Pain Management Clinic Birmingham

81 Harbourne Road
Edgbaston
Birmingham
B15 3HE

Call 020 7060 5109 today for an appointment.

Who is Dr Mark Miller?

Photo of Dr Miller

A highly experienced specialist in pain management. Dr Miller has been practising as a pain management consultant since 1999.

MBChB from Manchester University in 1990

Fellow of the Royal College of Anaesthetists in 1997

Fellow of the Faculty of Pain Medicine of the Royal College of Anaesthetists in 2007

What is Pain Management?

This branch of medicine is dedicated to easing the suffering of those living with chronic pain.

Living with pain on a day to day basis can be extremely stressful and debilitating, further more it can have a negative overall impact on quality of life, affecting an individual's personal and professional life.

Pain is a subjective sensation which differs from patient to patient, therefore, all our treatment is individualised to suit the particular needs of each patient.

The pain management clinic employs an interdisciplinary approach, understanding pain regarding a biopsychosocial model, this can be described as a 'whole person care' philosophy, that comprehends pain in terms of the biological, psychological (emotions, thoughts and behaviour) and social (socio-economic, socio-environmental).

Dr Miller's multidisciplinary pain management team consists of specialist surgeons, physiotherapists, psychologists and other health professionals. Dr Miller works closely with his team in order to provide the best quality patient care.

Treatment

Broadly speaking, treatment for pain management can be divided into 3 categories

Pharmacological

Physical

Psychological

How Dr Miller can help you

Back Pain

Without doubt, this is the most common complaint here at the pain clinic, frequently causing chronic pain, long term discomfort and suffering.

Types of back pain Dr Miller can help with:

  • Cervical Spine (pain felt in the neck)
  • Thoracic Back Pain (pain felt behind the chest wall or thorax)
  • Lumbar and Sacral Pain (pain felt in the lower back)
  • Coccydinia (Painful Coccyx felt in the lowest point of the spine)

Back pain can be felt at any point along the spine, and health professionals usually categorise symptoms into either mechanical or referred pain.

Mechanical Pain

This describes symptoms felt only in the area of the source of pain, it is caused by inflammation in the intervertebral discs and facet joints. Therefore if the inflammation is in the cervical spine, the pain will be felt in that area (the neck).

Referred Pain

This describes pain that radiates away from its source to other parts of the body, as seen in sciatica, where pain originating from compressed nerves in the lower back, result in shooting pain felt in the legs.

Diagnosis

The best radiological indicators of inflammatory spinal pain are SPECT CT and MRI scans. X-rays are not indicated unless there are red flag symptoms (signs that suggest a serious underlying condition such as cancer or infection).

Treatment

Dr Miller believes the best approach for treating back pain is via the biopsychosocial model, some possible treatments include: physiotherapy, medication, radiofrequency denervation and transforaminal root blocks.

Nerve Pain

Often causing acute excruciating pain, there are various different types of nerve pain.

Types of nerve pain Dr Miller can help with

  • Phantom Sensations and Pains
  • Scar Pain
  • Headaches
  • Shingles and Postherpetic Neuralgia
  • Trigeminal Neuralgia

Nerve pain, or neuralgia as it is also referred to as, is caused by a problem with one or more of the nerves themselves. Neuralgia is characterised by the sensations felt by the patient, they differ from nociceptive or tissue pain (the pain felt from a cut or a burn for example), and is often described as extreme shooting or stabbing pain. Other variable symptoms include; skin colour changes, swelling and skin sensitivity.

Frequently occurring neuralgias

Shingles and Postherpetic Neuralgia

Shingles is caused by the reactivation of the Varicella-Zoster virus (Chicken Pox), which lies dormant in the nervous system after the initial infection. Shingles causes some of the nerve cells to die off, this results in a painful rash on the skin above the damaged nerves. In some cases, after the rash has disappeared, the area of skin remains painful and sensitive. This is known as Postherpetic neuralgia.

Treatment

Dr Miller can advise on both topical and oral medication, offers pulsed radiofrequency treatment where necessary as well as Botox injections to the affected area which can help significantly in the long term.

Phantom Sensations and Pains

These occur after an individual has lost a body part, usually a limb. The patient feels as though the missing body part is still there and in some cases feels pain in the now missing, limb. This is known as phantom pain and is more likely to occur if the missing part, was painful prior to amputation or the amputation was due to a traumatic accident.

Pain in the stump of the missing limb is a more common complaint than phantom pain and in most cases is a result of the cut nerve endings in the limb growing swellings called neuromas. Pain in the stump scar and ulceration of the skin can also cause great discomfort.

Treatment

Patients have responded well to medication such as gabapentin, other neuropathic agents may also be used, different treatments include TENS machines or mirror box therapy. A spinal cord stimulator may be used in some cases where the patient responds poorly to all other treatments.

Trigeminal Neuralgia

This is a severe facial pain felt on only one side of the face, caused by the trigeminal nerve (the nerve that supplies sensations to the face). The actual pain itself doesn't last more than a few seconds but is described as an extreme sharp pain. Upon diagnosis, further investigation via an MRI or CT scan is always required.

Treatment

Medication for nerve pain is used, with drugs such as carbamazepine or oxcarbazepine.

Scar Pain

A common neuralgia here at the pain clinic, be it from an operative or traumatic cause. Scars are frequently hypertrophic or keloid, appearing larger than they should. Symptoms include, skin colour changes, itching, swelling, allodynia (further pain is provoked by a stimulus that would not usually cause pain), hyperalgesia (a stimulus such as a very light tap for example, causes severe pain), deeper palpation causes marked pain.

Treatment

Initial treatment is usually directed at the scar itself, in the use of topical lignocaine-impregnated patches for example. Botox injections into painful scars also have also had positive results. Pulsed radiofrequency treatment and P.E.N.S can be effectively used in the treatment of neuromas (nerve endings found in scar tissue)

Headaches – The Trigeminal Cephalalgias

Short Lasting Unilateral Neuralgia with Conjunctival Tearing, (SUN CT), Chronic Paroxysmal Hemicrania, Hemicrania Continua and Cluster Headache form a group of primary headache disorders. These pain states are often extreme and involve the distribution of the trigeminal nerve, pain is felt on only one side of the face and is associated with a headache.

Treatment

Neuropathic agents such as pregabalin, gabapentin, tricyclic antidepressants, and indomethacin. Occiptial nerve blocks with steroid, occipital nerve stimulation and botox may also be helpful.

Complex Regional Pain Syndrome (CRPS)

This condition can occur after musculoskeletal trauma, in particular surgery. It describes a group of symptoms that occur together in a painful part of the body. When there is NO associated nerve damage, it is called CRPS type 1 and when there IS associated nerve damage it is known as CRPS2. Symptoms can include; pain or even excessive pain caused by a stimulus that is not normally painful, swelling and skin colour changes. There may be some excessive hair growth and changes in nail quality and bone.

Treatment

Physiotherapy, psychotherapy, and medication such as pregabalin and gabapentin are also used. Other possible treatments include; nerve blocks and dorsal column stimulation.

Myofascial Pain

This syndrome describes a sensation of muscular pain isolated to one area of the body. It is characterised by painful pressure points and finding small knots in the muscle known as trigger points. Deeper skeletal and joint problems are on some occasions found during palpation of the muscle, if these abnormalities are found then MRI and SPECT CT are required for further investigation.

Treatment

May include acupuncture and or physiotherapy.

BOOK NOW

For the latest availability please call 020 7060 5109 or fill out the form below. Please note that there may be a 1-2 week appointment lead time.

Nerve Pain

nerve pain

Back Pain

back pain

Treatments

pain treatment