind-up) and in the brain (neuronal reorganisation) behind these changes. As results of sensitisation a painful stimulus elicits a stronger and longer lasting response, triggers a painful response to not normally painful sensations (such as touch or temperature) and changes neighbouring nerve cells so that pain can spread to a wider area. This is experienced as intensifying and spreading pain and hypersensitivity. This happens independently of the cause of pain, so even if the painful condition is stable the pain can intensify.

Other consequences

The mind is often struggling to cope with pain and it's consequences. Results can be anxiety, anger, frustration, sadness, low self-esteem, changes in daily routine, behaviour and personality. These are often first spotted by partners and friends. Typically, sufferers have to reduce physical and social activities, which in turn results in isolation and makes life rotate around the pain problem more and more. The changes of emotions and life-situation tend to further worsen the pain experience and so a self-reinforcing spiral is set in motion.
As a result of these factors the persisting pain becomes a disease of it's own; pain doesn't serve a useful purpose any more. So controlling the pain and it’s consequences becomes the focus of pain specialist treatment.
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Escaping the circle

To be successful, treatments need to address the various contributing factors in a coordinated way. Often, the cause of pain cannot be cured, but pain and central sensitisation can be partially relieved and controlled better. Emotional, behavioural and social problems should not be ignored. A holistic assessment is an essential starting point to tailor treatments to individual needs. In addition to various forms of pain relief, specialist physical therapies and sometime Psychotherapy are an important part of a comprehensive treatment plan.

Ultimately, all treatments are targeted to facilitate and enable active self-management to regain control of your day to day life. This is comparable to a person with diabetes learning how to manage blood sugar levels, diet, the importance of exercise etc. While it may sound daunting at an early stage, it can be done and many patients achieve this successfully. There is an excellent online leaflet  written by a pain sufferer which will tell you more about this. The NHS Pain Clinic runs Pain Management and Functional Restoration Programme for those who struggle with self-management of chronic pain.