Pain Medicine

Pain medicine is a branch of medicine easing the suffering and improving the quality of life of those living with chronic pain

Our pain medicine service provides for the assessment and management of sudden, severe and long-lasting pain.

What is Chronic Pain?

Chronic pain is characterised as pain that has been on-going for 12 weeks or more despite the use of simple pain medication like ibuprofen and paracetamol and despite carrying out a course of exercise and physiotherapy.Chronic pain is a disease of the central nervous system and can be defined as pain that either persists beyond the point that healing would be expected to be complete or that occurs in disease processes in which healing does not take place. The pain may be continuous or intermittent and can typically present for 3-6 months before patients seek active treatment.Chronic back pain, 95% of which originates from the lower lumbar spine, can be very debilitating, with patients often predisposed to sleep loss, long periods of absence from work and, in some cases, patients can develop depression.Chronic back pain can manifest with pain on one or both sides of the lower back and the pain can extend to the buttocks or thighs but often not lower than the knee

Pain can be classified by the type of pain or by body region.

Classification by pain types includes:

  • Neuropathic pain: burning, stabbing, tingling, insect crawling, shooting, associated with allodynia, hypersensitivity or other sensory changes.
  • Nociceptive pain: aching, boring, worse on movement, anatomically defined, fluctuates in severity.
  • Mixed Pain: combination of both neuropathic & nociceptive pain symptoms.
  • Visceral pain: dull, diffuse, ill-defined.
  • Although chronic pain is often neuropathic, it can also arise from other types of pain and it is possible to classify chronic pain by the underlying condition or body region which is causing the pain.

Common painful disorders seen in our chronic pain service include but are not limited to:

  • Post Surgical Pain
  • Peripheral Neuropathy
  • Post-Herpetic Neuralgia
  • Peripheral Nerve Injuries, including Complex Regional Pain Syndrome
  • Myofascial Pain
  • Persistent Post-Surgical Pain
  • Musculoskeletal Disorders
  • Joint Pain
  • Cancer Pain

Our pain services include the following:

  • Facet joint block - A needle is inserted into the jointand delivers a steroid medication which anaesthetises the joints and blocks the pain
  • Nerve root blockade for sciatica - An injection is given to relieve low back pain
  • Joint injection - An injection into the point to relieve pain
  • Epidural - An injection given to relieve pain
  • Intravenous infusions for management of chronic pain - Intravenous infusions (where medication is injected into the vein)can help manage long-term pain.
  • Psychology Services - Dr Gillian Moore-Groarke 
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Contact Details for Psychology Services:

Dr Gillian Moore- Groarke worked for over 10 years as part of a pain management team.  She regularly takes referrals from Consultnats in the Hospital.  Stress and anxiety can compound pain and psychological intervention helps patients to reduce pain intensity, frequency of flare-ups and to live within the limits of chronic pain 

CBT teaches patients to pace themselves and to set realistic goals to manage their pain. 

Tel/Fax:  021 4343073
Email:     gmg@eircom.net
Website:  www.irishpsychological.com
Private clinic address:  5a Block B, Harley Court, Sarsfield Road, Wilton, Cork

Epidural Steroid Injection

An epidural steroid injection (ESI) is a minimally invasive procedure that can help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves. ESI may be performed to relieve pain caused by spinal stenosis, spondylolysis, or disc herniation.

Injections of the Cervical and Lumbar Facet Joints

A cervical or lumbar facet joint injection involves injecting a small amount of local anesthetic(numbing agent) and/or steroid medication, which can anesthetize the facet joints and block the pain.

Percutaneous Electrical Nerve Stimulation

Percuntaneous Electrical Nerve Stimulation (PENS) therapy is used to treat chronic nerve pain including areas of hypersensitivity, headache and chronic post-surgical pain. A PENS machine delivers low voltage electrical current to the peripheral nerves via a probe/s placed just under the skin. It works by altering the state of the nerves resulting in pain relief. It does not destroy the nerves but makes them less sensitive to pain.

Peripheral and Autonomic Nerve Block

An Autonomic Nerve Block is the interruption of sympathetic pathways, by local injection of an anesthetic agent.  at any of four levels: peripheral nerve block, sympathetic ganglion block, extradural block, and subarachnoid block.

A sympathetic nerve block can be used to diagnose or treat pain involving the nerves of the sympathetic nervous system. Examples of conditions for which a sympathetic nerve block might be used include:Pain from spasms in the blood vessels,complex regional pain syndrome, previously called reflex sympathetic dystrophy and causalgia, some types of chronic stomach pain

Radiofrequency lesioning 

Radiofrequency lesioning is a procedure in which special needles are used to create lesions along selected nerves. The needles heat the nerve to 80°C (about the temperature of hot, not boiling, water). When this heat is applied to the nerve for about 2-3 minutes, the nerve stops carrying pain signals.

Sacroiliac joint injection

A sacroiliac joint injection is designed to diagnose and treat pain and inflammation from sacroiliac joint dysfunction. Either too much or too little movement in one of the sacroiliac joints, which are located at the bottom of the spine on each side of the sacrum, can cause lower back pain and/or leg pain.

Selective nerve root injection

Selective nerve root block injection (SNRB) is an injection of a long-lasting steroid (cortisone) around the nerve root as it exits the spinal column.

The injection reduces the inflammation and pain caused by pressure on the nerve. It can also be used as a diagnostic tool to help doctors determine whether the nerve is irritated by “numbing” the nerve.

Spinal cord stimulation

Spinal cord stimulation is a therapy that masks pain signals before they reach the brain. A small device, similar to a pacemaker, is implanted in the body to deliver electrical pulses to the spinal cord. It helps patients better manage their chronic pain symptoms and decrease the use of opioid medications. It may be an option if you suffer chronic back, leg or arm pain and have not found relief with other therapies.

Trigger point injection

Trigger point injection (TPI) may be an option for treating pain in some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin.

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Christine Cleary
Consultant in Pain Management
General Medicine, Pain Medicine Pain Management
Bon Secours Hospital Cork

Dr. Christine Cleary

Consultant in Pain Management

Biography

Dr. Cleary graduated from University College Cork in 2004. She completed training in Anaesthesia and Pain Medicine on the Irish National Anaesthesia Training Programme. Dr. Cleary was a Clinical Research Fellow in Pain Medicine at St Paul’s Hospital, Vancouver, Canada, where she trained in the pharmacological, interventional and multidisciplinary management of cancer pain and a broad range of chronic pain conditions.  Dr. Cleary completed further training in advanced interventional pain techniques at Guy’s and St Thomas’ Hospital, London, a prestigious centre particularly recognised for the interventional pain management service and the INPUT pain management program.

Dr. Cleary is a Fellow of the Faculty of Pain Medicine, College of Anaesthetists of Ireland and also a Fellow of the Faculty of Interventional Pain Practice, World Institute of Pain.

Dr Cleary is expert in a broad range of interventional techniques and offers evidence-based, multimodal management of a broad range of pain conditions including spinal pain, chronic postsurgical pain, chronic abdominal and pelvic pain, neuropathic pain, headache and cancer pain with a strong emphasis on holistic patient care.

Dr. C E Cleary MB, BCh, BAO, BMedSci, FCARCSI, FFPMCAI, FIPP

 

 

Additional Information

Clinic Times:

Monday PM 1.30-6.00
Tuesday AM 9.00 - 12.00
Thursday AM/PM 9.00 - 5.30

Appointments

Referrals & Enquiries Email:

contact@painmanagementcork.ie

Contact Details

  • Dr. Christine Cleary
  • Suite 21, Clinic B,Cork Clinic, Western Road,Cork, T12 Y7CW

Secretary

Donal Harney
Consultant in Pain Management
General Medicine, Pain Medicine Pain Management
Bon Secours Hospital Cork
Phone: 021 4935138 Fax: 021 4278428

Dr. Donal Harney

Consultant in Pain Management

Contact Details

  • Dr. Donal Harney

To access these services, you will need a letter of referral from your GP

To make an appointment, please contact

021 4345633 - Dr Christine Cleary

0214935137 - Dr Donal Harney

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