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Transcript
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.