Chronic Pain Management

Chronic pain is a result of various persistent syndromes associated with neurological conditions. Are your chronic pain symptoms affecting your quality of life?

Consult our senior consultant neurosurgeon today for an accurate diagnosis and personalised treatment plan.

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Dr Keith Goh

What Is Chronic Pain

Chronic pain is a result of various persistent syndromes associated with neurological conditions. It is a prolonged form of pain, extending beyond the normal course of acute injury or illness, typically lasting longer than three months.

Unlike acute pain, which is usually a temporary response to tissue damage, chronic pain can be ongoing and may not have a clear underlying cause.

Types of Chronic Pain

Chronic pain can be categorised into various types, each with distinct characteristics and underlying mechanisms.

  • Neuropathic Pain: This arises from damage to the nerves or the nervous system. Conditions such as post-stroke pain, post-traumatic pain, and neuropathies fall into this category. Patients often describe a burning, shooting, or electric shock-like sensation.
  • Nerve Impingement Syndromes: These involve the compression or irritation of nerves. Examples include sciatica, chronic neck and back pain, and carpal tunnel syndrome. The pain is often localised to the path of the affected nerve.
  • Headaches and Facial Pain: This group includes conditions like trigeminal neuralgia and various types of migraines and headaches. The pain can range from severe, stabbing pain in the case of neuralgias to throbbing or pulsating pain in migraines.

Causes of
Chronic Pain

Chronic pain can originate from a variety of sources. Identifying the cause can help manage and treat the pain effectively.

  • Nerve Damage or Dysfunction: Conditions such as diabetic neuropathy or post-herpetic neuralgia result from direct damage to the nerves, leading to chronic pain.
  • Central Nervous System Disorders: Diseases like multiple sclerosis or conditions resulting from stroke can affect the brain or spinal cord, leading to persistent pain.
  • Physical Injury or Trauma: Injuries, especially those that affect the nerves or spinal cord, can lead to chronic pain. This includes trauma from accidents or surgical procedures.
  • Cancer: Tumours can exert pressure on nerves or other structures in the body, resulting in chronic pain. Additionally, treatments for cancer, such as chemotherapy, can also cause neuropathic pain.
  • Degenerative Conditions: Diseases like osteoarthritis or spinal stenosis involve the gradual deterioration of body tissues, often leading to chronic pain.

Symptoms and Signs

Chronic pain presents with various symptoms and signs that vary based on the underlying condition.

  • Pain: Patients often report pain as burning, stabbing, shooting, aching, or electric shock-like sensations. It may be constant or intermittent. The pain can be localised to one area or spread along the path of a nerve. For instance, sciatica typically causes pain that radiates from the lower back down to the legs.
  • Tingling, Numbness or Loss of Sensation: Alongside pain, there might be tingling, numbness, or a loss of sensation, indicative of nerve involvement.
  • Functional Limitations: Chronic pain often restricts mobility or the ability to perform daily activities, affecting a patient’s quality of life.
  • Muscle Weakness: In some cases, there may be observable signs like muscle weakness.


Diagnosis of chronic pain involves a detailed assessment to determine the underlying cause and appropriate treatment plan.

  • Medical History Review: This encompasses an evaluation of the patient’s medical history, including any prior injuries, surgeries, and the onset and progression of pain symptoms.
  • Physical Examination: A thorough physical examination is conducted to assess pain location, nerve function, muscle strength, and reflexes.
  • Neurophysiology: These tests can help evaluate nerve damage and dysfunction. They may include nerve conduction studies and electromyography.
  • Imaging Studies: Techniques like MRI, CT scans, and X-rays help visualise internal structures and identify potential causes of pain such as spinal cord issues or nerve compression.

Treatment Methods

Treatment methods are highly specific, targeting the underlying causes and mechanisms of pain. Each option is selected based on a thorough evaluation of the patient's specific chronic pain condition, their overall health, and their response to previous treatments.

  • Microvascular Decompression: Primarily used for trigeminal neuralgia, this procedure involves repositioning blood vessels to relieve pressure on the trigeminal nerve. The aim is to relieve this pressure without damaging the nerve itself, thereby reducing or eliminating pain.
  • Gamma Knife Radiosurgery: This non-invasive technique is especially beneficial for patients with trigeminal neuralgia. It delivers targeted, high-dose radiation precisely to the areas in the brain related to pain transmission, without the need for a surgical incision. This method is recognized for its targeted precision and generally shorter recovery time.
  • Nerve Release Decompression Surgery: Applied in conditions like carpal tunnel syndrome, this surgery aims to alleviate pressure on entrapped nerves. By enlarging the space around the nerve, it can reduce pain and restore function to the affected area.
  • Nerve Block Injections: These injections are used to temporarily alleviate pain by directly applying anaesthetic or anti-inflammatory medication near the nerves causing pain. They are commonly used for chronic back pain or severe headaches.
  • Spinal Cord Stimulator and Intrathecal Pump Devices: In cases of severe pain, devices like spinal cord stimulators or intrathecal pumps may be implanted. Spinal cord stimulators emit electrical pulses to interrupt pain signals before they reach the brain, while intrathecal pumps deliver pain medication directly into the spinal fluid, offering continuous pain control.
  • Medical/Pharmacologic Therapy: Medication is often required to control the symptoms of neuropathic pain and its associated problems, especially insomnia and depression. Psychological assistance is often required to provide support for mental health issues.

Schedule An Appointment With Us

Are Your Chronic Pain Symptoms Affecting Your Quality Of Life?

Consult our senior consultant neurosurgeon for an accurate diagnosis & personalised treatment plan.

Dr. Keith Goh






With more than 20 years of experience in the field of Neurosurgery, Dr Keith Goh’s subspecialty includes treatment of brain and spinal cord tumours and pediatric neurosurgery.

He is the Medical Director of International Neuro Associates, which is based at Mount Elizabeth Medical Centre, and provides specialist neurological services to all the hospitals within the Parkway Pantai hospital group. He also was Honorary Associate Professor of Neurosurgery at the Prince of Wales Hospital of the Chinese University of Hong Kong.

  • Bachelor of Medicine & Surgery — National University of Singapore
  • Neurosurgical Residency at the Chinese University of Hong Kong
  • Advanced specialty training in paediatric neurosurgery at the Beth Israel Institute of Neurology & Neurosurgery in New York

His bibliography includes 40 original articles, 11 book chapters, and 104 abstracts and lectures on his various research interests, such as brain tumours, spinal cord tumours, head trauma, conjoined twins and congenital malformations in children.


Mount Elizabeth Medical Centre,
#09-10, 3 Mount Elizabeth
Singapore 228510

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    Frequently Asked Questions

    What Happens if Chronic Pain Goes Untreated?

    Untreated chronic pain can result in various complications. Over time, the pain may be exacerbated, as the underlying condition remains untreated. Timely treatment from a qualified neurosurgeon can help manage the pain and reduce the risk of complications.

    Can You Fully Recover from Chronic Pain?

    Recovery from chronic pain depends on its cause and the individual’s overall health. While some conditions can be effectively treated, leading to pain reduction or remission, other types of chronic pain may require ongoing management. Consult your neurosurgeon or qualified specialist to gain insight into the prognosis and treatment options available.

    Can Exercise Help Treat Chronic Pain?

    Exercise can be an effective component in treating chronic pain. It helps strengthen muscles, improve flexibility, and release endorphins, which are natural pain relievers. Approach exercise carefully and under the guidance of a qualified specialist, to ensure that the exercise regimen is suitable for the specific pain condition.