Orthopaedic surgeon Dr Dennis Chinedu Agbazue, Nigerian Born South Africa, is the first South African – in fact, the first doctor on the African continent – to qualify as an interventional pain sonologist. He now brings renewed quality of life to patients with chronic pain.

Dr Dennis Agbazue, an orthopaedic surgeon at Mediclinic Vereeniging, has always had a strong desire to help people. That’s what drew him to practise medicine and, more specifically, to the field of orthopaedics, where he specialises in spinal surgery and sports medicine. In addition to these focus areas, Dr Agbazue has moved steadily into the field of pain management. This is not surprising, he says, since most patients consult him because of an aching back or joint pain.

His first foray into the field came after he was introduced to radiofrequency ablation (fulguration) in 2008, laying the foundation for a growing interest that led him to further his qualifications and add to his skills base – ultimately culminating in his recent qualification as the first interventional pain sonologist in South Africa, if not the entire continent.

Dr Agbazue explains how his journey to this point came about: “Fulguration uses the heat given off by a medium-frequency alternating current to treat pain. The technique was still very new in South Africa when I first started studying this treatment; in fact, there were only a handful of qualified pain specialists in the world at the time. I made a point of increasing my learning and attending as many global conferences as possible.”

The more he progressed in this journey, the more fascinating he found the subject, especially as it relates to his immediate area of expertise. Often, he points out, patients who present with pain cannot be treated by physiotherapy alone but aren’t candidates for surgery. Fulguration is a solution that offers long-lasting relief.

Dr Agbazue’s burgeoning interest took him to Budapest (the global centre of pain management) three times, as well as New York. He became an expert on the subject, and in 2017 qualified as a Fellow of Intervention Pain Practice under the auspices of the World Institute of Pain. “My certificate number is 970, which shows just how few practitioners there are in the world,” he says.

Use of ultrasound for pain

Not content with the knowledge he had already amassed, Dr Agbazue started investigating the potential of ultrasound in the treatment of pain. “This was a particularly interesting area for me. As students, we orthopaedic surgeons have extraordinarily little exposure to ultrasound. The only contact we really have with this tool is when interpreting reports sent by radiographers.”

He returned to Budapest, as well as Miami and Istanbul, writing his exams and receiving his qualification as an interventional pain sonologist in September. “This means I’m now able to conduct ultrasonography in my office, using ultrasound to identify the source of a patient’s pain and to do a block there and then. The patient can walk out of my office pain-free.” What’s more, their quality of life is improved without any time in theatre, saving both time and money.

And patients from around the country are seeking out Dr Agbazue’s services. He says they range in age from 18 to 90, with most hoping for a solution to medical issues like headaches, axial spinal pain, musculoskeletal pain, failed back surgery syndromes, and complex regional pain syndromes.

An end to pain?

Dr Agbazue says because sonology is still new – it was introduced less than 10 years ago – it is still a specialist field. Only 20 people qualify every year – and, this time, the number on his certificate is 268, again indicating the dearth of practitioners. But he’s eager to see more people acquire the skill and knowledge and is helping to train others who want to become pain management experts.

In addition to sonology, Dr Agbazue still offers fulguration; in addition, he is also one of the few surgeons in South Africa who perform endoscopic spinal surgery and completed his 100th such surgery in July this year. “Combining pain management techniques with sports medicine and endoscopic procedures gives patients the best chance of a life without pain,” he says.