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Consultant in Pain Medicine

DR NICK FRASER

MBBS FRCA FFPMRCA

Scope of Practice

Spinal pain is my forte, as I feel it is this area that Pain Consultants have the most to offer with a series of proven effective treatments for certain conditions. This includes neck pain, low back pain, sacro-iliac pain, and sciatica. In many cases patients are managed jointly with Neurosurgeons or Sports medicine specialists. This shared care has many advantages to the patient and the doctor, a better overview of the condition can be achieved, and a realistic plan of management can be made.
Often injections treatments are used in place of surgery, or when surgery is not considered favourable. Keeping patients under a wider team achieves better results for the patient.
This team approach hinges around our MDT (Multi-Disciplinary Team), this comprises
Neurosurgeons, Pain doctors, Sport medicine doctors, and Neuro-radiologists. We meet every fortnight to discuss clinical cases confidentially to seek advice and plan management. This set up is rare in the Private sector, and at the time of writing is the only such set up outside of London. I expect in the future it will become a standard way of working.

For many years I have worked closely with the leading Neurosurgeons in Manchester, including Professor Andrew King, Mr Scott Rutherford, Mr John Leach, Mr Ankur Saxena, Mr Vivek Josan, and Professor Omar Pathmanaban.

So what happens when you see a Pain Consultant?

It all starts with an initial assessment, finding out more about you, your pain problem, how it affects
you. I also want to learn more about your past medical history, medications, and treatments and
investigations to date. Having some of these details with you when you attend is helpful as often we
do not have this information to hand. Usually a physical examination is required then together we
can discuss the problem together and plan the next step.

What Treatments are Available?

It usually focuses on intervention, i.e. procedures that I can offer to reduce your pain. Sometimes
there aren’t any interventional options unfortunately, but I will try to find something to help if I can.
Broadly speaking there are 2 types of intervention, steroid injections and Denervation treatments.

Steroid Injections: These are simple safe and usually effective injections of corticosteroid into a part
of the body that is causing pain, either from arthritis or injury such as a slipped intervertebral disc
trapping a nerve or a worn joint. In many this can relieve pain for 3 months while the body recovers
and rehabilitates.

Denervation treatments: This refers to a treatment that aims to turn off a nerve/s that are supplying
arthritic joints, we do this a lot for spinal facet joints in the neck and low back, sacro-iliac joints at
the back of the pelvis and also the shoulder. There are other areas that can be treated as well.
Denervations can reduce pain by about 50% for 6-18 months. They are considered relatively safe and
can be repeated if required.
There are other options, and sometimes ‘Pain Management’ is helpful, this involves finding out more
about chronic pain and how to makes the adaptations to better self care.

ABOUT ME

I qualified as a Doctor in 1995, in London. Having undertaken my house jobs in Aldershot with the
Army and then Kings Lynn, I took a well-earned break from the NHS and got a commission in the
RAMC, which is where I developed an interest in Musculo-skeletal medicine whilst a Battalion
doctor. After completing nearly 3 years of general duties I then chose Anaesthesia and started my
training in the incredible and historic Royal Hospital Haslar (Naval Hospital in Gosport) then nearby
Portsmouth where I first encountered Pain Medicine, an established branch of Anaesthesia and
found myself fascinated by the myriad of roles a Pain doctor must master and interested in the X-ray
guided injection treatments.
I then re-joined the NHS and moved to Manchester and got onto the Anaesthesia specialist registrar
training program, and again got to do a Pain clinic module at Stepping Hill Hospital which I took to
like a duck to water, it was obvious that this particular field was right for me so I applied for
advanced pain training and undertook that in my penultimate registrar year. I was then fortunate to
be offered a substantive Consultant job at Stepping Hill in 2007 which is where I have worked ever
since.
I now do Chronic Pain management full time, split between the NHS and the private sector. I
consider myself lucky to work with a group of very capable and experienced doctors who put their
patients first and set high standards of care. I feel very supported in my work by the wider team,
which makes for a happy work place.
In my spare time, I am married with 2 children, and live out in the sticks. I like to keep fit with
running, cycling and skiing plus a little motor sport when I can.

Places of Work

  • OrthTeam Centre Didsbury

  • The Alexandra Hospital Cheadle.

CONTACT

PA Contact Details

Lesley Wilson

0161 495 7008

nick.paindoctor@outlook.com

The Alexandra Hospital

Mill Lane

Cheadle

SK8 2PX

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