Opinion and advice from a British Pain doctor.            About:

Why I Started this Website

I'm sure I read, somewhere, that the difference between an expert in his field and a layman is that the expert knows 200 facts. I don't know if this is true; I do know that I seem to spend a great deal of time telling people a remarkably small number of things that they didn't know about chronic pain. And, whether they are colleagues from other specialties or patients they're usually astonished, incredulous and a little confused by what I say.

My idea is to simply set out the general advice that I give to my patients so that I can refer them to this site to remind them (no-one takes away as much from a medical consultation as the doctor thinks they have) and to cite and discuss the evidence.

Some patients, indeed some doctors, have great difficulty in believing the basic truths behind chronic pain: my hope is that you can see that there is a rational, evidence-base behind much of what I say. And when the evidence is controversial, I'll try to present both sides of the argument so that you can decide if you agree with me.


I hope that this will turn into a useful resource in the fullness of time. Please remember that it is general advice and it is based on my opinion it is not specific to you and I don't want some evil American attorney trying to sue me because Mrs O'lady from Arkansas tried to excise her own facet joints based on a diagram that she'd seen on this website, using a mirror and a chainsaw.

The information is offered pro bono and my liability is limited to the amount that I charged you: £0. More importantly, your doctor may not agree that something on this website applies to you: or she may not share my opinion. Please don't use this website to get me into a fight with a colleague I haven't even met.


For some reason, and I really don't know what it is, colleagues often ask me to speak at meetings, so over the years I've accumulated a large number of PowerPoint presentations on various aspects of pain medicine. I thought that a good way to start would be to turn these into little internet slide shows and I've finished the first one, so here it is for your edification.

The plan is to add more when time allows.


I intend to add essays  (I think that these days people would call them "blogs") as and when they occur to me. I'll try to cover the subjects  that  crop up in the  pain clinic  most frequently.


There are some established facts:  or at least statements which appear to be true. By themselves they are not very helpful to the uninitiated, none-the-less, I shall build a list of them because they form the nearest thing that we have to a scientic basis for our speciality.

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