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Pain Management Unit The Pain Management Unit (PMU) is a multidisciplinary unit where patients suffering long-term or persistent pain can be assessed diagnosed and treated. The aim of the unit is to aid and support patients in the long-term management of their pain. Patients referred to the PMU will undergo a multidisciplinary assessment. The assessment process involves: • Consultation with a pain medicine specialist • Consultation with clinical psychologist specialised in pain • A detailed musculoskeletal examination by a physiotherapist. There will also be questionnaires and other assessment tools used too. Following these consultations a treatment plan will be formulated and communicated to the patient in a feedback session. This normally occurs on the same day as the initial consultation. The conclusions and recommendations will be communicated to the referring doctors and the patient's family doctor. • A spouse, a close relative or friend should accompany the patient • The Pain Management Unit questionnaire with details of prior medications, operations, illness, etc, must be completed • All prior X-rays, other investigation reports, prior specialist reports, and all current medications must be brought to the Centre as a key component of our assessment. The majority of patients referred to PMU will have had a large number of specialist consultations. This is why it is very important for patients to present copies of all previous consultations. In some cases, it will be decided that further consultations are needed with appropriate specialists. All treatments are preceded by a comprehensive multidisciplinary assessment as noted above. Treatment may be provided on an out-patient or day patient. Treatment options: • Medications: rationalisation of current medication or introductions of new medications • Neural blockade techniques including epidural corticosteroid and local anaesthetic, intra-articular local anaesthetic and steroid, celiac plexus, lumbar sympathetic, etc • Other temporary neural blockade techniques combination with rehabilitative physical therapy • Individualised clinical psychology services for pain management • Individual physiotherapy services such as training in self directed exercise and activity programs, reduction in use of unnecessary aids, postural analysis and correction, etc • Spinal drug administration via epidural and intrathecal drug delivery systems • Spinal dorsal column stimulation • Radio frequency lesioning (e.g. medial branch of dorsal ramus for mechanical neck and low back pain) Regardless of the use of pharmacotherapy, neural blockade or other options to reduce pain, many patients will require treatment with one of the PMU's cognitive behavioral programs, namely the IMPACT Pain Management Program which aim to assist patients to return to as normal as possible physical and mental functioning, which have invariably been impaired in association with chronic pain. IMPACT stands for integrated medication reduction physical activity and cognitive therapy. Psychology services • The psychology services are provided by one of the clinical psychologists • In some cases the treatment provided may be a combination of psychological and physical therapies at the PMU. Referral & management guidelines Making an appointment Referrals may be made by either by the patient's family doctor or specialist. It is vital that referrals include as much information as possible about current and previous consultations. The referral should include copies of previous specialists report, imaging reports such as x-rays, scans, etc. After the referral has been received and prior to the patient being seen, patients will be sent a questionnaire to complete.