Advanced Pain Treatment Techniques

Pain is not a single condition, it is a signal. At FV’s Pain Clinic, we treat it as one: a symptom with a source that can be identified, understood, and addressed with precision.

Our team manages the full spectrum of pain, from acute post-surgical discomfort to complex, long-standing conditions that have resisted other treatments. Whether the cause is a damaged nerve, a compressed spine, an inflammatory joint, or cancer pressing against surrounding structures, we build a plan around the root cause, not a standard protocol.

We don’t simply ask “how much does it hurt?” We ask why, where, since when, and what has been tried. That clinical thoroughness is the foundation of effective pain relief.

Interventional Procedures

Nerve Blocks A local anaesthetic, sometimes combined with a corticosteroid, is injected at a specific nerve or nerve cluster to interrupt the pain signal at its source. Think of it as temporarily switching off the alarm rather than just turning down the volume. Nerve blocks are used for diagnosis as well as treatment, helping us confirm which structure is responsible before committing to a longer-term approach.

Nerve blocks we perform include:

• Epidural steroid injections (cervical, thoracic, lumbar)
• Facet joint and medial branch blocks
• Sacroiliac joint injections
• Sympathetic nerve blocks (coeliac plexus, stellate ganglion)
• Intercostal nerve blocks
• Peripheral nerve blocks

Radiofrequency Ablation (RFA) When a nerve block confirms that a specific nerve is responsible for chronic pain, radiofrequency ablation can provide longer-lasting relief. Using precise heat energy delivered through a needle-sized probe, the nerve’s ability to transmit pain signals is interrupted. The procedure is guided by imaging to ensure accuracy. Relief typically lasts 6 to 18 months, and the procedure can be repeated.

RFA is commonly used for: facet joint pain, sacroiliac joint pain, and occipital neuralgia.

Epidural and Intrathecal Drug Delivery For patients with severe pain that cannot be controlled by oral medications, particularly in cancer or advanced neurological conditions, medication can be delivered directly into the epidural or intrathecal space, the region surrounding the spinal cord. This route allows much lower doses to achieve the same or better effect, significantly reducing systemic side effects such as sedation and nausea.

Spinal Cord Stimulation (SCS) For certain chronic pain conditions that have not responded to other treatments, spinal cord stimulation offers a reversible, non-destructive option. A small device delivers mild electrical impulses to the spinal cord, interfering with the transmission of pain signals to the brain. Think of it as rerouting an unwanted message before it reaches its destination. SCS is used for conditions including failed back surgery syndrome, CRPS, and refractory neuropathic pain.

Trigger Point Injections Used for musculoskeletal pain caused by tight, hypersensitive muscle knots (trigger points), this procedure delivers a small injection directly into the affected area to release the contraction and restore normal tissue function.

Ozone Therapy / Prolotherapy

Cancer Pain Management

Pain is one of the most feared consequences of cancer, and one of the most undertreated. At FV, our Pain Clinic works in close collaboration with the Hy Vong Cancer Centre to ensure that pain management is integrated into every patient’s oncology journey from the outset, not added as an afterthought.

We follow WHO analgesic ladder principles while going beyond them, using interventional techniques where oral medications are insufficient, titrating treatments as the disease evolves, and always weighing the impact on the patient’s ability to engage with life and treatment.

Our cancer pain management includes:

• Individualised opioid and non-opioid analgesic regimens
• Coeliac plexus block for pancreatic and upper abdominal cancer pain
• Intrathecal drug delivery for refractory cancer pain
• Vertebroplasty for painful spinal metastases (in coordination with Interventional Radiology)
• Palliative nerve blocks for end-of-life comfort