For many patients, pain lingers long before they reach specialist care. At KPJ Sabah, Dr Aldred Soo sees how fear, delay, and misunderstanding shape when and how treatment begins.
Changing how chronic pain is understood, treated
For many patients, the journey to a pain clinic begins long after the suffering starts. By the time they arrive, years of discomfort, fear, and hesitation have already shaped their decisions. Since 2016, pain specialist Dr Aldred Soo has witnessed this pattern repeatedly — patients who believe surgery is their only option, and others who avoid it entirely until it may be too late. Yet modern pain medicine is no longer just about cutting or curing; it is about timing, trust, and understanding the body before it reaches a crisis point.
Currently based in KPJ Sabah, Dr Aldred has a decade of experience as a pain specialist, where his focus goes beyond symptom relief to helping patients understand when to intervene, when to delay, and when recovery is still possible without surgery.
Throughout the numerous patients he has seen, the doctor shared that by alleviating pain, patients are often able to move again, rebuild confidence in their bodies, and begin the long process of recovery that pain had previously stopped them from doing.
When surgery is not the first answer
With today’s modern technology and medicine, surgery is not always the first solution, and many patients often opt out of it. According to Dr Aldred, these days patients in pain prefer alternatives like injections, nerve blocks, or nerve radiofrequency to get rid of the pain instead.
“Many of the patients who came to me often said they do not want to go under the knife or have a prosthetic knee in their body. They just want something to ease off the pain. Unless it is life-threatening, it is possible to treat this pain without surgery,” said the doctor.
He explained that this shift is especially common in knee and spine conditions, where many patients worry about long-term mobility and surgical implants. Younger patients, in particular, often delay surgery in favour of injections or nerve-related procedures, hoping to manage pain while postponing the need for joint replacement.
For older patients, fear is often the main barrier.
“Some of them are in their 70s and above. They worry that once they go under anaesthesia, they may not wake up again. So they prefer injections or nerve blocks just to help them continue daily life, even if they know surgery might eventually be needed,” he said.
In more complex cases such as trigeminal neuralgia — a nerve condition affecting the face — patients can experience sudden, severe pain triggered by simple actions like brushing their teeth or even light touch.
In such situations, Dr Aldred said minimally invasive procedures such as nerve radiofrequency or cryotherapy can be used to reduce nerve sensitivity without immediately resorting to brain surgery.
“These procedures don’t remove the problem completely, but they reduce the pain signals and give patients a chance to function again,” he added.
Myths surrounding pain treatments
One of the most common misconceptions about pain management, according to Dr Aldred, is the belief that all pain inevitably leads to surgery. In reality, he said, surgery is only considered when there is clear structural damage or when conservative treatments are no longer effective.
Another widespread myth is that painkillers are always the first and best solution. While medications such as paracetamol and anti-inflammatory drugs can help manage mild to moderate pain, Dr Aldred cautioned that long-term use without proper guidance can lead to complications, particularly affecting the kidneys, stomach, or liver.
“There is a fine line between tolerance (the body gets used to medication) and addiction (where the patient is looking for and seeking the drug). As long as it does not come to being addicted to painkillers, then it is fine.”
Nevertheless, there is no such thing as a harmless painkiller if it is taken wrongly or for too long. He added that patients often self-medicate without understanding dosage limits or underlying risks.
Dr Aldred also pointed out that many people assume stronger medication means better treatment. However, in chronic pain cases, treatment often requires a combination approach — including medication, nerve-targeted procedures, rehabilitation, and lifestyle modification — rather than relying on drugs alone.
When cognitive behavioural therapy comes into play
But managing pain can go beyond consuming drugs. In his practice, Dr Aldred introduces cognitive behavioural therapy to his patients to assist in easing the pain. The therapy, when practised, helps the mind to overcome the pain.
Sharing further, the pain specialist explained that there are patients who refuse to consume painkillers for fear of side effects.
“I would tell them to think of their happy place. Some I would offer them a pressure ball to squeeze, or advise them to play a game during an injection so they won’t feel too much pain.”
With cognitive behavioural therapy in play, Dr Aldred also manages the pain of injection treatments by asking his patients to cough. This, he said, stops the pain signal from the hand to the spine and going to the brain.
“The cough somehow dampens or reduces the signal reaching your brain that, oh, this is painful.”
Movement, comfort, and recovery
As a pain specialist, the patients he meets vary, from muscle pain to post-surgical pain; each is handled with care through personalised treatments.
“I have one female patient who was against painkiller injections, but when I did it for her, she went on for two years happily.”
Remembering the case, Dr Aldred disclosed that the patient was able to do her chores, gardening, move around, and socialise with friends. While pain may be an inevitable consequence of certain conditions and treatments, Dr Aldred believes it can often be managed well enough for patients to maintain a quality life.
“There is always pain. So first, we must try to break the cycle of it. Oftentimes when patients understand this, then they are able to anticipate the pain when it comes back, and to be ready to manage it when they need to.”
With post-surgery pain management, to break the cycle of pain, Dr Aldred advised against prolonged immobility, which can lead to complications such as blood clots in the legs, muscle weakness, and delayed recovery.
“Walking to the toilet, moving around the room, and doing light activities are generally encouraged. What we advise against is heavy lifting or strenuous movements that can strain the surgical wound,” he explained.
Therefore, pain control plays a crucial role in this process. While some patients worry that painkillers may mask warning signs and cause them to overexert themselves, Dr Aldred said appropriate pain management actually helps patients regain mobility safely. By reducing pain to a manageable level, patients are more likely to move, participate in rehabilitation, and avoid complications associated with prolonged bed rest.
For Dr Aldred, successful recovery is not just about healing the pain, but about helping patients regain confidence in movement, restore function, and return to daily life with as few side effects as possible.
A new era for pain management
There is a new era for pain management, according to Dr Aldred. While traditional treatments often focused on blocking or destroying pain signals, newer approaches are increasingly centred on preserving the body’s natural structures and promoting healing.
In explaining this, he said advances in technology have allowed pain specialists to deliver treatments with greater precision and fewer complications. One of the most significant developments has been the widespread use of ultrasound guidance, which enables doctors to visualise nerves, muscles, and surrounding tissues in real time during procedures.
According to him, this not only improves accuracy and success rates but also reduces risks, costs, and waiting times, as many procedures can now be performed outside the operating theatre without exposing patients to radiation.
At the same time, treatment philosophies have evolved. In the past, procedures such as radiofrequency ablation were commonly used to disable pain-transmitting nerves for prolonged relief. While still effective in selected cases, Dr Aldred said he now favours approaches that preserve nerve function whenever possible.
One example is cryotherapy, which uses extremely low temperatures to temporarily interrupt pain signals without permanently damaging the nerve. By reducing pain for several months, patients are given a window of opportunity to undergo physiotherapy, strengthen weakened muscles, and restore mobility.
“The goal is not just to remove pain, but to give patients a chance to heal,” he said.
Beyond pain control, regenerative treatments are also gaining ground. These include platelet-rich plasma (PRP), prolotherapy, and stem-cell-based therapies, which aim to support the body’s repair processes in damaged joints, muscles, and nerves.
For patients with conditions such as early-stage knee degeneration, these therapies may help delay, and in some cases avoid, major surgeries like total knee replacement.
However, Dr Aldred stressed that injections alone are rarely enough. Long periods of pain often cause patients to unconsciously limit their movements, resulting in weakened muscles and reduced function. Once the pain is relieved, rehabilitation and physiotherapy remain essential to help the body regain strength, confidence, and normal movement patterns.
In the end, pain management is not just about nerves, injections, or technology. It is about helping patients reclaim parts of their lives that pain once took away — the ability to move, to work, to connect, and to hope again. For Dr Aldred, every treatment is ultimately aimed at one simple goal: giving patients back the life they thought they had already lost.
