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.

19/01/2026

Trigeminal Neuralgia pain can be invisible on MRI.

Many people with trigeminal neuralgia are told their scan is “normal” or that nothing serious is going on, yet the pain is relentless, debilitating, and life-altering.

In this episode of The Pain Diaries Podcast, pain specialist Dr Nick Christelis speaks with highly experienced neurosurgeon Dr Jeremy Russell about how trigeminal neuralgia is really diagnosed, why MRI reports are often misleading, and why listening to the patient matters more than the scan.

We discuss:
• Why TN is a clinical diagnosis, not a scan diagnosis
• How MRI scans can miss the real cause of facial pain
• When microvascular decompression (MVD) works — and why it sometimes doesn’t
• What “nerve combing” (internal neurolysis) is and when it’s considered
• Other treatment options, including Gamma Knife and balloon compression
• The psychological toll of severe facial pain

If you’re living with facial pain, have been told your MRI is normal, or feel stuck with no clear answers, this conversation may help you understand what to ask next.

▶️ Watch the full episode here: https://youtu.be/LrFqpYPc3xY

14/01/2026

That is the blunt reality check most back pain patients don't expect to hear from a surgeon.

In this episode, Neurosurgeon Dr. Jeremy Russell reveals why he refuses to operate on most back pain cases and why "treating the MRI" instead of the patient is a recipe for disaster.
If you are considering spinal surgery or fusion, you need to hear this first.

WATCH THE FULL EPISODE: https://youtu.be/XZ1L93YtRjY

08/01/2026

⚡️ RFN vs PRF: The Cheat Sheet

Confused by the acronyms? Here is the simple breakdown:

1️⃣ RFN (Radiofrequency Neurotomy): Uses heat to "burn" or lesion the nerve. Great for facet joint pain.
2️⃣ PRF (Pulsed Radiofrequency): Uses energy bursts to "stun" or reset the nerve. Often better for sensitive areas.

Choosing the wrong one is a common reason why treatments fail.

Dr. Anthony Njo and Dr. Nick Christelis explain exactly how to choose the right path in this week's episode of the Pain Diaries Podcast
👇👇👇
https://ow.ly/gOE150XTmWv

Find us here: https://ow.ly/QQ7P50XTmWx

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

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Level 4, 600 Victoria Street
Richmond, VIC
3121

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Monday 8:30am - 5pm
Tuesday 8:30am - 5pm
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Thursday 8:30am - 5pm
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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.