Annaliza Borg

The Pain Clinic at Mater Dei Hospital is rarely the subject of news stories. However, with the help of a multi-disciplinary team of specialists and visiting consultant Charles Gauci, patients in a desperate situation are being given sterling treatment and often relieved of their symptoms.

Addressing a press conference yesterday morning, Health Minister Joe Cassar said that although few people know about it, the service is very important.

He pointed out that anaesthetist Dr Marilyn Casha is focused full time on the needs of these patients who will have seen doctors countless number of times and taken many pills and other medication.

Dr Casha explained that chronic pain is often accompanied by a lot of anxiety and this means people would be out of work or having great social difficulties because their personalities often change.

Often, when she first sees a patient, she will be asked to amputate a leg, for example, because of the pain that is being suffered, but this is usually far short of being a solution.

The Pain Clinic tries to help patients get back to work by managing – and when possible – treating their pain. Some 80 per cent of the cases Dr Casha sees are not related to cancer or terminal illness and somatic (holistically orientated) therapies are often used to treat muscle or nerve pain. She also carries out some 30-35 invasive techniques a week on patients with spinal and nerve problems. These are often one-day cases, meaning the patient is not required to stay in hospital overnight.

Some 80 to 90 per cent of non-terminal cases are related to back pain and/or arthritis. X-rays are very often used in diagnosis to enable the doctors to know exactly what needs to be treated and a radio frequency generator – a machine used to treat the pain, also helps with diagnosis.

Dr Casha explained that the procedures are very safe. She sees 50 to 60 patients a week at the clinic while another consultant, Mr Charles Gauci – who provides a similar service at the clinic on a part-time basis – sees additional patients.

Some 1,200 pain-relieving procedures were carried out in Mater Dei operating theatres last year. Dr Casha referred to the fact that trials have been carried out this week to place implants in the spine and had been very successful. Moreover, she explained that the visiting consultant often provides a second opinion to patients who either wish or need it. This saves patients the trouble and expense of going abroad.

Whilst in Malta, Dr Gauci also shares his expertise with the staff and in the spring he will be participating in a conference being organised with the University of Malta to pass on techniques used in pain management to other doctors working in different fields.

Dr Gauci said that he has been coming back to his homeland of Malta since 2004 but has been practicing in chronic pain since 1978. He currently travels the world, lecturing, teaching and carrying out interventions, but said he intended to retire to Malta next year. He described the Pain Clinic at Mater Dei Hospital as being of an international standard.

Pio Mangion, a patient undergoing treatment at the clinic, said he woke up one morning in 1998 with severe pain on one side of his face– a feeling similar to having been hit by a whip.

At one point he was taking 13 pills a day but these still did not prevent the pain, which may have been caused by an attack of shingles attack that went untreated because he had not noticed it.

However, he believes that Dr Casha and God had performed a miracle on him. Thanks to an intervention, he no longer feels the pain on that side of his face, although this has now appeared on the other side. He was due to undergo another procedure yesterday.