Pain Management is a medical service focused on understanding pain and finding ways to make daily life more manageable. The aim is to reduce symptoms where possible, improve movement and help people return to the activities that matter to them.
Understanding symptoms and reviewing medical information are important steps in planning pain care
A pain consultation looks beyond the question of where it hurts.
When did the problem begin? Does pain travel into an arm or leg?
Is it affecting sleep, work or walking?
What treatments have already been tried?
The assessment helps distinguish between possible sources of pain, such as joints, muscles or irritated nerves. A clinician may review previous medical reports and scans, carry out an examination, and recommend further investigations where needed. Similar symptoms can have different causes, so treatment needs to suit the individual.
Dr Johana Camejo Sánchez is a specialist in neurosurgery and consultant GP dedicated to pain management. Her background is relevant to the assessment of conditions involving the spine and nervous system, where understanding the source of symptoms helps guide the next step.
For patients, a consultation is also an opportunity to understand unfamiliar medical terms, discuss treatment choices and ask what improvement might realistically look like.
Dr Johana Camejo Sánchez, specialist in neurosurgery and consultant GP dedicated to pain management
Spinal pain is one of the areas commonly assessed in pain medicine. You may hear the terms cervical, meaning the neck, and lumbar, meaning the lower back. Spondylosis describes degenerative changes in the spine, while spinal stenosis means narrowing of spaces through which nerves pass.
Radiculopathy refers to symptoms caused by irritation or compression of a spinal nerve root. These may include pain, tingling, numbness or weakness. Sciatica commonly describes pain travelling from the lower back or buttock down a leg. Pain that travels into an arm can sometimes be linked to a nerve problem in the neck.
These terms help describe a condition, but a scan or a medical label alone does not determine which treatment is right for someone.
Sciatica can cause pain that travels from the lower back or buttock into a leg. This is an explanatory illustration, not a patient scan.
What are facet joint blocks and epidural injections?
Two procedures used in pain medicine are facet joint blocks and epidural injections. They target different structures and are considered for different reasons.
Facet joints are the small joints linking the bones at the back of the spine. In selected cases, an injection into or around a joint may be used to investigate or treat pain thought to come from it. A related procedure, called a medial branch block, places local anaesthetic near the small nerves supplying the joint to help assess whether it is a source of pain. These procedures are related, but they are not identical.
An epidural injection places medicine in the epidural space around the spinal nerves. In pain treatment, this may include a corticosteroid to reduce inflammation, sometimes with a local anaesthetic. It may be considered for selected nerve-related symptoms, such as certain cases of sciatica or pain travelling into an arm.
The clinician should explain why a particular procedure is being considered, how imaging will guide it, its alternatives and its risks. Injections do not help everyone, and any relief may be temporary. Possible complications include bleeding, infection, headache and nerve injury; the relevant risks depend on the procedure and the patient.
A pain management plan may combine a review of medication, advice about activity, physiotherapy or rehabilitation, and selected procedures when appropriate. Some patients need referral to another specialist or assessment for surgery. The plan depends on the diagnosis, general health and personal goals.
For one person, progress might mean walking more comfortably. For another, it could mean sleeping better or managing daily tasks with less difficulty. Follow-up helps establish whether the chosen approach is making a useful difference.
If you live in The Gambia or return for extended visits, planning care locally begins with finding out what assessment, treatment and follow-up are available. Bring previous scan reports, medical letters and an up-to-date medication list if you have them. Explain how long you will be in the country so that any treatment and review can be planned around your stay.
Persistent pain is worth discussing with a clinician. A consultation can help you understand the problem and explore the available options before deciding what to do next.
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