The service consists of a multidisciplinary team, comprising pain physicians, neurosurgeons, neurologists, psychologist and clinical nurse specialists who are involved in triage, assessment and implantation of the stimulators. All patients undergo multidisciplinary assessment before being offered neuromodulation. The clinical service is supported by neurophysiology, for programming and follow up.
Besides being the pivotal service for East London and adjoining area, the service caters to wide geographic area from Hertfordshire, Essex and Kent to East of England. There are strong and established links with community clinics and majority of referrals are triaged from community pain clinics (attended by secondary care pain physicians) into multidisciplinary assessment pathways.
1) Neuromodulation for Intractable Neuropathic Pain
Spinal cord stimulation (SCS) for chronic intractable neuropathic pain due to conditions like radicular back and neck pain, CRPS and previous spinal surgery. This treatment is recommended by the NICE guidelines 159 and DOH The Map of Medicine pathway. We offer SCS with standard settings, high frequency settings, MRI compatible devices as well else devices offering varying frequencies and threshold for better experience.
Pathway for SCS
2) Neuromodulation for Intractable Headache
The tertiary care specialised service consists of a multidisciplinary team, comprising neurologists with headache interest, pain physicians, neurosurgeons, psychologist and clinical nurse specialists who are involved in triage, assessment and implantation of the occipital nerve stimulators (ONS). All patients need to undergo multidisciplinary assessment in a dedicated tertiary care MDT Headache clinic before being offered neuromodulation for headache as per the NICE interventional procedures guidance IPG 452. The follow up service is supported by neurology and pain medicine teams for programming and clinical follow up as per the Barts Headache Neuromodulation Pathway (see below). Besides being the pivotal service for East London and adjoining area, the service caters to wide geographic area and we are currently one of the most active and leading implanting centres for ONS for intractable headache in the country. There are strong and established links with secondary care neurology clinics across the region and all referrals are triaged from secondary neurology clinics (assessed by neurologist with headache interest) into multidisciplinary assessment pathway.