Dr Tzvetanka Ivanova-Stoilova

Consultant in Anaesthesia and Pain Medicine

Qualifications

MD PhD FRCA, FFPMRCA

Year of first medical qualification: 1979

Professional profile

Dr Tzvetanka Ivanova-Stoilova is a Consultant in Anesthesia and Pain Medicine.

She qualified from the Higher medical School in Sofia with Hippocratus award for best academic achievement. She specialised anaesthesia and intensive care in St. Petersburg in 1983 and completed a PhD in pathophysiology and anaesthesia in 1985.

 She was Head of Anaesthetics department of the  University Clinic of Plastic and reconstructive surgery in Sofia. Her pivotal work in anaesthesia techniques for cleft lip and palate babies won her international recognition.

 Since 1994 Dr Ivanova-Stoilova lives in Wales. She has completed the postgraduate training in anaesthesia and became a Consultant/Director of Chronic Pain Clinic in 1999.

She is one of the very few full-time consultants in pain medicine in Wales.

Her expertise in diagnosis and management of patients with complex pain conditions while in hospital and as outpatients is very much sought after. She has got a formidable reputation in tireless and devoted work for her patients and her colleagues comment about her as being an asset to the hospital.

Since 1999 Dr Ivanova-Stoilova has established a private clinic in  St.Joseph’s Hospital for patients referred from GPs or hospital specialists.

 Dr Ivanova-Stoilova is very highly respected and trusted by her patients, some of whom come back to see her for her expertise and guidance year after year.

Dr Ivanova-Stoilova’s clinic is welcoming patients with all types of chronic or recurrent pain. Her specific expertise has proven very helpful for patients with postsurgical pain on face, sinuses, neck, spine, abdomen, pelvis, upper and lower limbs.

She deals with patients with medically unexplained pain who might have been to various specialists and clinics for years.

Dr Ivanova-Stoilova has established a multidisciplinary clinic for patients with primary widespread pain such as fibromyalgia and chronic fatigue syndrome.

Her clinic welcomes patients with medical conditions such as poststroke, severe osteoarthritis, osteoporosis with fractures of the spine with resultant intractable pain.

Dr Ivanova-Stoilova looks after women with chronic pain conditions during conception, pregnancy, after childbirth and early parenthood.

She has a special interest in helping patients with diabetic neuropathies to halt the progression of the neuropathic disease and avoid ulcerations and amputations.

She treats pain from osteoarthritis, rheumatoid arthritis, slipped intervertebral discs, radiculopathy, facet joints and sacroiliac joints’ pain, as well as visceral and pelvic pain and complex regional pain syndrome.

Dr Ivanova-Stoilova performs the full range of local anaesthetic interventions on the spine- facet joint, sacroiliac joint injections, spinal nerve blocks, caudal, lumbar and cervical epidurals.

She is one of the few consultants in Wales who perform autonomic blocks- lumbar sympathetic, coeliac plexus, greater splanchnic nerves block.

She performs myofascial blocks to the iliopsoas muscle, piriformis, quadratus lumborum and other muscles.

She performs  NICE recommended radiofrequency denervation for facet, sacroiliac joints blocks.

She is the first pain specialist in Wales to perform radiofrequency treatment of the sensory nerves of the knees for patients with poor outcome after knee replacement or with osteoarthritis.

Dr Ivanova-Stoilova performs botulinum toxin treatment for myofascial pain and localised neuropathic pain.

Over the years she has arranged annual educational seminars with lectures, quiz and exercise programme for the diabetic patients which proved to be very popular.

Dr Ivanova-Stoilova always approaches her patient condition holistically. She combines pharmacological treatment, injection treatment with advice on lifestyle, diet and arranges individual exercise or rehabilitation programme.

She has prepared many reports to be served to Courts in her role as a medico-legal expert in high volume multi-track complex pain cases.

Radiofrequency Therapy

Dr Ivanova-Stoilova will be very happy to assess your suitability for radiofrequency treatment if you have recurrent pain from your spine or other sites of your body which respond to local anaesthetic/steroid injections but only for a short period. She will be able to discuss whether radiofrequency treatment is likely to bring substantial relief of your symptoms for more than 12 months. This will allow you to reduce or stop your pain medication, improve the mobility of the spine and allow you to carry on with your professional and personal pursuits. The treatment is performed in an operating theatre setting under local anaesthetic. The effect of treatment develops within 3-4 weeks but usually, some relief of symptoms is noticeable a lot sooner.

Radiofrequency therapy is performed with the help of special equipment which creates an electromagnetic field and high or low levels of energy in the tissues to which it has been applied. It has been used to treat pain transmitted via the small sensory nerves of the spinal joints and other peripheral nerves innervating the face, head, shoulder, knee, abdomen and feet. There are two different modes of application of radiofrequency treatment. The thermal mode creates high energy levels in tissues and ablates, i.e. freezes the affected nerves which stops the transmission of pain.
The pulsed mode heals the affected nerve by creating a powerful electromagnetic field and reducing the levels of pain provoking chemicals.

Dr Ivanova-Stoilova has got 20 years’ experience with this technique which has got increased applications in the management of chronic recurrent pain from spinal and extra-spinal sites.

Medically unexplained pain

Dr Ivanova-Stoilova is regularly receiving requests for helping patients with medically unexplained pain. They have been investigated by gastroenterologists, urologists, neurologists, cardiologists and other specialists and no identifiable cause of the pain has been found. In medically unexplained abdominal pain Dr Ivanova-Stoilova has been able to diagnose complex musculoskeletal and nerve-related pain which could then be well managed with special medication, injections, rehabilitation.

In cases of chest pain, she has been able to identify the source of the condition and offer comprehensive treatment. In intractable head and neck pain, she will analyse the contributing factors for the symptoms and offer a comprehensive treatment which may include change of medication, special nerve blocks, joint work with health psychologist and physiotherapist.

Postsurgical pain after any type of surgery, especially after hip and knee replacement surgery is disappointing and distressing. Dr Ivanova-Stoilova can help reduce symptoms by accurately diagnosing where the pain is coming from and offering special treatment for that.

Head and facial pain

In intractable head and neck pain, Dr Ivanova-Stoilova will analyse the contributing factors for the symptoms and offer comprehensive treatment which may include change of medication, special nerve blocks, joint work with health psychologist and physiotherapist.

Recurrent spinal pain

Dr Ivanova-Stoilova will be able to discuss your symptoms, examine you thoroughly, review in details your X-rays or MRI scans and diagnose accurately where your pain is coming from. She will be able to advise on medication, perform for you spinal injections to facet, sacroiliac joints, nerve roots or paravertebral blocks, caudal epidurals. She will be very meticulous in analysing your symptoms so that the most suitable injection treatment is been offered to you. You will be able to engage thereafter with special physical restoration programme which may include hydrotherapy.

The aim of the treatment is to keep you well and to help you retain or improve your mobility which has got huge benefits for your general health.

Painful diabetic neuropathy

In 2004 Dr Ivanova-Stoilova has established the first in the UK Diabetic Polyneuropathy Pain Clinic in conjunction with secondary diabetes services. Diabetic neuropathies affect 50% of all patients with type 2 or type 1 diabetes with duration of disease of 15 years or more. They damage different type of nerve fibres of the body and extremities and can lead to poor health, disability, ulcers and loss of limbs.

Dr Ivanova-Stoilova will be able to monitor the nerve function by regular reviews, medication optimisation, special exercises and injection techniques. The aim will be to reduce the severity of the pain, improve balance, reduce the incidence of injurious falls and halt the progression of the neuropathic disease.

Dr Ivanova-Stoilova loves the castles and coastline of Wales. She is a keen gardener and she prepares the “ famous” raspberry juice and strawberry jams to the delighted palates of her family members. 

They all share with her joys and sorrows loving and respecting her as the matriarch of the family.

Substantive Consultant post in Anaesthesia and Pain Medicine at The Pain Clinic in Aneurin Bevan Health Board.

Clinical teacher at Cardiff School of Medicine.

Medically unexplained complex pain syndromes,

Diabetic Neuropathies, 

Fibromyalgia syndrome,

Recurrent chronic pain from spinal and extra-spinal sites,

Male and female pelvic pain,

Complex abdominal pain.

Dr.Ivanova-Stoilova has been awarded a price “Great women of the 21st century” by the American Bibliographic Institute in 2005.

She has won many prizes for her poster presentations on the Welsh Pain Society annual scientific meetings, prizes from Research and Development scientific meetings of the Health Board.

In 2008 she was awarded a prize form the Aneurin Bevan University Health Board for going the “Extra mile” for her work with patients with diabetic neuropathies.

In 2017 she was nominated by her patient for “Patient choice award”

 In 2018 she was nominated for two awards: “Going the extra mile” by her team and “ Patient’s choice award”.

In 2016 Dr Ivanova-Stoilova has been elected a Member of Honour to the Bulgarian Society for the Study of Pain for her contribution to the affirmation of the society, the establishment of teaching programmes and pain service developments.

Dr Ivanova-Stoilova has more than 60 peer-reviewed publications, including chapters in reference textbooks. She lectures nationally on pain management topics for GPs, hospital consultants, medical professionals and trainees.

She lectures internationally on novel treatments and applications of radiofrequency ablation, medically unexplained pain syndromes, managing the complex patients with diabetic neuropathies.

Conditions and Treatments

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