Here are just some of the conditions that we treat, although the list is not exhaustive, so get in touch to discuss your symptoms. Lots of chronic pain conditions cannot be diagnosed by diagnostic scans and and this is where I can draw on my expertise to assist you.

Groups of patients with chronic pain

Patients with chronic pain come into different groups. The ones that need very urgent treatment, the ones that need quick control of a flare-up, the ones that are going to have their pain condition for life and the patients with cancer and those who are undergoing treatment for cancer.

Degenerative spinal disc disease

Degenerative spinal disc disease refers to back or neck pain caused by injury or the natural wearing down of the rubbery discs between our vertebra that allow us to comfortably bend and twist the back. After the age of 40, most of us will have some disc degeneration but may not experience pain. For many though it can low-level chronic pain and also cause weakness, numbness or shooting pains down the arms and legs.

Low back pain with or without leg pain

Pain in the lower back, with or without pain that travels down the buttocks, legs and feet, is a common concern with most of us experiencing at least one episode in our lifetime. Low back pain, often known as lumbago, is not a specific disease but rather a symptom. It often results from an injury or poor posture, but severe or persistent pain may point towards a medical condition such as osteoarthritis or fibromyalgia.

Medically unexplained back and leg pain

Although back and leg pain may be a sign of a serious underlying medical condition, for many patients that have been suffering from low-level, persistent pain affecting the back and lower joints, they have often received no specific diagnosis. For these patients, Dr Ivanova-Stoilova has often been able to diagnose complex musculoskeletal and nerve-related pain which could then be well managed with special medication, injections, rehabilitation.

Joint pain after trauma, inflammation and degenerative disease

Joint pain is the most common presentation of arthritis. The most common cause is wearing out of cartilage, the rubbery substance that protects our joints, and is known as osteoarthritis. Post-traumatic arthritis is another common form of osteoarthritis and occurs when there has been physical injury to the joint. Virtually any joint in the body can be affected by pain, although the knees, hips, back and shoulders are most common areas to be affected. Pain can vary from mild discomfort to debilitating and chronic pain that has a significant impact on quality of life.

Whiplash injuries

Whiplash is commonly caused by rear-end car crashes but can result from any sudden movement back and forth of the head. Typically, it describes neck pain as a result to trauma to the intervertebral joints, ligaments, muscles and nerves. Headaches and neck stiffness, muscle soreness, pain in the shoulders and in the lower back are also common symptoms. Although symptoms usually subside within a few weeks, some patients continue to develop symptoms over many months and years.

Cancer pain

Patients with a cancer diagnosis will have different pain syndromes related to both their disease and the cancer treatment they are receiving. Cancer pain, in particular, can be short-lived or long-lasting, mild or severe and can affect many organs and systems in the body. It is important that cancer patients are reassured that their pain can be controlled and managed.

Male and female pelvic pain

Pain that is located in the lower abdomen or pelvis can affect both men and women. For many female patients, chronic pelvic pain follows a regular cycle and is often linked to hormonal causes. Men can experience chronic pain in the groin, bladder, perineum or genitals and they may suffer pain when urinating or ejaculating. Correct diagnosis is essential for effective treatment and common causes include endometriosis, IBS, painful bladder syndrome and MSK conditions.

Pain in pregnancy

Many women experience lower back pain during pregnancy due to the softening and stretching ligaments. Pelvic pain can also develop during pregnancy and this is sometimes called pregnancy-related pelvic girdle pain (PGP) or symphysis pubis dysfunction (SPD). This is caused by stiffness or uneven movement of your pelvic joint. However, there are a number of different treatments that can be safely used during pregnancy to manage any pain you’re experiencing.

Head and facial pain

Occasional head and facial pain, due to headaches, sinus infections or tooth pain, are common and usually short-lived. However, ongoing and severe episodes of craniofacial pain could be a sign of an underlying condition. This includes migraines, Trigeminal neuralgia, Occipital neuralgia, Temporomandibular joint pain and facial neuropathic pain. With the correct diagnosis and an individualised treatment plan, your head and face pain can be effectively managed and improved.

Complex regional pain syndrome

Complex Regional Pain Syndrome or CRPS is a chronic pain condition following trauma to the bone or soft tissue. Typically, pain is out of proportion to the initial injury and can spread to other areas of the body. Patients often feel an intense ‘burning’ pain along with skin sensitivity, joint stiffness, muscle spasms and weakness and motor disability. There is no specific cure for CRPS, but treatment focuses on relieving painful symptoms.

Peripheral neuropathic pain caused by nerve injury, diabetes, chemotherapy, shingles

Peripheral neuropathic pain results when the peripheral nerves in the body’s extremities are damaged. The peripheral nerves send messages to the body’s central nervous system – the brain and spinal cord – and transmit sensations such as pain and touch, control muscles and regulate important bodily functions. Symptoms can include numbness, tingling, loss of balance and muscle weakness, but patients can also experience burning, stabbing or shooting pain in the hands, legs and feet.

Central neuropathic pain caused by stroke, spinal cord injury or inflammation or cauda equina

Central neuropathic pain or central pain syndrome is common in patients that have experienced damage to the central nervous system in the form of a stroke, multiple sclerosis, brain tumours or a spinal cord injury. Patients can experience loss of sensation and weakness, often in the arms or legs, but a common symptom is pain. Pain can range from mild to severe and either be constant or intermittent. In severe cases, pain can dramatically affect a patient’s quality of life.

Pain in survivors of critical illness, including Long COVID

It is well-reported that patients who have survived critical illnesses go on to experience chronic pain which can affect their ability to return to work and impact their quality of life for many years after discharge. The impact of Long COVID is not yet fully understood but chest pain and MKS pain seem to be one two of the most commonly reported symptoms.

Pain after sports injuries

Sports injuries can be classified broadly as acute or chronic. Acute injuries occur suddenly, such as a tear, sprain or fracture, and you’ll typically experience sudden, severe pain, swelling, and a visible dislocation or break of the bone. A chronic sports injury is the result of overuse and you may experience consistent pain when active and a dull ache when you’re resting. Sports injuries can affect bone, cartilage, joints and ligaments, synovial joints, muscles and tendons. With the appropriate treatment, you should fully recover from an acute or chronic sports injury, but many patients do not and pain can eventually become debilitating.

Post-surgical pain – after hernia repair, after surgery on abdominal organs, chest, after hip and knee replacements

Post-surgical pain after any type of surgery, especially after hip and knee replacements, is disappointing and distressing. Dr Ivanova-Stoilova can help reduce symptoms by accurately diagnosing where the pain is coming from and offering special treatment.

Intractable angina pain

Refractory angina or intractable angina is a condition in which heart disease patients continue to suffer from angina even when following the appropriate medication program. Angina is chest pain caused by restricted blood flow to the heart and, even when they have undergone an angioplasty or other medical interventions, patients can still experience chronic and incapacitating chest pain. Treatments to improve blood flow are applied alongside treatments to control pain.

Abdominal pain due to irritable bowel, pancreatitis, ulcerative colitis

There can be many causes of pain in the abdomen and the first step is to try and diagnose the cause. Abdominal pain can be a sign of diseases or disorders affecting the internal organs in the abdominal cavity as well as soft tissue injuries. Chronic abdominal pain can either be sharp or dull and constant or intermittent. Patients may experience cramping pains, tenderness to the stomach, bloating, pain in the side or back and it may be associated with repetitive episodes of either diarrhoea or constipation.

Foot and leg pain due to deformities, diabetes, peripheral vascular disease

Patients with conditions such as diabetes and peripheral vascular disease are susceptible to foot problems. Diabetics can develop numbness in the feet are prolonged periods of high blood pressure, which reduces the awareness of wounds, infections and patients may not notice when shoes are too tight and rubbing. Peripheral vascular disease blocks blood flow leading to the extremities. This can lead to pain, infection and slowly healing wounds.

Pain in rare conditions – Erythromelalgia, Neurofibromatosis

Pain is often the most frequently reported symptom of many conditions, from the common to the rare. Dr Ivanova-Stoilova has an extensive knowledge of medical conditions that could cause pain and how it is likely to present. She brings this vast experience to bear when diagnosing and managing a patient’s pain and she believes firmly that a person’s report of an experience as pain should be respected.