About Dr Chua
Dr Nicholas HL Chua completed his Medical and Anesthesiology training in the National University of Singapore. He is currently the Medical Director of Specialist Pain International Clinic in Mt Elizabeth Hospital. Prior to this, he served as the Head of the Acute Pain Service and as a Consultant Anesthesiologist and Pain Specialist in Tan Tock Seng Hospital, Singapore.
He completed his Fellowship of Interventional Pain Physician (FIPP) accreditation in 2007 by the World Institute of Pain (WIP) in Memphis-Tennessee, United States of America. He is a certified Diplomate with the American Academy of Pain Management (DAAPM) and has undergone training and certification in Quantitative Sensory Testing (QST) for Pain Diagnostics in Bochum, Germany.
Dr Nicholas Chua completed 14 months of Advanced Pain Fellowship with a special focus on Pain Diagnostics and Interventional Pain Management in the University Medical Centre of Nijmegen, The Netherlands. His PhD thesis focuses on Chronic Neck Pain and the development of Cervicogenic Headache. He has published and presented a number of original manuscripts in that area and has also reviewed numerous submissions in various journals including The Lancet, Neurosurgery, Neuromodulation, Pain Practice, Annals of Academy of Medicine-Singapore and The Open Pain Journal. He currently serves as Associate Editor of the journal Anesthesiology and Pain Medicine and as an editorial board member in the Journal of Spine and Neurosurgery as well as the World Journal of Anesthesiology.
Dr Chua is a member of several professional organizations including the Academy of Medicine, Singapore, World Institute of Pain (WIP), American Academy of Pain Management (AAPM), Singapore Society of Anaesthesiology and serves as a committee member in the Pain Association of Singapore. He specializes in Interventional Pain Management for chronic cancer and non-cancer pain.
Interventional Pain Management
Interventional Pain Management, the missing link between conservative care and surgical options.
For the longest time, patients had only conservative options or surgical treatments to choose from, with nothing in-between. Interventional Pain Management bridges that in-between, offering an intermediate option before surgical solutions are undertaken.
Indications include:
• Headaches and Facial Pain
• Neck and Back Pain
• Joint Pain
• Nerve Pain
• Cancer Pain
Interventional pain procedures are divided into either diagnostic or therapeutic. Diagnostic procedures are important as "PAIN" as a symptom is not diagnosable using conventional methods like CT or MRI scans. Therapeutic percutaneous procedures in contrast, are indicated when the source of pain has been identified. They help the patient (1) maintain an ambulatory or outpatient treatment status; (2) maintain participation in a physical therapy or rehabilitation program; (3) decrease the need for analgesics; and (4) in some cases, avoid or delay surgical intervention. These procedures are particularly useful in instances where (a) patients are medically unfit for surgery; (b) there are no surgical indications; (c) symptoms are mild and/or not persistent; (d) medications fail to control symptoms.
Specialized Treatments Offered
Epidural Injections (for neck and back pain)
• Interlaminar (midline) Epidural Steroid injection
• Transforaminal Epidural Steroid injection
• Epidural Blood Patch (Low CSF pressure headache)
Selective Nerve Root Injections (for sciatica)
Epiduroscopy/ Spinal Endoscopy (for sciatica related to fibrosis)
Facet joint injections (for neck and back pain)
• Medial Branch blocks
• Intra-articular Facet Joint injection
Radiofrequency Ablation / Neurolysis / Denervation (for neck and back pain)
• Medial Branch Nerves
• Dorsal Root Ganglion
Pulsed Radiofrequency Interventions (for nerve pain)
Intervertebral Disc Procedures (for slipped disc)
• Annuloplasty / Biaculoplasty (for discogenic pain)
• Plasma Disc Decompression / Nucleoplasty
• Targeted Disc Decompression (TDD)
• Discography / Discogram
Sympathetic Nerve Blocks (for sympathetically-mediated pain conditions)
• Stellate Ganglion block (for Complex Regional Pain Syndrome)
• Celiac Plexus block
• Lumbar Sympathetic Plexus block (for Complex Regional Pain Syndrome)
• Superior Hypogastric Plexus block
• Ganglion Impar block
Sympathetic Nerve Neurolysis / Ablation (for sympathetically-mediated pain conditions)
• Stellate Ganglion Neurolysis
• Celiac Plexus Neurolysis
• Lumbar Plexus Neurolysis
• Superior Hypogastric Plexus Neurolysis
• Ganglion Impar Neurolysis
Headaches and Facial Pain
• Trigeminal Ganglion Radiofrequency Rhizotomy (for trigeminal neuralgia)
• Sphenopalatine ganglion PRF Injection (for cluster headaches)
• Migraine Botox Protocol (for migraine)
• Greater & Third Occipital Nerve Block (for occipital neuralgia)
• Lateral C1/2 PRF treatment (for cervicogenic headache)
Neuromodulation (Severe intractable pain)
• Spinal Cord Stimulation
• Peripheral Nerve Stimulation
• Sacral Nerve Root Stimulation
• Intrathecal Medication delivery
Vertebral Interventions for Compression Fractures
• Vertebroplasty
• Kyphoplasty
• Peripheral Nerve blocks (for nerve pain)
• Iliohypogastric
• Ilioinguinal
• Genitofemoral
• Intercostal
• Occipital
• Supracapular
• Supratrochlear
• Supraorbital
• Pudendal
Joint Injections (for joint pain)
• Hip
• Knee
• Sacroiliac
• Shoulder
Bursa Injections (Bursitis)
Intravenous Medication
Trigger Point Injections (for muscle pain)
Botox Injections (for muscle pain)
CT / Fluoroscopy/ Ultrasound guided
Professional Memberships
• Fellow, Academy of Medicine, Singapore
• Member, World Institute of Pain (WIP)
• Member, American Academy of Pain Management (AAPM)
• Committee Member, Pain Association of Singapore
• Member, Society of Anaesthesiology, Singapore
• Faculty, 1st Pan-Asian NYSORA Symposium, Singapore
Publications
• Halim, W., N.H. Chua, and K.C. Vissers,
Long-term pain relief in patients with cervicogenic headaches after pulsed radiofrequency application into the lateral atlantoaxial (C1-2) joint using an anterolateral approach.
Pain Pract, 2010. 10(4): p. 267-71.
• Chua NH, Gultuna I, Riezebos P, Beems T, Vissers KC.
Percutaneous thoracic intervertebral disc nucleoplasty: technical notes from 3 patients with painful thoracic disc herniations.
Asian Spine J. 2011 Mar;5(1):15-9.
• Chua, N.H., K.C. Vissers, and M.E. Sluijter,
Pulsed radiofrequency treatment in interventional pain management: mechanisms and potential indications-a review.
Acta Neurochir (Wien), 2011. 153(4): p. 763-71.
• Chua, N.H., R. Dongen, and K.C. Vissers,
Intrathecal analgesia for cancer pain: externalised intrathecal catheters.
Ann Acad Med Singapore, 2010. 39(11): p. 879-80; author reply 880-1.
• Chua NH, Vissers KC, Wilder-Smith OH.
Quantitative sensory testing may predict response to sphenopalatine ganglion pulsed radiofrequency treatment in cluster headaches: a case series.
Pain Pract. 2011 SepOct;11(5):439-45.
• Chua NH, Vissers KC, Wilder-Smith OH.
Comment on: Quantitative somatosensory testing of subjects with chronic post-traumatic headache
by R. Defrin et al.
(Eur J Pain 2010, 14(9), 924-931). Eur J Pain. 2011 May;15(5):540-1; author reply 2-3.
• Chua NH, Vissers K, Suijlekom H, Arendt-Nielsen L, Wildersmith, OH.
Differences in sensory processing between chronic cervical zygapophysial joint pain patients with and without cervicogenic headache.
Cephalalgia, 2011. 31(8): p. 953-63.
• Chua HL, Vissers K, Arendt-Nielsen L, Wildersmith O.
Do diagnostic blocks have beneficial effects on pain processing?
Reg Anesth Pain Med, 2011. 36(4): p. 317-21.
• Chang, G., G.N. Rajamoney, and N.H. Chua,
Preliminary experience in acute pain control for nonoperated hip fracture.
J Trauma, 2011. 71(1): p.269.
• Chua, N.H., K.C. Vissers.
2 cases of Glossopharyngeal Neuralgia successfully treated by Pulsed Radiofrequency Treatment.
Ann Acad Med Singapore 2011, 40 (8): 387-89.
• Nicholas HL Chua, Willy Halim, Tjemme Beems, Kris CP Vissers.
Pulsed Radiofrequency Treatment for Trigeminal Neuralgia.
Anesthesiology and Pain Medicine, 2011. DOI: 10.581
• Nicholas HL Chua, Willy Halim, Andrea Evers, Kris CP Vissers.
Whiplash patients with cervicogenic headache (CEH) after lateral atlanto-axial joint pulsed radiofrequency treatment.
Anesthesiology and Pain Medicine, 2011. (Accepted and awaiting DOI)
• Lee RM, Tey JBL, Chua NHL.
Postoperative Pain Control for Total Knee Arthroplasty: Continuous Femoral Nerve Block versus Intravenous Patient Controlled Analgesia.
Anesthesiology and Pain Medicine, 2011. (Accepted and awaiting DOI)
• Chua, N.H., Timmerman H, K.C. Vissers, and O.H. Wilder-Smith.
Multimodal Quantitative Sensory Testing in patients with unilateral chronic neck pain: An exploratory study.
Submitted and undergoing review. Reg Anesth Pain Med 2011
• Chan Ee-Yuee, Fransen M, Sathappan S, Chua NHL, Teo YH, Chan YH, Chua NPP.
Comparing the analgesia effects of single-injection and continuous femoral nerve blocks with patient controlled analgesia after total knee replacement: A prospective, randomized controlled trial.
Submitted and undergoing review. Reg Anesth Pain Med 2011
• Chua NHL, Suijlekom H, Vissers KCP.
Understanding cervicogenic Headache.
Invited Editorial. Anesthesiology and Pain Medicine, 2011.
• Chua NHL, Suijlekom H, Vissers KCP.
The Neck: An important pain generator for the Head.
Invited Editorial. Pain Management, 2011.