Chronic Pain Treatment in London
Living with persistent pain that hasn’t settled deserves proper specialist assessment, not just another appointment. Dr Yasser Mehrez is a Consultant in Pain Medicine and Anaesthesia with 20+ years of NHS and private practice experience, based at 107 Harley Street, London.
-
Same-week
appointments -
20+ years
experience -
Harley Street plus
6 regional clinics
- Same-week Appointments
- No GP referral needed for self-pay
- Harley Street plus 6 regional clinics
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Understanding Chronic Pain
Living with pain for months, not days, changes daily life. Sleep, work and simple tasks all get harder, the pain itself can start to feel unpredictable.
Persistent pain does not always mean something serious is wrong, but it does mean your body is responding differently than it did to a short-term injury. A specialist assessment, as part of our wider pain management service, can help identify what’s driving it and which treatment is likely to help.
Chronic pain is common in the UK. A 2016 study in BMJ Open estimated that 43.5% of UK adults live with it, rising to around 62% among people over 75.
Why Chronic Pain Is Different: Understanding the Pain Cycle
Chronic pain often works differently from an injury that heals on its own, and understanding why can make sense of a lot of what follows. It also explains why relief sometimes needs more than one kind of treatment.
The Pain Cycle: How Chronic Pain Feeds Itself
Acute pain usually starts with an injury or illness and improves as the body heals. Chronic pain can continue well past the expected healing period, with the pain signal still firing after the injury has settled.
Moving less because it hurts can lead to stiffness and reduced fitness, which makes movement harder still. Poor sleep and stress add further strain on top.
Over time, the nervous system itself can become more sensitive to pain, a process sometimes called central sensitisation. This helps explain why chronic pain does not always settle the way an acute injury does.
Chronic Primary vs. Chronic Secondary Pain
Current UK guidance from NICE distinguishes between chronic primary and chronic secondary pain, and the difference shapes how each is assessed. Chronic secondary pain is linked to an underlying condition, such as osteoarthritis, endometriosis or back pain from a clear structural cause.
Chronic primary pain has no single identifiable cause, or the pain is out of proportion to any visible injury, as with fibromyalgia or chronic widespread pain. Because both types can occur together, a proper assessment matters before deciding on treatment.
What Causes Chronic Pain?
Chronic pain can have several possible causes. Sometimes there is a clearly identifiable condition behind it; in other cases, investigations do not point to one single cause.
Chronic Pain Following Injury or Surgery
Pain can continue after an injury or operation, even once the original tissue has healed, including back pain that has become chronic.
Nerve damage can also cause pain to continue beyond the expected healing period. An assessment can help determine whether persistent post-surgical pain points to nerve pain, inflammation, an underlying structural problem, or something else.
Chronic Pain Linked to an Underlying Condition
Chronic pain can occur alongside conditions such as arthritis, diabetes, IBS, endometriosis and fibromyalgia. If you have fibromyalgia, treatment may need to address both the condition itself and how the pain affects your daily life.
The right approach therefore depends on the condition, the type of pain, and any other health problems or medicines involved.
Chronic Pain Without an Obvious Cause
Sometimes tests or scans do not show a clear structural cause for pain. A normal scan does not mean the pain is not real; it can simply mean imaging alone cannot capture every factor contributing to your symptoms.
That is why a specialist assessment looks at your symptoms, medical history, examination findings and previous treatments. It also considers how pain affects your life, and arranges further tests where clinically appropriate.
Symptoms & the Wider Impact of Chronic Pain
Chronic pain rarely stays contained to where it hurts. It tends to spread into daily life in ways that are easy to underestimate until you’re living with them.
Do You Recognise Any of These Symptoms?
Sleep and fatigue
Pain can disturb sleep and leave you feeling tired through the day.
Movement and activity
Pain may make everyday movement, exercise or physical activity more difficult.
Mood and mental wellbeing
Ongoing pain can affect your mood and make daily life feel harder.
Work and daily activities
Pain can interfere with work, study and everyday tasks.
Relationships and social life
Pain can affect the time and energy you have for family and friends.
Concentration and enjoyment
Pain and poor sleep can make it harder to concentrate or enjoy things.
These effects can overlap. If pain has been affecting more than just your body, your sleep, your mood, your work, it is worth talking to someone who treats the whole picture.
Our Multidisciplinary Approach to Chronic Pain Management
Chronic pain rarely has one single cause, which is exactly why one treatment on its own is rarely the whole answer. The pain cycle above shows how physical, psychological and lifestyle factors can all feed into ongoing pain. Treatment works best when it addresses more than one of them at the same time.
Your care may include:
- Pain Medicine Assessment: Understanding your symptoms, diagnosis and treatment options.
- Specialist Nursing Support: Helping with treatment, symptom management and ongoing care.
- Physiotherap: Supporting movement, strength and physical activity.
- Clinical Psychology: Helping with the emotional and psychological effects of living with pain.
- Medication Review: Reviewing your current medicines and whether they remain appropriate.
- Interventional Procedures: Considering procedures such as nerve blocks, epidural injections or radiofrequency treatment when suitable.
Expert Assessment. Accurate Diagnosis. Personalised Care.
Dr Mehrez brings these disciplines together around one treatment plan, rather than treating each issue in isolation. That coordinated approach reflects how chronic pain guidance describes good management: addressing the physical, psychological and lifestyle factors together, not one at a time
How We Diagnose & Assess Chronic Pain
Dr Mehrez looks at the whole picture, not just the site of pain, before recommending treatment.
Not sure which service is right for you?
Book a consultation to specifically diagnose your chronic pain
and discuss your options.
| What We Look At | What It Tells Us |
|---|---|
Your Pain | Where it is, when it started, how it has changed. |
Your Daily Life | Effect on sleep, movement, work, everyday activities. |
Medical History | Previous diagnoses, operations, investigations, treatments. |
Medicines | What you take now, and any concerns about them. |
Physical Health | Relevant examination findings. |
Wider Health | Psychological and lifestyle factors affecting your pain. |
Your Goals | What you want treatment to help you do. |
Bring any previous scans, test results or medical letters to your appointment. A new scan or MRI beforehand is not usually necessary, because further tests are arranged only where they would genuinely help
The information above is general. It is not a substitute for individual medical advice.
Chronic Pain Treatment Options in London
There is no single best treatment for every type of chronic pain. The most appropriate plan depends on the cause, your symptoms, examination findings, previous treatment and your goals.
Interventional Pain Procedures
For pain linked to a specific, identified source, an image-guided procedure can sometimes reduce pain enough to make rehabilitation possible. For example, epidural injections can help with selected spinal pain and inflammation. Radiofrequency treatment uses controlled heat to reduce signalling from nerves causing ongoing pain, and nerve blocks can help identify or treat a specific source of pain.
These procedures are considered for chronic secondary pain, where a cause has been identified, rather than used as a default first step. Dr Mehrez will discuss whether one is appropriate for your specific diagnosis, along with the realistic benefits and risks.
Neuromodulation
Neuromodulation uses electrical stimulation to change how pain signals are processed by the nervous system. It may be an option for selected patients whose pain has not improved sufficiently with other treatments, most often for certain types of long-standing nerve-related pain.
Suitability always depends on a detailed assessment. Where appropriate, Dr Mehrez can then arrange it as part of your wider treatment plan.
Medication Review & Management
Medication can play a role in managing chronic pain. For chronic primary pain, though, current UK guidance from NICE has moved away from long-term opioids and several other medicines as a default option. The evidence for lasting benefit is limited, and the risks, including dependence, are real.
NICE instead points toward supervised exercise and psychological therapies for chronic primary pain. In some cases it also considers specific medicines usually used for other conditions, alongside a broader treatment plan.
This does not mean medication has no place. Chronic secondary pain, where a clear cause has been identified, is assessed differently, and any medication decision is made with you, based on your own diagnosis and history.
Psychological & Physical Support
Physiotherapy, pacing and psychological support, such as cognitive behavioural therapy, are central to managing chronic pain well, not an alternative to "real" treatment. They address the deconditioning, activity avoidance and emotional impact described in the pain cycle above, working alongside any procedure or medication rather than instead of it.
Dr Mehrez's multidisciplinary team can also bring these elements into your plan where they are likely to help.
20+
Year's Experience
Consultant
Since 2007
Meet Dr Yasser Mehrez
Consultant in pain medicine
Dr Yasser Mehrez is a Consultant in Pain Medicine and Anaesthesia with 20+ years of NHS and private practice experience. A consultant since 2007, he holds FRCA and FFPMRCA qualifications. He is registered with the General Medical Council under number 5171889.
He is Lead Clinician for Chronic Pain at Milton Keynes University Hospital and founded a community-based multidisciplinary pain clinic. His practice covers chronic pain assessment and a range of interventional procedures.
Dr Mehrez also undertakes medico-legal assessments for solicitors, including cases involving complex regional pain syndrome, whiplash-associated disorder and chronic widespread pain claims.
What to Expect: Your Treatment Journey
We’re with you at every stage, from your first consultation to ongoing care and support.
Consultation
Tell us about your pain, previous treatment and goals
Assessment & Diagnosis
We assess your symptoms, history and existing results
Personalised Plan
We explain your options and agree your treatment plan
Treatment
Your agreed treatment begins based on your diagnosis and plan
Recovery & Rehab
We support your recovery with tailored rehabilitation and guidance
Follow-up & Relief
We review your progress and adjust your plan as needed
Dr Mehrez leads your assessment and treatment from diagnosis through to follow-up.
Access coordinated care from pain specialists, nurses, physiotherapists and psychologists via the Pain Management service.
What Our Patients Say
I had a complicated issue and Dr Mehrez was thorough and understanding, took the time to explain so I knew the risks, even making diagrams that even I could (mostly) understand.
24 July 2025 A.L.
Excellent service over the last 18 months with clear explanations and continued support with my chronic pain
12 December 2024 J.P.
Incredible doctor. Very easy to talk to, makes sure that you understand the risks of each procedure. I felt extremely confident in his company and with his work. Would highly recommend. Not only that he has worked magic and I am no longer living in pain!
28 November 2024 C.C.
Dr. mehrez treated my longstanding coccyx pain. He was very kind listed to my problems and made me feel at ease. Most importantly I am now much better and couldn’t be happier. Very pleased.
5 September 2024 E.G.
Visit Our Harley Street Clinic
Our main clinic is on Harley Street in central London. Consultations are also available at several hospitals across the wider region.
Dr Yasser Mehrez Pain Clinic
Availability, fees and treatment options vary by location. Contact the clinic before travelling to confirm the relevant location and appointment arrangements.
Other Locations
Dr Mehrez also consults at:
- Saxon Clinic, Milton Keynes
- New Foscote Hospital, Banbury
- Three Shires Hospital, Northampton
- Royal Buckinghamshire Hospital, Aylesbury
- Spire Harpenden Hospital, Harpenden
- Wellington Hospital, London
Frequently Asked Questions About Chronic Pain
The information below is general and does not replace individual medical advice. If your symptoms are severe, getting worse, or you develop new weakness, numbness, or loss of bladder or bowel control, seek urgent medical attention.
Understanding Chronic Pain
How long does pain have to last before it is considered chronic?
Pain is generally considered chronic when it persists or recurs for more than three months. Duration alone does not identify the cause or determine the right treatment; assessment also considers your symptoms, medical history and how pain affects your daily life.
What is the difference between chronic primary pain and chronic secondary pain?
Chronic secondary pain is linked to an underlying condition that adequately explains the pain or its impact. Chronic primary pain has no clear underlying condition that adequately explains it. Both types can occur together, so a proper assessment is important.
Can chronic pain occur even when scans and tests look normal?
Yes. Scans and tests do not show every factor that can contribute to pain, and a normal result does not mean the pain is not real. Your symptoms, examination, medical history and how pain affects your daily life are also considered.
Is chronic pain the same as fibromyalgia?
No. Chronic pain describes pain that persists or recurs for more than three months. Fibromyalgia is a condition associated with chronic primary pain and can involve widespread pain, fatigue and increased sensitivity to pain.
Why can stress make chronic pain feel worse?
Stress can affect sleep, muscle tension, activity and emotional wellbeing, and these factors can influence how pain feels day to day. This does not mean the pain is psychological or imagined; understanding these factors can help with managing symptoms and daily activities.
Diagnosis & Treatment
What is the best treatment for chronic pain?
Success rates vary by individual and cause, and no clinic can honestly guarantee a result. Epidurals also target sciatica rather than back pain on its own. Dr Mehrez will talk through the evidence relevant to your case rather than quoting a figure.
Can chronic pain be cured, or only managed?
For most back pain, a pain management consultant is the right first specialist to see, offering non-surgical, image-guided treatment. An orthopaedic or spinal surgeon becomes relevant where a clear structural problem needs surgical assessment. Dr Mehrez can advise which applies to you.
Do I need a scan or MRI before seeing a pain specialist?
Pain lasting more than three months is generally classed as chronic and is common, but it’s not something to simply live with. It’s worth getting a specialist assessment for chronic back pain lasting more than 12 weeks if you haven’t already.
What does current UK guidance from NICE say about treating chronic pain?
Prolonged sitting, particularly with poor posture or an unsuitable chair, is a genuine contributing factor to back pain. It’s rarely the only cause, so a proper assessment still matters if the pain persists.
Why might a pain specialist recommend against long-term opioid use?
Most back pain doesn’t need surgery. Generally, image-guided injections and conservative treatment are the right first step. Surgery is considered where there’s a specific structural cause that hasn’t responded to less invasive options, and where imaging matches your symptoms.
Still have questions? Speak to Dr Mehrez directly.
What is neuromodulation and how does it help chronic pain?
Most back pain doesn’t need surgery. Generally, image-guided injections and conservative treatment are the right first step. Surgery is considered where there’s a specific structural cause that hasn’t responded to less invasive options, and where imaging matches your symptoms.
Still have questions? Speak to Dr Mehrez directly.
How soon can I expect to feel the benefit of treatment?
Most back pain doesn’t need surgery. Generally, image-guided injections and conservative treatment are the right first step. Surgery is considered where there’s a specific structural cause that hasn’t responded to less invasive options, and where imaging matches your symptoms.
Still have questions? Speak to Dr Mehrez directly.
Living With Chronic Pain
Can chronic pain affect mental health?
Pain is generally considered chronic when it persists or recurs for more than three months. Duration alone does not identify the cause or determine the right treatment; assessment also considers your symptoms, medical history and how pain affects your daily life.
Is chronic pain considered a disability in the UK?
Chronic secondary pain is linked to an underlying condition that adequately explains the pain or its impact. Chronic primary pain has no clear underlying condition that adequately explains it. Both types can occur together, so a proper assessment is important.
Can I still work or exercise with chronic pain?
Often, yes. However, the right level and type of activity depends on your symptoms and condition. A treatment plan may include gradual activity, physiotherapy and pacing to help you maintain or improve physical function.
Will I need to manage chronic pain for the rest of my life?
No. Chronic pain describes pain that persists or recurs for more than three months. Fibromyalgia is a condition associated with chronic primary pain and can involve widespread pain, fatigue and increased sensitivity to pain.
Seeing Dr Mehrez
Do I need a GP referral to see a private chronic pain consultant?
Success rates vary by individual and cause, and no clinic can honestly guarantee a result. Epidurals also target sciatica rather than back pain on its own. Dr Mehrez will talk through the evidence relevant to your case rather than quoting a figure.
What happens at a first consultation for chronic pain?
For most back pain, a pain management consultant is the right first specialist to see, offering non-surgical, image-guided treatment. An orthopaedic or spinal surgeon becomes relevant where a clear structural problem needs surgical assessment. Dr Mehrez can advise which applies to you.
Does Dr Mehrez offer remote or e-consultations for chronic pain patients?
Pain lasting more than three months is generally classed as chronic and is common, but it’s not something to simply live with. It’s worth getting a specialist assessment for chronic back pain lasting more than 12 weeks if you haven’t already.
Is chronic pain treatment covered by private health insurance?
Prolonged sitting, particularly with poor posture or an unsuitable chair, is a genuine contributing factor to back pain. It’s rarely the only cause, so a proper assessment still matters if the pain persists.
Book Your Consultation
Tell us what is going on and the team will arrange your appointment. If you would rather talk it through first, call the number below.
Expert Pain Management in London for Pain-free Living
- Private pain management clinic in Harley Street, London
- Image-guided injections and interventional procedures
- Personalised treatment plans for complex pain conditions