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.

10/06/2026

Told you need neck surgery? Here's what a leading spine surgeon wants you to know.

This week on The Pain Diaries Podcast, Dr. Nick Christelis, sits down with A/Prof Aaron Buckland, an Australian spine surgeon who trained at NYU Langone Health in New York and spent five years there as faculty before coming home to Melbourne.

In this episode he tells me something most spine surgeons won't say out loud.
"I've never told a patient they need surgery."

We talk about:
- When ACDF surgery is actually the right answer, and when it isn't.
- Why ACDF treats arm pain more reliably than neck pain (and why this matters before you sign the consent form).
- How cervical disc replacement compares to fusion at C5-C6 and C6-C7.
- Adjacent segment disease - the long-term risk patients are rarely told about before surgery.
- The 6-month decompression window - and why timing matters for nerve pain.
- Why "failed back surgery" and "failed neck surgery" are the wrong terms — and what persistent spinal pain syndrome actually means.
- What to do if you've already had spine surgery and you're still in pain.

If you're trying to decide whether you really need neck surgery, or if you've already had ACDF and you're still in pain, this conversation will give you the questions worth asking before your next decision.

Full episode on YouTube: https://ow.ly/hcq850Z9JhT

If you've had spine surgery and you're still in pain, that's exactly who we see at Pain Specialists Australia. A normal scan doesn't mean the pain isn't real. It means the diagnosis needs to go deeper.
Book an assessment: https://ow.ly/R3oS50Z9JhV

"It feels like molten lava on my skin. All the time." If that sentence made you nod, this may be for you.The shingles ra...
31/05/2026

"It feels like molten lava on my skin. All the time." If that sentence made you nod, this may be for you.
The shingles rash healed weeks, maybe months ago. You've been told the shingles is "over." So why does your skin still burn? Why does a bedsheet feel like sandpaper? Why does the pain get worse the moment the lights go off?

People don't imagine it. And it's not slow healing. It's called postherpetic neuralgia.

The shingles virus damaged the nerve itself, and that injured nerve keeps firing pain signals long after the infection has gone. That's why the skin looks normal while the pain is anything but.

Here's something worth knowing: if gabapentin or pregabalin isn't giving you enough relief, other options may exist.

Those medications work across your whole body. But this pain often comes from one specific damaged nerve, the dorsal root ganglion (shown in the diagram). A systematic review of interventional treatments found moderate evidence that targeting that exact nerve directly, with a non-burning procedure called pulsed radiofrequency, can reduce pain for suitable patients.

That review: Aggarwal A, et al. Post-herpetic Neuralgia: A Systematic Review of Current Interventional Pain Management Strategies. J Cutan Aesthet Surg. 2020;13(4):265-274. https://ow.ly/BnvA50Z3sgu

We've also written a full, plain-English guide to PHN. What happens to the nerves, why it hurts this much, and options to consider. https://ow.ly/AGEG50Z3sgs

Pain Specialists Australia | Richmond • Heidelberg • Sandringham (Bayside)

As always; general information, not medical advice. Treatment suitability varies and requires individual specialist assessment

24/05/2026

Ketamine for chronic pain: real treatment or hype?

Ketamine acts on the NMDA receptor and may help some patients with central sensitisation when other treatments haven't, but it's off-label, not for everyone, and used very differently from ketamine for depression.

In our new episode of The Pain Diaries, two of our pain specialists, Dr. Nick Christelis and Dr. Roshan Tawale, give the clinical reality, how it works, who it may suit, and who should avoid it.

Watch the full episode here: https://ow.ly/C5iV50Z3w2Q

Remember, Ketamine is not TGA-approved for chronic pain; any use is off-label. General education only, not medical advice.

FInd us here https://ow.ly/LG7n50Z3w2U

24/05/2026

Shingles gone but the pain won't stop?

That burning, stabbing nerve pain is called postherpetic neuralgia (PHN), and if gabapentin or pregabalin isn't enough, other options may exist.

Pain specialists, Dr.Nick Christelis & Dr. Roshan Thawale, explain why PHN happens and what can help. https://youtu.be/J_Gax7XMJsA

Remember, general educational information, not medical advice.

Shingles cleared up. The nerve pain didn't.If that's your experience - or someone you care for - you're not imagining it...
10/05/2026

Shingles cleared up. The nerve pain didn't.

If that's your experience - or someone you care for - you're not imagining it, and you're not alone.
What you're describing has a name: Post-Herpetic Neuralgia (PHN).

It's caused by permanent nerve injury from the varicella-zoster virus, and it doesn't always respond to standard medications like gabapentin or pregabalin.

In our latest video, Dr Nick Christelis - Specialist Pain Medicine Physician (FFPMANZCA) - explains:
✅ Why the pain continues long after the shingles rash heals
✅ Why first-line medications often fail to provide lasting relief
✅ What Pulsed Radiofrequency (PRF) of the Dorsal Root Ganglion actually is - and why it targets the nerve injury at the source
✅ The 3-month rule - when to stop waiting and see a specialistThis is the information every shingles patient deserves access to early.

📺 Watch now → https://ow.ly/GCl150YWsrV

Know someone still suffering after shingles? Please share this with them. 💙

Get in touch here: https://ow.ly/WtP450YWsrX

03/05/2026

The "Perfect" Scan Paradox: Why Nighttime Pain Persists After Surgery

It is a challenging scenario for both patient and clinician: the surgery was successful, the hardware is pristine, yet the patient cannot sleep due to persistent burning or "electric" sensations in the knee.

When the structural "plumbing" is fixed, why does the pain remain?

The Neuropathic Explanation
Clinical evidence suggests that persistent post-surgical pain may be related to the nervous system rather than the joint itself. Processes such as nerve sprouting and peripheral sensitization can cause injured nerves to remain in a state of "high alert," a phenomenon that often intensifies at night.

"Research indicates that for many surgical procedures, there is approximately a one in five risk of developing persistent pain." — Dr. Nick Christelis.

In our latest discussion, we explore why an accurate clinical diagnosis is essential to identifying these "wiring" issues that standard X-rays often miss.

(Note: Sarah is a hypothetical case used for illustrative purposes.)

Watch the Full Podcast: https://ow.ly/8SrY50YLw08

26/04/2026

The Clinical Paradox: When "Perfect" Surgery Doesn’t Resolve Pain

It is a common scenario in clinical practice: the surgeon is satisfied, the post-operative X-rays are textbook, but the patient continues to experience persistent pain. When the "structure" of the joint has been successfully addressed, why does the pain remain?

The Role of the Nervous System
Clinical research suggests that post-surgical pain can often be a "wiring" issue rather than a "plumbing" issue. When a nerve is affected during surgery, the body initiates a healing process. In some cases, this can lead to peripheral sensitization or nerve sprouting, where the nervous system remains in a state of "high alert."

"Research indicates that across many surgical procedures, there is approximately a one in five risk of developing persistent pain." — Dr. Nick Christelis.

In our latest clinical deep-dive, Dr. Nick Christelis and Dr. Andy Kwok discuss why the nervous system may require a "reset" through targeted neuromodulation and advanced diagnostic strategies.

Find the clinical source of your pain:
📺 Watch the Full Podcast: https://ow.ly/lejT50YLvY1

Explore our Knee Pain Clinical Resources:

Understanding Persistent Knee Pain: https://ow.ly/JxfR50YLvY0

Evidence-Based Arthritis Management: https://ow.ly/eIP650YLvY3

Guide to Nerve Blocks & RFA: https://ow.ly/jkGY50YLvY4

19/04/2026

Why a "Textbook" X-Ray May Not Explain Persistent Knee Pain

When a surgical recovery doesn't go as planned, it can be incredibly frustrating. If a surgeon confirms the joint replacement is structurally sound, yet burning, sensitivity, or night pain persists, we must look beyond the "structure" to the nervous system.

Why can pain persist when the hardware is fine? The answer often involves clinical processes like nerve sprouting and peripheral sensitization. When a nerve is affected during surgery, the body’s natural response is to initiate a healing process. This can involve neurons "sprouting" new connections. In some cases, if this process becomes uncontrolled, these new nerves can become hypersensitive, potentially turning normal movement or light touch into a pain signal.

"Research suggests that across various surgeries, there can be approximately a one in five risk of developing persistent pain." — Dr. Nick Christelis.

Our latest deep-dive explores this 20% statistic and discusses why the nervous system may remain sensitized after a knee replacement.

The first step toward management is an accurate clinical diagnosis. Watch the full clinical discussion here: https://ow.ly/NBLF50YLvUO

Clinical Resources & Pathways:

Persistent Knee Pain: https://ow.ly/btxe50YLvUM

Osteoarthritis & Management Options: https://ow.ly/YMB950YLvUK

Guide to Genicular Nerve Procedures: https://ow.ly/ol5350YLvUN

Did your knee burn before surgery? This might explain why it still hurts.“The joint is stable. The X-ray looks perfect. ...
02/04/2026

Did your knee burn before surgery? This might explain why it still hurts.

“The joint is stable. The X-ray looks perfect. Everything is fine.”

If you have heard this but your knee is still burning, zapping, or feels like it is in a vice, you are not alone.

Around 1 in 5 people have ongoing pain after knee replacement.

A 2025 study found that if you had burning, tingling, or nerve-type pain before surgery, you are 2.75 times more likely to develop persistent pain afterwards.

Read the study here
https://ow.ly/5b7350YAqq3

Surgery can fix the joint, but it does not always reset the nervous system.

Nerves can remain overactive.
Pain pathways can stay switched on.
The system can remain in a protective high alert state.

Scans show structure.
They do not show nerve sensitivity or how pain is being processed.

Persistent pain after knee replacement is often not just a joint problem.
It is a nervous system problem.

The key step is identifying the true driver of pain.
Because treating the joint and treating the nervous system are not the same.

More on pain after knee replacements here https://ow.ly/fnuw50YAqq2

Find us here https://ow.ly/VuuS50YAqq1

Did you have burning or tingling before your surgery?
What does your pain feel like now?

Why does a “perfect” knee replacement still hurt months later?Is your knee still burning, tight, or zapping at night? Do...
29/03/2026

Why does a “perfect” knee replacement still hurt months later?

Is your knee still burning, tight, or zapping at night? Does your surgeon say the hardware is "textbook” and all is “fine”?

You aren’t imagining the pain. You are not alone.

Up to 1 in 3 people experience persistent pain after a knee replacement. A major 2025 review in the Journal of Pain Research (Banks et al.) highlights a key fact: Often, the issue is not the implant. The issue is the nervous system surrounding the implant. https://ow.ly/jJkx50YAqpx

The Science of "The Alarm System"
The research explains that surgery can sometimes trigger a process called sensitisation. While the "plumbing" (the joint and hardware) may be fixed, the "wiring" (the nerves) can stay in a "protective" high-alert state.
• Peripheral Sensitisation: Small nerves around the knee, such as the saphenous nerve, can become hyperexcitable. This happens due to direct irritation or inflammatory markers.
• Central Sensitisation: Prolonged pain signals can cause spinal neurons and glial cells to stay "on." This essentially re-wires the spinal cord or brain to maintain a state of pain long after healing is complete.
• The Scan Gap: X-rays and scans see bone and metal. They cannot see nerve sensitivity, neuro-immune activation, or pain processing.

Diagnosis Before Treatment The Banks et al. study makes one thing clear: There is no "one size fits all" treatment for post-surgical pain after a knee replacement. Because the cause of this pain is often a mix of nerve injury and sensitisation and even inflammation. The most important step is getting the right diagnosis first.

An expert who can look past the hardware and identify the specific "pain generator" is required.

Only when the driver of the pain is identified can a targeted treatment plan be created. Specialists with FFPMANZCA qualifications are trained to find these biological answers and treat pain holistically. Remember we have to also treat the person that is suffering from the pain.

Pathways to Relief when standard rehab and medications don’t help, targeted options can help quieten the nervous system:
• Genicular Nerve Blocks: To precisely diagnose the source of pain.
• Radiofrequency Ablation (RFA): To desensitise the nerves for 6 to 12 months.
• Neuromodulation: Advanced and more targeted treatments for nerves to interfere with pain signals at the source.

The team at Pain Specialists Australia focuses on moving people from "technically successful" to "clinically restored."

What does your pain feel like right now? Is it burning, a tight band, or sharp zaps? Are you getting pain at night?

https://ow.ly/qiOy50YAqpz

Get a diagnosis https://ow.ly/eVcp50YAqpy

Address

Level 4, 600 Victoria Street
Richmond, VIC
3121

Opening Hours

Monday 8:30am - 5pm
Tuesday 8:30am - 5pm
Wednesday 8:30am - 5pm
Thursday 8:30am - 5pm
Friday 8:30am - 5pm

Telephone

+611300798682

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