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.

Coming Soon: Why Does Knee Pain Persist After a “Perfect” Knee Replacement?We are putting the final touches on our next ...
11/03/2026

Coming Soon: Why Does Knee Pain Persist After a “Perfect” Knee Replacement?

We are putting the final touches on our next YouTube video looking at one of the most frustrating experiences patients face after surgery.

Your knee replacement looks perfect on X-ray.
Your surgeon says the operation went well.
But months later the pain is still there.

If this sounds familiar, you are not alone. Around 1 in 5 patients experience chronic pain after knee replacement surgery. This condition is known as chronic post-surgical pain (CPSP) and it is increasingly recognised as a problem of pain biology and nerve signalling, not simply joint mechanics.

Our upcoming video explores exactly why this happens and what can be done about it.

In the meantime, a recent review paper provides an excellent overview of the science behind this condition.

Banks DW, Park H, Oehlermarx W, et al. Chronic Post-Surgical Pain After Hip and Knee Arthroplasty: An Update on Mechanisms, Risk Factors, and Interventional Treatment Modalities. J Pain Res. 2025 Nov 20;18:6205-6219. https://ow.ly/CKae50YsChi

The authors highlight several important themes.

Why pain can persist after joint replacement
• Changes in the way nerves around the joint transmit pain signals
• Central sensitisation, where the nervous system becomes hypersensitive
• Ongoing inflammation and neuro-immune activation
• Pre-existing pain conditions that prime the nervous system

Who may be at higher risk
• Patients with severe pain before surgery
• Anxiety, depression, or pain catastrophising
• Widespread pain conditions such as fibromyalgia
• Surgical and tissue factors affecting nerve pathways

Emerging treatment approaches
• Targeted nerve blocks
• Genicular nerve procedures
• Radiofrequency neurotomy
• Neuromodulation strategies in selected patients

The key message is simple but important.

Persistent pain after joint replacement is real.
And understanding the underlying neurobiology of pain is often the first step toward finding better treatment options.

Our new video breaking this down for patients and families will be released within the next 48 hours.

Check out our YouTube channel here https://ow.ly/8ogj50YsChe

Get in touch here https://ow.ly/UZu050YsChh

In the meantime, if you have experienced pain after a knee replacement, what is the one question you would most like answered about why this happens?

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

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

Website

Alerts

Be the first to know and let us send you an email when Pain Specialists Australia posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to Pain Specialists Australia:

Shortcuts

Share

Share on Facebook Share on Twitter Share on LinkedIn
Share on Pinterest Share on Reddit Share via Email
Share on WhatsApp Share on Instagram Share on Telegram

Category

The story of 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.