What We Treat

Conditions We Treat

Chronic pain takes many forms. Below you will find every condition we manage, the treatments available for each, and what the research says about outcomes — explained in plain language.

Our Treatment Modalities

Click any treatment name on a condition card to learn more about how it works.

Epidural Steroid Injections Facet Joint Injections Nerve Blocks Medial Branch Blocks Radiofrequency Ablation (RFA) Trigger Point Injections Joint Injections PRP Therapy Prolotherapy Ketamine Infusion Therapy Cryoneurolysis Spinal Cord Stimulation (SCS) Peripheral Nerve Stimulation (PNS) Physiotherapy Psychological Support (CBT)

Lower Back Pain

Affects 80% of adults at some point

The most common reason people visit a pain clinic. Your lower back pain might come from a worn-out disc, an inflamed joint in the spine (facet joint), strained muscles, or a pinched nerve. We use imaging and diagnostic injections to find the exact source — then target it directly, so you are not just masking the pain.

Neck Pain

Cervical facet joints cause up to 65% of chronic neck pain

Neck pain can radiate into your shoulders and arms, cause headaches, and limit your ability to turn your head. Common causes include cervical disc herniation, arthritis of the neck joints, whiplash injury, and pinched nerves. A precise diagnosis lets us target the right structure and avoid unnecessary surgery.

Sciatica

Epidural injections help 70-80% of patients avoid surgery

Sciatica is a sharp, shooting pain that travels from your lower back down through your buttock and into your leg. It happens when a herniated disc, bone spur, or narrowed spinal canal squeezes the sciatic nerve. Most people improve with the right targeted treatment — a study in the Journal of Bone & Joint Surgery found that 71% of patients who were candidates for surgery avoided it after receiving targeted epidural injections.

Neuropathic Pain

Affects roughly 7-10% of the general population

Nerve damage pain feels like burning, tingling, electric shocks, or numbness. It can come from diabetes (diabetic neuropathy), shingles (post-herpetic neuralgia), nerve injuries, or nerve compression. Standard painkillers often do not work well for nerve pain — that is why we offer specialized treatments that target the nervous system directly. For diabetic neuropathy, a landmark RCT in JAMA Neurology (Petersen et al., 2021) showed 79% of patients achieved at least 50% pain relief with high-frequency spinal cord stimulation.

Arthritis & Joint Pain

PRP therapy helps 60-80% of knee OA patients

Arthritis — whether osteoarthritis from wear-and-tear or inflammatory arthritis — causes stiffness, swelling, and pain in your knees, hips, shoulders, and hands. When over-the-counter medications and physiotherapy plateau, we can inject treatments directly into the joint. PRP therapy uses your own blood to stimulate healing — a 2021 meta-analysis in the American Journal of Sports Medicine (Belk et al.) pooling 18 studies found PRP significantly outperformed hyaluronic acid for pain and function at up to 12 months. Cryoneurolysis can also freeze the pain-carrying knee nerves for 3-6 months of relief.

Fibromyalgia

Affects 2-4% of the population, mostly women

Fibromyalgia causes widespread pain throughout the body, deep fatigue, sleep problems, and mental fogginess often called "fibro fog." The pain comes from an overactive nervous system that amplifies normal signals — not from joint or tissue damage. No single treatment works alone. A combination approach using ketamine infusions (which can "reset" the overactive pain system), trigger point injections for localized muscle knots, psychological support, and graded exercise produces the best results.

Complex Regional Pain Syndrome (CRPS)

Ketamine and SCS both show significant relief in RCTs

CRPS produces severe, burning pain — usually in a hand, foot, arm, or leg — that is far worse than the original injury. The affected area often swells, changes colour, and becomes extremely sensitive to touch. Early, aggressive treatment is essential. A landmark trial in the New England Journal of Medicine (Kemler et al., 2000) showed that spinal cord stimulation combined with physiotherapy significantly outperformed physiotherapy alone at 6 months. An RCT by Schwartzman et al. found that a 10-day course of IV ketamine produced significant pain reduction compared to placebo, with relief lasting approximately 11 weeks.

Migraines & Chronic Headaches

Occipital nerve blocks relieve 85% of patients initially

Chronic migraines, tension headaches, cluster headaches, and headaches originating from the neck (cervicogenic headaches) can be debilitating. When standard medications fall short, we can target the specific nerves involved. Occipital nerve blocks numb the nerves at the back of the head and show an 85% initial response rate in clinical studies. For severe, medication-resistant headaches, peripheral nerve stimulation — a tiny device placed near the occipital nerve — offers long-term relief.

Post-Surgical Pain (Failed Back Surgery)

SCS helps about 50% of failed back surgery patients

When pain persists or worsens after surgery — including failed back surgery syndrome and post-thoracotomy pain — it can feel hopeless. But there are effective options. The PROCESS trial showed that 48% of patients with failed back surgery got at least 50% pain relief with spinal cord stimulation, compared to only 9% with medications alone. Cryoneurolysis can also reduce post-surgical pain and opioid use by about 50%, according to a trial published in Anesthesiology.

Spinal Stenosis

Most common in adults over 50

Spinal stenosis means the space inside your spine has narrowed, squeezing the spinal cord and nerves. This causes pain, numbness, or weakness in your legs (lumbar) or arms (cervical), and often makes it hard to walk long distances. Epidural steroid injections can reduce the swelling around compressed nerves, creating a window for physiotherapy. When injections are not enough, spinal cord stimulation provides an alternative to surgery.

Herniated Disc

71% of surgical candidates avoided surgery with injections

A herniated (slipped or ruptured) disc occurs when the soft centre of a spinal disc pushes through a crack in the tougher outer casing. This presses on nearby nerves, causing pain, numbness, or weakness in your arm or leg. The good news: most herniated discs do not need surgery. Targeted epidural injections reduce the inflammation around the pinched nerve, and PRP therapy can support disc healing. A major study showed 71% of people who were initially told they needed surgery were able to avoid it after receiving transforaminal epidural injections.

Cancer Pain

Interventional techniques reduce opioid need by 50-70%

Pain from cancer or its treatment (surgery, chemotherapy, radiation) deserves expert care. Our goal is to reduce your suffering and minimize reliance on high-dose opioids. Nerve blocks can interrupt pain signals from tumours pressing on nerves. Celiac plexus blocks for abdominal cancers and intercostal blocks for chest wall pain are well-established techniques. Ketamine infusion and spinal cord stimulation offer options when other approaches plateau. We coordinate closely with your oncology team.

Sacroiliac (SI) Joint Pain

Accounts for 15-30% of lower back pain cases

The SI joint connects your lower spine to your pelvis. When it becomes inflamed or dysfunctional, it causes deep pain in the low back and buttock, often mistaken for sciatica or hip pain. SI joint problems are responsible for up to 30% of chronic lower back pain. A diagnostic injection into the joint confirms it as the source. If confirmed, radiofrequency ablation using cooled probes can provide relief lasting 6 months or more — a study showed 47% of patients achieved at least 50% pain reduction at 6 months versus only 12% with a sham procedure.

Myofascial Pain Syndrome

Trigger point injections help 50-70% of patients

Myofascial pain comes from "trigger points" — tight, tender knots in your muscles that can send referred pain to other parts of your body. It is one of the most commonly overlooked causes of chronic pain. A review of 23 clinical trials found that the needle itself is the key therapeutic tool — by physically releasing the knot, blood flow is restored and the pain-spasm cycle is broken. Best results come when injections are combined with stretching and posture correction.

Phantom Limb Pain

Affects 50-80% of amputees

After an amputation, many people feel real pain in the limb that is no longer there. This is not imagined — it is caused by the brain and spinal cord continuing to send and receive pain signals from nerves that were cut during surgery. Ketamine infusion therapy can interrupt these signals by blocking NMDA receptors in the brain, essentially "resetting" the pain processing system. Spinal cord and peripheral nerve stimulation can also modulate these signals at the nerve level.

Degenerative Disc Disease

RFA provides 6-12 months of relief per session

As we age, the discs between our vertebrae lose water content and height, sometimes causing chronic aching back or neck pain. Despite the name, it is not really a "disease" — it is a normal part of aging that becomes painful in some people. When the worn discs irritate nearby facet joints or nerves, we can target those structures directly. Radiofrequency ablation of the facet joint nerves provides 6-12 months of relief and can be safely repeated. PRP and prolotherapy can also support disc and ligament healing.

Occipital Neuralgia

85% of patients respond to occipital nerve blocks

Occipital neuralgia causes piercing, throbbing, or electric-shock-like pain in the back of the head, upper neck, and behind the ears. It is caused by irritation or injury to the occipital nerves that run from the top of the spinal cord up through the scalp. Occipital nerve blocks — a quick injection of numbing medication and anti-inflammatory around the nerve — provide relief in about 85% of patients, lasting 1-3 months. For long-term control, cryoneurolysis freezes the nerve for 3-6 months of relief, and peripheral nerve stimulation offers a permanent implantable option.

Whiplash & Post-Traumatic Pain

Cervical RFA provides a median of 9 months relief

Whiplash occurs when your head is suddenly thrown forward and backward, commonly in car accidents. This damages the soft tissues, facet joints, and discs in your neck. While most whiplash resolves within weeks, up to 50% of people develop long-term neck pain. A landmark study in the New England Journal of Medicine proved that radiofrequency ablation of the damaged cervical facet joint nerves provided a median of 263 days (about 9 months) of relief, compared to just 8 days with a placebo procedure. This is preceded by diagnostic medial branch blocks to confirm the source.

Central Sensitization

Recognized driver of fibromyalgia, chronic widespread pain & persistent post-surgical pain

Central sensitization means your nervous system has become "turned up to maximum volume." Even after the original injury has healed, your brain and spinal cord keep amplifying pain signals — so normal touch, pressure, or movement can feel intensely painful. This is not "in your head" — it is a measurable change in how your nervous system processes signals, first described by Clifford Woolf in a landmark 2011 paper in Pain. It often drives conditions like fibromyalgia, chronic widespread pain, and persistent post-surgical pain. Because central sensitization involves NMDA receptors in the spinal cord, ketamine — which blocks these receptors — can interrupt the cycle.

Chronic Pain & Depression

Up to 65% of depression patients have chronic pain; up to 61% of pain patients have depression

Chronic pain and depression feed each other in a vicious cycle. Pain limits activity and sleep, which worsens mood; depression lowers pain tolerance, making everything hurt more. A review in JAMA Internal Medicine (Bair et al.) found that up to 65% of patients with depression suffer from pain, and pain patients are 3-5 times more likely to develop clinical depression. When standard antidepressants and painkillers are not enough, ketamine infusion therapy offers a unique advantage — it can improve both pain and mood simultaneously. Multiple RCTs confirm that IV ketamine produces rapid antidepressant effects within hours rather than the weeks required by conventional antidepressants.

Tendon Injuries & Tendinopathy

PRP improves tennis elbow in 84% of patients at 24 weeks

Tendons — the tough cords connecting muscle to bone — heal slowly because they have a limited blood supply. Tendinopathy (chronic tendon degeneration) causes persistent pain in the shoulder (rotator cuff), elbow (tennis or golfer's elbow), knee (patellar tendon), or heel (Achilles). When rest, bracing, and physiotherapy plateau, regenerative treatments can restart the stalled healing process. PRP therapy concentrates your own growth factors and injects them directly into the damaged tendon. An RCT in the American Journal of Sports Medicine (Mishra et al., 2014) showed 84% improvement in the PRP group for lateral epicondylitis at 24 weeks.

Plantar Fasciitis

Affects 1 in 10 people over their lifetime

That stabbing pain in the bottom of your foot when you take your first steps in the morning is usually plantar fasciitis — inflammation and micro-tearing of the thick band of tissue running from your heel to your toes. It is one of the most common causes of heel pain. When stretching, orthotics, and rest are not enough, targeted injections can help. A systematic review in the American Journal of Sports Medicine (Hohmann et al., 2021) found that PRP significantly outperformed corticosteroid injections at 6 and 12 months for chronic plantar fasciitis across multiple RCTs.

Ligament Injuries & Joint Instability

Prolotherapy strengthens lax ligaments through collagen repair

When ligaments — the bands holding your joints together — are stretched, partially torn, or chronically lax, the joint becomes unstable. This causes pain, giving way, and repeated sprains in the ankle, knee, shoulder, or spine. Unlike muscle, ligaments heal very slowly and often incompletely. Prolotherapy was specifically designed for this problem: a series of dextrose injections triggers new collagen growth that tightens and strengthens the damaged ligament over time. An RCT in the Annals of Family Medicine (Rabago et al.) showed significant improvement in knee function at 52 weeks.

Bursitis

Corticosteroid injections provide significant short-term relief

Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles around your joints. When a bursa becomes inflamed — from overuse, injury, or arthritis — it causes aching pain and tenderness in the affected area. The most common sites are the hip (trochanteric bursitis), shoulder (subacromial bursitis), and knee (prepatellar bursitis). When rest and anti-inflammatory medication are not enough, an ultrasound-guided corticosteroid injection directly into the inflamed bursa provides fast, targeted relief.

Costochondritis & Chest Wall Pain

Cryoneurolysis can reduce post-thoracic pain and opioid use significantly

Costochondritis is inflammation where your ribs attach to the breastbone, causing sharp chest pain that can mimic a heart attack. Other chest wall pain can arise from rib injuries, intercostal nerve irritation, or post-surgical scarring. Once cardiac causes have been ruled out, we can target the pain directly. Intercostal nerve blocks numb the specific nerves between the ribs, providing rapid relief. For persistent cases, cryoneurolysis freezes the nerve for months of relief — an RCT by Ilfeld et al. in Anesthesiology (2022) showed that intercostal cryoneurolysis after mastectomy reduced opioid consumption by 98%.

Pelvic Pain & Pelvic Girdle Pain

SI joint dysfunction accounts for up to 30% of lower back pain

Chronic pelvic pain can arise from the sacroiliac (SI) joints, pelvic floor muscles, or the ligaments that hold your pelvis together. It is especially common after pregnancy, where the ligaments stretched during childbirth may not fully tighten again. SI joint dysfunction, pubic symphysis pain, and pelvic girdle instability can all cause deep, aching pain in your lower back, hips, and groin. Diagnostic SI joint injections confirm the pain source, and radiofrequency ablation using cooled probes can provide 6 or more months of relief.

Learn More

Understanding Your Pain

These short videos from leading medical institutions explain common pain conditions and treatments in plain language.

Understanding Low Back Pain — Dr. Mike Evans

How Spinal Cord Stimulation Works — Boston Scientific

PRP Injections Explained — Johns Hopkins Medicine

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