Assessment and Treatment of Chronic Pain

The Pain Clinic at Cambridge Memorial Hospital can offer patients assessment and treatment for chronic pain. Referring clinicians are welcome to refer all types of patients with chronic pain to this clinic. These include, but are not limited to: 

• Patients with post-spinal surgical chronic pain
• Post surgical chronic pain
• Chronic non-cancer pain after failed pharmaceutical intervention
• Some sub-acute pain like rib fractures, whiplash, and shingles
• Post nerve-injury pain
• Cancer pain for palliation
• Joint pain from arthritis, etc.

Medications alone may not be enough to manage certain kinds of pain. Some medicines are more effective in fighting pain when they are combined with other methods of treatment. Such treatments can be Injection treatments, nerve blocks, physical and aquatic therapy, electrical stimulation, acupuncture, psychological support or surgery. Speak with a member of your care team to learn what might be best to treat your pain. 

The Pain Clinic uses interventional methods such as injection treatments to stop or manage pain. These may include:
 

• Various types of nerve blocks including peripheral nerve blocks, paravertebral blocks, stellate ganglion blocks, intercostal blocks, trigger point injections, etc.
• Epidural steroid injections
• Joint injections including hip, knee, shoulder, facet joints, etc.
• Ultrasound guidance is also available

This clinic does not prescribe narcotics or adjuvants.

Referral & Appointments

You cannot refer yourself to the clinic at this time. All referrals to the pain clinic must be made from a health care provider.
 

Once the referral is made, you will be contacted by phone with an appointment date and time. 

Please note that if you cannot make the appointment, contact the Pain Clinic clerk at 519-621-2333 extension 1120 or email painclinic@CMH.org to cancel or reschedule. The Pain Clinic requires 48 hours notice if you wish to cancel your appointment.

Injections and/or Nerve Blocks for Chronic Pain

Please read this information carefully before your treatment.

Medications alone may not be enough to manage certain kinds of pain. Some medicines are more effective in fighting pain when they are combined with other methods of treatment. Such treatments can be Injection treatments, Nerve blocks, Physical and aquatic therapy, Electrical stimulation, Acupuncture, Psychological support or Surgery.
 

Treatments

Injection treatments: Local anesthetics, with or without cortisone-like medicines, can be injected around nerve roots and into muscles or joints. These injections may reduce swelling, irritation, muscle spasm and pain. Examples: Trigger point injections, Epidural steroid injection, Sacro-iliac joint injection, etc.
 

Nerve blocks : Local anesthetics, with or without cortisone-like medicines, can be injected around nerves or a group of nerves, called a plexus or ganglion. These nerve blocks may reduce swelling, irritation, muscle spasm and pain, and may improve function. Examples: Occipital nerve block, Stellate ganglion injection, etc.

Your chances of improvement with above injections or nerve blocks are about 50%. Improvement may be temporary or long lasting. It may not be permanent, in other words, it may not cure your condition.
 

Side effects of treatments

Side effects vary with the treatment. These may include nausea, vomiting, dizziness, fainting spell, blood pressure changes, drooping eye lid, lumpy feeling in the throat, temporary leg weakness lasting up to 24 hours, temporary loss of bladder and bowel control, headache, etc.
 

Serious complications:

These are rare, but they do happen. They are as follows lung puncture, blood in lungs, irregular heart beat, cardiac arrest, paralysis, blindness, convulsions, epidural space infection, epidural hematoma formation, total spinal anesthetic requiring intubation and ventilation in ICU, septicemia (generalized infection in the body), temporary or permanent damage to nerves, etc. All serious side effects and complications are very rare, but can happen even if an injection is performed correctly.
 

Complications and side effects of Steroids : These may include diabetes and hypertension, thinning of bones, compression fracture of bones, weight gain, sometimes psychosis, etc.
 

A final word…..

If you have any questions about nerve blocks or injections , please speak to your Anaesthesiologist. Every precaution will be taken for your safety and comfort.

If you would like a printable version of the above, please click here.

You will meet your pain specialist when you come in for your first appointment. You can expect up to a 30-minute wait to see your specialist. 

Here is what you need to bring:

• Bring a list of all the medications and supplements you are taking
• Wear loose comfortable clothing
• Please bring any personal assistive devices that you require to support you for your appointment. For example, any communication or mobility device you many need like a walker, hearing aid, etc.
• Bring a valid health card to every visit. Clinic fees are covered by OHIP
• WSIB information (if applicable)
• Please eat something and take your scheduled medications prior to first appointment

CMH is a scent free facility. Please refrain from wearing perfumes and scents to your appointments.

Upon receipt of referral, patients will be seen by the next available physician. Our current wait time is 6 to 8 months. If you have any urgent patient concerns, please call one of our physicians to discuss setting up an urgent appointment.

With your referral, please provide patient demographics, chief complaints, medical history, a list of current medications, and any relevant investigations - particularly relevant imaging. Thank you for referring your patients to the Pain Clinic and for giving us the opportunity to participate in their care.

The Pain Clinic is located in Wing D, Level 0 in the Outpatient Clinic area. The parking lot closest to this entrance is Visitor Lot #4. Please enter through the "D" doors - you will see a large "D" sign near this entrance. 

See graphic below.