Dr Neil Cuninghame

Dr Neil Cuninghame Helping you break free from pain and live fully again. Empowering patients and practitioners with expert pain insights.

Chiropractor and pain management specialist | Speaker & educator | Husband, father, athlete. I am a Chiropractor with a special interest in pain, chronic pain specifically, and how the nervous system plays a role in our function and outcomes

People sometimes apologise to me for talking too much in a first appointment.They have usually been through a few rooms ...
09/09/2026

People sometimes apologise to me for talking too much in a first appointment.

They have usually been through a few rooms by then, each one shorter than the last, and somewhere along the way they have picked up the idea that the story is the bit we get through on the way to the examination, when the story is, in fact, most of the examination.

It is where we find the patterns, what winds it up, what settles it, what has already been tried and how that went.

I am not going to claim that listening is treatment on its own, because it’s not. What I can tell you is that I have never put together a useful management plan for persistent pain without it, and people tend to do better when they are not spending the appointment defending the fact that they are sore.

So take the time when you are in the chair telling your doctor your story and practitioner’s, take your time actually listening to the person in front of you.

Somebody sat in my rooms recently and asked me whether I thought they were making their pain up.They had been sore for w...
06/09/2026

Somebody sat in my rooms recently and asked me whether I thought they were making their pain up.

They had been sore for well over a year, they had been sent for imaging, and the report came back looking pretty normal for their age. They had been told twice that there was nothing wrong, which by then had started to sound to them like there was nothing wrong with them.

They were not making it up. The scan had done exactly what a scan does, which is show us structure, and the structure was fine. What imaging cannot show us is how the protective system that produces pain is behaving, and the research currently suggests that system can stay switched up long after the tissues themselves have settled down.

So there are two separate questions sitting in that consultation. Have the things that needed ruling out been ruled out, which the imaging answered well, and why is this person still sore, which the imaging was never going to answer.

We spent most of that appointment on the second question, which meant going back through the history properly, examining them, and working out what tends to wind this up and what tends to settle it down. I could not promise them an outcome and I did not try to. What I could tell them is that a clear report is not the end of the conversation, and that there is usually more to work with than they have been told.

03/09/2026

The cortisone question comes up in my rooms most weeks.

It can be a good painkiller, and for a frozen shoulder caught early, a trigger finger or an inflamed joint, it can be the right first step.

But there are a few things to check before you go ahead:

1. If surgery is on the cards in the near future, the three month window is important.

2. If you are diabetic, the injection can push your blood sugar up for a few days afterwards, so tell whoever is injecting you so you can monitor it properly.

3. If it is a large weight-bearing tendon, ask about rupture.

4. And if it is your third in the same spot, then it is a really good time to re-examine the diagnosis.

The decision ultimately belongs with you and your doctor but part of my job is making sure that before you have one you have explored all the options, know the facts and risks, and understand what the window it opens needs to be used for and how we can maximise long term outcomes.

Save this and send it to whoever is weighing up a cortisone injection. Full article on my site, drneilcuninghame.com/cortisone-injection/

painmanagement hillcrestchiropractor upperhighway kzn shockwave diabetes

28/08/2026

Context is important when we are dealing with pain and what you say to somebody in pain can have more impact than the issue itself. Words matter, big time!

Tennis elbow is a misleading name, since most people who get it never pick up a racquet (although Padel is increasing th...
17/07/2026

Tennis elbow is a misleading name, since most people who get it never pick up a racquet (although Padel is increasing those numbers 😅).

It is a tendon at the outer elbow that has failed to heal under repeated gripping and loading, and it shows up in manual trades and desk work as much as in sport.

A cortisone injection can settle it quickly, but it tends to fade over time. By three and six months, shockwave has shown to have much better outcomes.

Save this, and share it with anyone battling with and trying to figure out how to treat a stubborn elbow.

15/07/2026

Movement is lotion people! Stop trying to find the perfect posture and start moving regularly! Your brain and your body will thank you 🤗

Pain can rise and fall for reasons that have nothing to do with a fresh injury. Sleep, stress, worry, an alarming scan r...
14/07/2026

Pain can rise and fall for reasons that have nothing to do with a fresh injury.

Sleep, stress, worry, an alarming scan report and long spells of doing very little all feed into how loud pain gets.

Knowing that can take some of the fear out of a bad day.

18/06/2026

How long do you think it takes for your body to actually recover after an endurance event?

I often compare pain to a Toblerone, it has sharp spikes and sudden dips, which often makes it difficult to predict what...
29/05/2026

I often compare pain to a Toblerone, it has sharp spikes and sudden dips, which often makes it difficult to predict what is going to happen next. The goal of recovery isn’t to eliminate the Toblerone, unless you are like my kids of course, because then that Toblerone ain’t gonna last the day 😅. The goal is to rather try and smooth it out so that we have smaller peaks, and smaller dips.

There are a number of ways that we can start to shave down those peaks. This includes things like predictable daily movement, consistent pacing, slow breathing, graded exposure, and reducing fear driven decisions, to name a few.

Over time flare ups become smaller, spikes flatten, and your confidence grows again.

Healing isn’t a straight line, but it doesn’t need to be like a Toblerone.

Flare ups often feel like the worst part of persistent pain and that you have failed. More often than not it is because ...
13/05/2026

Flare ups often feel like the worst part of persistent pain and that you have failed.

More often than not it is because your system has become momentarily overwhelmed and most of the time you have just moved faster or farther than normal, you were stressed, tired, or tense, and your brain has predicted that there is a threat and reacted accordingly.

The best thing we can do in these instances is to pause, breathe slowly, let your body relax, and reassure yourself that you are safe. This lowered intensity allows you to continue at a reduced level.

If possible avoid stopping everything completely and rushing back too quickly.

Address

2 Meyrickton Place
Hillcrest
3650

Opening Hours

Monday 07:30 - 16:30
Tuesday 07:30 - 16:30
Wednesday 07:30 - 16:30
Thursday 07:30 - 16:30
Friday 07:30 - 16:30

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