Private pain management in Cardiff: injections, nerve pain and referral rules

Spire Cardiff's pain management page describes an integrated approach with specialists, physiotherapists, psychologists, neurosurgeons and orthopaedic surgeons. It names the types of pain it deals with: spinal pain, nerve pain, headaches, post-surgical pain, cancer pain and pain secondary to diabetes or shingles. It says its pain specialists are accredited Fellows of the Faculty of Pain Medicine at the Royal College of Anaesthetists.

Nuffield Health's Cardiff and Vale page does not carry a dedicated pain page in the material I read, but its referral guidance names pain management as one of three specialties, with cardiology and neurology, for which it requests a GP referral. So the pain service exists, and the entry route is more formal than for most other specialties at Nuffield.

Because the two sites are different hospitals, it makes sense to ask each what it can do on site: assessment, imaging, injections under X-ray guidance, and whether any procedures require referral to a different centre.

Spire Cardiff's A-Z has separate entries for epidural injections, facet joint injections and a combined entry on pain management injections for back and facet joints, plus joint pain injections more generally and back pain investigation by discography. Its pain page says a wide range of injections is available specific to individual complaints. Epidurals place medicine around spinal nerves, and facet joint injections target the small joints at the back of the spine.

Injections are usually part of a plan, not the plan itself. They can reduce pain enough to let exercise and rehabilitation progress, and sometimes help show which structure is causing the pain. If relief is short-lived, a consultant may discuss repeating, a different technique, or a referral for surgical opinion, which at Spire Cardiff sits alongside its orthopaedic and neurosurgical offer.

Its pain page also describes medication delivered orally, by patch or via an implanted pump, stimulation techniques from TENS to implanted spinal cord stimulators and complementary approaches including acupuncture and massage.

• Ask what structure the injection targets and how that was decided.

• Ask about anything that needs pausing beforehand, such as anticoagulants.

• Ask what happens next if the first injection helps only briefly.

Nerve pain has its own entry at Spire Cardiff. Its neuralgia page describes trigeminal neuralgia and post-herpetic neuralgia, and lists medicines including anticonvulsants, membrane stabilisers and antidepressants, plus heat treatments and neurosurgery. Diagnosis involves a neurologist and may use EMG or nerve conduction tests, which Nuffield Cardiff Bay runs at its neurophysiology unit.

Headache treatments sit on a separate page and include nerve blocks and injections for chronic migraine. For this reason the Cardiff neurology guide on this site is a useful companion if your pain is mainly in the head or face.

Spire Cardiff describes itself as an orthopaedic centre of excellence, with hip, knee, shoulder and ankle replacement, rotator cuff repair, carpal tunnel surgery and back surgery on its A-Z. Nuffield's orthopaedic pages cover shoulder, elbow, hip, knee, ankle, foot and spinal surgery across The Vale and Cardiff Bay, with physiotherapy teams at both. For someone whose pain comes from a worn joint, the decision may eventually be injections now and replacement later.

Spire Cardiff's theatre set-up, with two laminar flow theatres designed for orthopaedic work according to its about page, matters more if surgery follows than for injection procedures, which are usually minor day procedures.

Cardiff and Vale University Health Board lists pain management among its specialty services. A GP referral is the usual way in. Wales has no right to choose and no e-Referral Service of the English kind, so ask your GP how your health board manages referrals and what NHS pain programmes exist locally, including those that combine exercise, education and psychological approaches.

On waits, Senedd Research, in an article last updated in December 2024, sets Welsh targets of 95 percent of patients under 26 weeks and everyone within 36, and says neither was being met. NHS 111 Wales offers advice out of hours.

Ask the clinic how success will be measured, for example fewer days off work or better sleep, rather than only a pain score. Ask about the risks of each procedure and what you will need to arrange: a driver after sedation, time off work and follow-up. If you take opioids, discuss a plan for review and reduction with a clinician, and do not stop suddenly yourself.

New weakness in a leg, numbness around the groin or saddle area, trouble passing urine or controlling the bowels, or severe back pain with fever or after serious injury needs urgent assessment through 999 or A&E.