Chronic Pain Treatment in Marylebone, London

Pain that lasts beyond three months behaves differently from pain that follows an injury. The original problem may have healed, or may never have been found on a scan, and yet the pain continues and often spreads. Ordinary touch, pressure or a change in temperature can start to register as painful. Flare-ups begin to track stress and activity rather than new damage.

The name for that change is central sensitisation. Your nervous system stays in a heightened state of reactivity, so signals that should be filtered out are amplified instead. Two things are happening at once. The spinal cord and brain turn the volume up, and the brain stem pathways that normally damp pain down work less well. This is why treating only the tissue so often disappoints.

Magnetic stimulation targets that processing directly. In pain, the usual brain target is the primary motor cortex rather than the prefrontal cortex used in depression. Stimulating it is understood to act on the descending pathways that regulate how much pain reaches you. Where the problem sits in a specific nerve or muscle instead, peripheral magnetic stimulation treats that site in the body, from £250 a session.

The evidence is narrower here than in depression and it depends on the type of pain. The 2020 international consensus guidelines from Lefaucheur and colleagues, in Clinical Neurophysiology, treat high-frequency stimulation of the motor cortex for neuropathic pain as one of the better-supported uses of rTMS. For other pain presentations the studies are smaller and less consistent, and your clinician will tell you which group you fall into before you commit to a course.

What we will not do is treat you as a diagnostic dead end. Your pain is assessed properly, the mechanism is explained in words you can repeat to someone else, and progress is measured with the same tools at the start, the middle and the end.