Pain Specialists Australia

Pain Specialists Australia Pain is the centre of our world because we know it's the centre of yours. We're a pain control clinic staffed by specialists & leaders in pain management.

28/12/2025

If your trigeminal neuralgia medications are not working, it is easy to feel like you have failed treatment.

The truth is simpler and more important.

There are only four reasons medications fail in trigeminal neuralgia. The diagnosis is wrong. The dose is wrong. Side effects get in the way. Or the condition is changing.

In this short clip, Dr Nick Christelis explains why medication failure is common and why it does not mean you are out of options. For some people, especially those with classical trigeminal neuralgia, this is the point where procedures or surgery may be discussed.

For people with classical trigeminal neuralgia, this is often the point where there is a clear treatment roadmap. When medications no longer help, procedures and, in selected cases, microvascular decompression surgery may be considered.

This video includes brief clinical and surgical footage shown for education.

Watch the full video to understand what comes next when medications stop helping and how treatment pathways are decided.

Full video link here: https://ow.ly/gu5I50XO6Gl

Find us here: https://ow.ly/eQI850XO6Gm

25/12/2025

Many people with trigeminal neuralgia are told they have tried everything.
That is rarely true.

What usually happens is this: the diagnosis is not clear, so treatments are tried in the wrong order. When that happens, even good treatments can fail.

In this short clip, Dr Nick Christelis explains why trigeminal neuralgia treatment often does not work and why surgery can be life-changing for some people but completely inappropriate for others.

Diagnosis comes first. Always.

Watch the full video to understand the different treatment pathways for trigeminal neuralgia and why getting the diagnosis right can save months or years of guesswork.

Full video link here https://ow.ly/R8l850XO6AS

Find us here https://ow.ly/qqsn50XO6AR

Merry Christmas all & Happy Holidays.
We're going to take a break but will see you next year.

16/12/2025

Face pain is not always trigeminal neuralgia.

Some patterns of facial pain are danger signs of serious underlying medical conditions that can masquerade as TN or “nerve pain”.

If facial pain is:
• new or rapidly worsening
• constant rather than brief electric shocks
• associated with numbness, weakness or vision changes
• spreading or changing in pattern
• not fitting the classic TN picture

It needs urgent specialist assessment, not repeated dental work or reassurance.

Missing these red flags delays diagnosis and treatment.

Watch the short to learn which facial pain signs should never be ignored.
Full video link here https://ow.ly/LXR950XI3hy

Or find us here https://ow.ly/pocv50XI3hE

When Your Back Pain Is Not Your Spine: The Sacroiliac Joint Problem Most People MissChronic low back pain is not always ...
11/12/2025

When Your Back Pain Is Not Your Spine: The Sacroiliac Joint Problem Most People Miss

Chronic low back pain is not always coming from the discs or nerves. A major 2025 international guideline has confirmed something pain specialists have known for years. Up to one in three people with ongoing low back pain, especially pain below the belt line, may actually have sacroiliac joint pain, not a spine problem.

Here is the simple version.

The sacroiliac joints sit at the back of your pelvis. When they become irritated or overloaded, they can create pain in the lower back, buttock, groin or even the thigh. Scans often look normal because this type of pain is more about irritated ligaments and joint stress than major structural damage.

What the new guideline found
• SIJ pain is far more common than most people realise
• Scans are usually not helpful for diagnosis
• Hands on tests can help rule pain in or out
• A small, image guided injection is the most reliable way to confirm the diagnosis
• Targeted treatments like radiofrequency of the SIJ nerves can give months of relief for the right person
• Fusion surgery is only for a very small group with severe, long term pain

At Pain Specialists Australia we see many people who have been told their back pain is due to discs or arthritis, yet their symptoms point strongly to the sacroiliac joint. Getting the source right matters because the treatment pathway is completely different.

If you have ongoing low back or buttock pain that has never been fully explained, could your sacroiliac joint be the missing piece?

https://ow.ly/pim150XFzj3

09/12/2025

Electric shocks in your face, but your dentist can’t find anything wrong?
It might not be your tooth at all but it could be your trigeminal nerve.

Trigeminal neuralgia (TN) is often misdiagnosed for months or even years. In this video, I break down the 4 clues that point to TN, the different TN subtypes, and how specialists actually make the diagnosis so you can get onto the right pathway sooner.

Watch the full video here: https://ow.ly/WG3h50XGauh

If you’re dealing with facial pain, tell us your symptoms in the comments. We read every message and will do our best to get to you.

Alternatively get to us here: https://ow.ly/ApJ350XGaui

Magnetic Stimulation for Chronic Pain: New FDA Clearance, But More Evidence NeededThe FDA has just cleared a new magneti...
04/12/2025

Magnetic Stimulation for Chronic Pain: New FDA Clearance, But More Evidence Needed

The FDA has just cleared a new magnetic stimulation device, Magstim Rapid, for use in chronic pain. It works by delivering magnetic pulses to peripheral nerves, aiming to change how pain signals are processed.

It is a promising development. It is non invasive, drug free and designed to target nerve pathways involved in post surgical, post traumatic and other persistent pain conditions.

But it is early days.

Right now, the available data comes mainly from the company and small clinical studies. We do not yet have long term independent research, head to head trials, or clear guidance on which patients benefit most. Like many new technologies, the real test will come when it is studied in larger, unbiased settings.

At Pain Specialists Australia we support innovation, but we stay cautious until strong evidence is available. New treatments must prove that they are effective, safe and worth the cost for the people who live with chronic pain every day.

We will monitor the emerging research and update our patients as the science becomes clearer.

What would you want to know before considering a technology like magnetic nerve stimulation for your pain?

We're here: https://ow.ly/jAhY50XzwSS

Why tiny holes in your thigh bone might matter for your knee painChronic knee pain from osteoarthritis is not just about...
02/12/2025

Why tiny holes in your thigh bone might matter for your knee pain

Chronic knee pain from osteoarthritis is not just about “worn cartilage”. The bone underneath the joint surface is packed with tiny nerves that can drive constant, aching pain.

A new 2025 open access study in Interventional Pain Medicine by Tran and colleagues looked at these nerves in a very precise way. They mapped the small “nutrient foramina” in the end of the femur, the tiny holes where blood vessels and pain nerves enter the bone under the knee joint.

Here is what they found, in simple terms:
• These nerve entry points are not random, they cluster in specific zones on the inside and outside of the lower femur
• Most foramina sit on the front and inner side of the knee, just above the joint line
• If you want to “turn down” pain from the subchondral bone, it probably makes more sense to block or treat the nerves as they approach these holes, rather than drilling into the bone itself

For people living with knee osteoarthritis, this matters because procedures like genicular nerve blocks and radiofrequency ablation work by targeting the nerves that carry pain from the joint. Better anatomical maps mean more precise treatments, potentially less invasive approaches, and a lower chance of missing key pain pathways.

At Pain Specialists Australia, we see this kind of detailed anatomy research as essential to improving knee denervation techniques and giving patients with stubborn knee pain more options beyond “more tablets” or “just wait for surgery”.

If you live with chronic knee pain, what would you most like your specialist to explain about nerve based treatments for knee osteoarthritis?

Get your knee pain diagnosis https://ow.ly/Ppqp50XzwJ9

CRPS and the Budapest Criteria: Getting the Diagnosis Right MattersCRPS is already a life changing diagnosis. Getting it...
30/11/2025

CRPS and the Budapest Criteria: Getting the Diagnosis Right Matters

CRPS is already a life changing diagnosis. Getting it wrong makes things worse.

The original IASP criteria were very sensitive, they picked up almost everyone with CRPS, but they were not specific. Too many people with other neuropathic pain conditions were being labelled as CRPS, which meant confusion, wrong expectations and sometimes inappropriate procedures.

Harden and colleagues tested new diagnostic rules called the Budapest Criteria in people with confirmed CRPS and people with other limb neuropathic pain. The Budapest clinical criteria kept almost perfect sensitivity (0.99), but significantly improved specificity compared with the old IASP criteria. In simple terms, they were much better at separating “true CRPS” from “other nerve pain” while still missing almost no real cases.

At Pain Specialists Australia, we support using the Budapest Criteria, together with careful specialist assessment, to avoid both overdiagnosis and missed diagnosis. CRPS needs to be recognised early and correctly, so that people are offered the right mix of medical, interventional, physical and psychological care.

If you have ongoing limb pain after an injury or surgery, how confident are you that your diagnosis truly fits what you are living with?

Get Your Diagnosis https://ow.ly/ojJA50XzwGt

27/11/2025

Electric shocks in the face, but the dentist cannot find anything wrong?

Sharp, stabbing pain on one side that feels like a live wire?
These are classic warning signs that the problem may be trigeminal neuralgia, not a tooth.

Trigeminal neuralgia (TN) is one of the most misdiagnosed pain conditions. Many people spend months or years in dental chairs, ENT clinics or on antibiotics, when the real issue is a nerve disorder.

In this video, pain specialist Dr Nick Christelis explains the 4 key signs that help distinguish trigeminal neuralgia from tooth pain, TMJ problems and other causes of facial pain.

This clip is taken from our full episode, where he covers:
• what trigeminal neuralgia actually is
• why it causes sudden, electric shock pain
• the four main TN categories
• a simple 4-point checklist to recognise TN early
• how to separate TN from dental or TMJ pain
• when you need an MRI and what it should look for
• red flags that need urgent review
• who diagnoses and treats trigeminal neuralgia
• treatment pathways in Australia

If you have been searching terms like “electric shock pain in face”, “tooth pain but dentist says nothing is wrong”, or “jaw pain one side”, this may finally help you make sense of what is going on.

Watch the full episode here: https://youtu.be/zDW-d1cYJyE

Electric shocks in your face?Before you blame your teeth, hear this.A huge number of people with trigeminal neuralgia sp...
25/11/2025

Electric shocks in your face?
Before you blame your teeth, hear this.

A huge number of people with trigeminal neuralgia spend months or years chasing dental answers that never fix the pain.

Our new video breaks down the 4 signs that separate nerve pain from tooth pain, and why getting this wrong delays the right diagnosis.

If you’ve had:
• sudden electric pain on one side of your face
• pain triggered by brushing, chewing or talking
• normal dental scans
• pain that disappears between attacks

This video could finally make sense of it.

Coming Friday 28 November 2025.

Subscribe on YouTube so it lands straight in your feed:
https://ow.ly/qfLG50XwzgE

Phentolamine and Chronic Pain: Why Scientists Are Paying AttentionPhentolamine is an old medication mainly used for bloo...
23/11/2025

Phentolamine and Chronic Pain: Why Scientists Are Paying Attention

Phentolamine is an old medication mainly used for blood pressure issues and reversing dental anaesthetic. But new research suggests it may have an unexpected effect on the nerves that drive chronic pain.

Your body has different pain fibres.
A-delta fibres carry sharp, quick pain.
C-fibres carry slow, burning, ongoing pain, the type that becomes overwhelming when it never stops.

The study looked at nerve tissue from mice, pigs and humans. Across every species, phentolamine reduced activity in C-fibres far more than A-delta fibres. The higher the dose, the more these slow pain signals dropped.

The researchers also used mice that lacked two sodium channels, NaV1.8 and NaV1.9. These channels help nerves fire. Without them, C-fibres became less sensitive to phentolamine. Patch clamp tests confirmed the reason. Phentolamine blocks sodium channels, especially NaV1.8, which is heavily found on C-fibres.

What does this mean for people with chronic pain?

It suggests phentolamine is doing more than blocking adrenaline receptors. It may be directly calming the very fibres that produce burning, ongoing pain. Current pain medicines often affect the whole nervous system, which can lead to tiredness or brain fog. A treatment that targets only the fibres responsible for chronic pain would be a major step forward.

Phentolamine is not a chronic pain treatment yet, but this research points toward future medicines designed to block C-fibres more precisely. For people living with neuropathic pain, burning pain or chronic itch, that is a promising direction.

PSA’s view
This type of research matters. Targeted C-fibre drugs could change how we treat nerve pain. It is early, but it moves us toward treatments that calm the right nerves without unwanted side effects.

If you live with nerve-related pain, what change in your symptoms would matter most to you?

https://ow.ly/CpGP50Xwz2c

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Richmond, VIC
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Pain is the centre of our world because we know it's the centre of yours. We're a pain control clinic staffed by specialists & leaders in pain management.