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The Management of Spinal Pain. Dr. Christopher A. Jenner MB BS, FRCA Consultant in Pain Medicine, Imperial Healthcare NHS Trust Medical Director Spinal Healthcare 4 th  October 2009
Agenda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definitions  ,[object Object],[object Object]
Definitions (2) ,[object Object],[object Object],[object Object],[object Object]
Definitions (3) ,[object Object],[object Object],[object Object],[object Object]
 
 
Pain Physiology ,[object Object],[object Object]
 
Pain Physiology  (funky version)  www.londonpainconsultants.com
 
Noxious Stimulus
Impulse Transmission
Afferent sensory fibres
Spinal cord
Dorsal Horn
Synapse
Ca and Glutamate
Synaptic Cleft
Post Synaptic
Nociceptive Neuron
Pain perception
Brain
The Challenges of Chronic Pain ,[object Object],[object Object],[object Object],[object Object],[object Object]
Massive Financial Burden ,[object Object],[object Object],[object Object],[object Object],[object Object]
Physical and Alternative Treatments
Physiotherapy
Physical/ Alternative Treatments ,[object Object],[object Object],[object Object]
Any Vets in the audience? ,[object Object]
5. (a)  Veterinary practitioners?
Headache!
Pharmacological Treatment
Acute Pain Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Pharmacological Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Opioid Therapy ,[object Object]
 
 
Pharmacological treatment of Neuropathic Pain ,[object Object]
Neuropathic Pain Management ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Future Agents for Neuropathic Pain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Psychologicaly based therapy
Pain Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pain Management Programmes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Functional Restoration Programmes www.londonpainconsultants.com
MRI scans
 
 
 
Minimally Invasive Pain Management
 
C-arm
Targets www.londonpainconsultants.com
 
Spine Pain Cervical/ Thoracic/ Lumbar >65% workload
Epidural Steroid Injections
Facet Joint Injections
Nerve Root Injections
Sacroiliac Joint Injection
Radiofrequency
[object Object],[object Object],[object Object],[object Object],[object Object]
Botulinum Toxin A
Other Minimally Invasive Techniques  www.londonpainconsultants.com
Epiduroscopy
IDET
Disc Dekompressor
Vertebroplasty/ Kyphoplasty
Musculoskeletal www.londonpainconsultants.com
Shoulder ,[object Object],[object Object],[object Object],[object Object],[object Object]
Limbs ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Neuropathic Pain www.londonpainconsultants.com
Complex Regional Pain Syndrome (CRPS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other Neuropathic Pain ,[object Object],[object Object],[object Object],[object Object],[object Object]
Advanced Pain Management Techniques www.londonpainconsultants.com
Nerve Stimulation
Nerve Stimulation (2)
Intrathecal Pumps
Intrathecal Pumps (2)
The Future? www.londonpainconsultants.com
The Future? ,[object Object],[object Object],[object Object],[object Object]
www.londonpainconsultants.com
 
London Pain Consultants Clinics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Team ,[object Object],[object Object],[object Object],[object Object]
The Team (2) ,[object Object],[object Object],[object Object],[object Object]
www.spinal-healthcare.com
Summary www.londonpainconsultants.com
Summary ,[object Object],[object Object],[object Object],[object Object],[object Object]
Case reports/ Blogs/ Links/ Appointments [email_address] 0845 045 0250
[object Object]

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The Management Of Spinal Pain Presented At Back Show 4.10.09