Pain Services

Pain Services

Pain Management Centre staff_09.jpg

The North West Anglia NHS Foundation Trust’s Pain Service, for adults aged from 18 years old, has been located at Stamford and Rutland hospital for many years. Ongoing developments and an increased understanding of the importance of pain management and the need for collaborative care with each patient has led to a significant expansion of the Pain Management Service in recent years, with the result that the Pain Service is now amongst the busiest in the East of England.

The Pain Management Service provides an assessment, advice and treatment service for people with a wide variety of pain conditions. These services include an out-patient service for persistent pain (also known as chronic pain), and an in-patient service (for hospital in-patients with pain).

Since April 2019, we are not commissioned to see any patients from Lincolnshire as they now have their own county wide pain service.

The Pain Service consists of a team of pain specialists including doctors, nurses, psychologists, physiotherapists and occupational therapists, as detailed below:

The Coronavirus pandemic has brought with it lots of change, fear and uncertainty, and these implications are felt in every aspect of our lives. With so much on the news about it and the concerns we have for our families and loved ones; it can feel overwhelming.  Juggling personal life's demands alongside a chronic health condition can be a challenge at the best of times, and the virus poses more complexity and additional pressures for everyone.

However we know that now it is even more important to try to apply pain management strategies to our lives as best as we can. Without the ability to go out much/at all it’s likely you will lose fitness and/or your mood may drop because you aren’t able to do the fun activities or you’re unable to connect in the same way with family and friends.

We appreciate that it will be difficult waiting for input from the Department of Pain Management. Some of you will have material which you have received from us already which you are working through, however some of you may not. So we wanted to make sure that everyone waiting for further input, has access to information they can be learning about and/or trying to put into action.

We also wanted to give you access to some really good resources to help you and your families through this difficult time. Please pace yourself through this information. We’re in a time where we can be bombarded with information from the news and other sources. Please be gentle with yourselves.

Coping with Covid-19: Here are some useful resources bearing in mind the situation we are all in;  

The following videos are all about pain and the important role the brain in explaining and managing chronic pain. Even if you have watched these before it may be useful to do so again. You can use a search engine to look up …..

  • ‘explain pain in less than 5 minutes’ – 5 minute video about chronic pain and what you can do about it
  • ‘Brain tricks – this is how your brain works’  – 5 minute video from ASAP science
  • ‘Can you trust your eyes’  – 2 minute video from ASAP science
  • ‘How do nerves work? Elliot Krane’ – 5 minute TED-talk
  • ‘The rubber hand illusion – Horizon – BBC’ – a 4 minute clip from a Horizon programme
  • ‘The scientific power of thought’ – a 3 minute video from ASAP science
  • ‘The scientific power of meditation’ – a 3 minute video from ASAP science
  • ‘Lorimer Moseley why things hurt’ – a 15 minute video explaining pain

Useful online resources to access further support around putting pain management into practice. You can use a search engine to look up…

  • ‘My live with pain’ website; a collection of helpful videos and other resources designed to help you learn the skills you need to become an effective self-manager of your pain. http://my.livewellwithpain.co.uk/
  • Pain concern; https://painconcern.org.uk/ is a charity providing advice and support to people with chronic pain. There are publications, access to the Airing Pain Radio programmes, videos etc.
  • Pain Toolkit; https://www.paintoolkit.org/ is great self-management resource, developed by Pete who lives with chronic pain. Pete also does a regular online café – look at the news section of the website for more details. 

Useful ways to get more active:

Stay active at home – strength and balance exercises

Low Back Pain - Simple stretches

   
Pilates for lower back

 
Neck pain - Simple stretches

 
Yoga for neck, shoulders, upper back

 
Physical Activity Ideas 10-15 minutes yoga

     
Tai Chi- 5 minutes

  •   https://www.youtube.com/watch?v=cEOS2zoyQw4 or put 'tai chi 5 minutes a day' into search engine  


  • Relaxation: It’s important for us all to be able to relax. Many of us relax by doing activities we enjoy which is great but here we are recommending you try and develop the skill of formal relaxation through breathing exercises, visualisation, body awareness etc.

  •  Insight Timer App (thousands to choose from - most of the app is free. They charge you if you do a course but I've used the app for years now and not paid a penny. There's lots on there without having to pay). Remember to book mark ones you like so you can find them again. Some good ones to start with would be short ones like:

    1. Vidyamala Burch, Take a break one minute breathing space;

    2. Kristin Page, Awareness Meditation;

    3. Richard Miller, Peel away stress, tension & anxiety.

  • Look up ‘Neil Berry living with chronic pain’ http://www.paincd.org.uk/. You can download, listen or buy his CD

     

People who live with persistent pain are often very hard on themselves. These videos are about psychology and compassion. Again use a search engine to look them up….

  •  ‘Rick Hanson on Hardwiring Happiness’ – a 14 minute TED talk from October 2013

  • ‘Paul Gilbert talk nicely to yourself’ – there are 4 x 10 minute videos of Paul being interviewed where he talks about self-criticism

  • ‘Dr Russ Harris introduces ACT…’ – a 10 minute interview with Russ Harris

  • ‘Cognitive Behavioural Therapy for treatment of pain’ – a 10 minute talk by Dr Craig

  • Practice ‘Kirsten Neff’s self compassion break’ which is on Insight timer App (see section number 5 above) or on her website; https://self-compassion.org/

Books:

  •  Cole, F., Macdonald, H., Carcus, C. (2020) Overcoming Chronic Pain, 2nd Edition

  • Dahl, J. C., & Lundgren, T. L. (2006). Living Beyond Your Pain: Using Acceptance and Commitment Therapy to Ease Chronic Pain.

  • Owen, R. (2013) Living with the enemy – coping with the stress of chronic illness using CBT, mindfulness and acceptance

  • Burch, V. & Penman, D. (2013) Mindfulness for Health: A practical guide to relieving pain, reducing stress and restoring wellbeing. Vidyamala lives with chronic pain & uses mindfulness to manage her pain so I think it has real validity. It also had a cd in the back with a number of guided meditations.

Consultants

  • Dr Namita Arora - Clinical lead
  • Dr Jennine Ratcliffe
  • Dr Suchi Kanagasundaram
  • Dr Arun Sehgal
  • Dr Subhash Kandikattu
  • Dr Andreas Erdmann

Nurses

  • Sister Paula Kiddie
  • Sister Sarah Woolfitt

Therapists

  • Dr Sarah Ronaghan - Consultant Clinical Psychologist
  • Ms Danni Penacchia - Clinical Specialist Physiotherapist
  • Ms Rebecca Livings - Clinical Specialist Physiotherapist
  • Ms Paula Wilkinson - Clinical Specialist Occupational Therapist

Administrative Support

  • Mrs Wendy Carr
  • Ms Abby Coles
  • Mrs Alison Hunt
  • Mrs Wendy Drake

The service is available for people who experience long term persistent or chronic pain. Commonly seen conditions include persistent back or neck pain, sciatic pain, joint pain, fibromyalgia, pain following surgery and neuropathic (nerve) pain etc.

In many cases the treatment and management of pain is complex and difficult and there may be no straightforward cure or solution. It is therefore important that the patient and specialist team work in partnership. The team aims to support and help people to manage their pain, whilst trying to maintain or improve their functioning, reducing the distress caused by pain and improving the quality of life.

How is the service accessed?

We are referred patients from a wide range of health providers, including G.P.s, Hospital Consultants, Nurse Practitioners and Extended scope Physiotherapy practitioners (Musculoskeletal services).

We advise patients to consult with their healthcare provider to assess the suitability of a referral to our service.

What happens following referral?

At the current time, all referrals are triaged by the Consultants in Pain Medicine. At this point the medical consultant reading the referral and any associated available notes, makes a decision about what aspect of the service to direct the person towards initially. This may mean that a person will be offered a range of treatment or assessments including:

  • Anindividualised assessment by a Consultant in Pain Medicine, who is a medically qualified and trained specialist doctor. During this assessment a treatment plan will be agreed and further arrangements for treatment (if appropriate) made.

  • Being referred for attendance at a Nurse Led Practical Pain Management Session (medical focus offering practical approaches to pain management), and a Pain Management Information session (biology of pain and non-medical approaches to pain management). The focus of both of these sessions is to offer information, advice and guidance regarding the impact of pain, and the positive ways to implement strategies based on the biopsychosocial approach.

  • After attending an appointment with a member of the team, or attending one or both of the sessions mentioned earlier, either may lead on to the option of a therapy assessment, specialist therapy workshops, medical reviews with one of the nurses, which are all tailored to the person’s needs and preferences.

What treatments are available?

As treatment is delivered by a multi-disciplinary team, there is a wide range of possible treatment options available. These may include:

  • General advice and support with the management of the pain condition- including self-help measures.

  • Injections for pain relief (only in selected cases and where appropriate). Other interventions may include radiofrequency denervation, pulsed radiofrequency or lidocaine infusions and in rare cases a referral to a spinal implantation centre for dorsal column stimulation.

  • Specialist Clinical Nurse support and follow-up, and advice about general pain relief measures, TENS machines, external neuro-modulation treatment and medication.

  • Workshops about how to apply self-management techniques

  • Individualised therapy

  • Physiotherapy –assessment of physical function and facilitating improvement of fitness and function through exercise and self-management strategies, for improved quality of life.

  • Occupational Therapy – assessment of an individual’s self-care, leisure and purposeful occupations, with the purpose of minimising the impact pain has on the performance of such tasks. This is achieved through establishing therapy goals, chosen by the person as their priorities for change. Where relevant, advice and support is offered to also help people stay in work, or start the return to work process.

  • Psychological therapy- assessment of emotional/psychological difficulties and exploring the relationships between pain, understanding and emotions, so that the person can learn new ways to respond to their pain.

What will progress look like?

As everyone is different, this is difficult to predict and dependant on many factors, including each person’s individual response and personal motivation and engagement in the treatment options offered. In some patients there can be a significant relief from pain following medical treatment, which enables an increase in exercise and activity, and leads to an improved quality of life.  In many situations, learning ways to manage and continue or improve functioning  despite the pain - can be a positive and helpful way forward, so that the pain no longer dominates the person’s life. However, expected changes are often gradual and may take many months.

This service provides advice on the management of pain to all areas of the hospital. This is delivered by the Specialist Nurse in Acute Pain, Sr Tracey Taylor and is supported by additional Medical Consultant sessional input.

The service is based at Stamford Hospital. All outpatient clinic appointments are held in the outpatient department.

All procedures/injections take place in the Greenwood Ward procedure suite.

Individual therapy appointments are delivered at the department of pain management in the outpatients clinic.

There is also a very limited outpatient pain clinic service available from Peterborough City Hospital. All other service arrangements are subject to change and patients are strongly advised to read their appointments letters carefully.

The videos below involve the therapists in the team presenting the Pain Management Information Session presentation. This is usually a 'lecture' style presentation where people would attend in person but in these current times we are making them available to patients as online resources. Usually patients will be directed to this page as part of their preparation for a Therapy Assessment but if you are a patient under the team and you'd like to pursue this approach please let your consultant/nurse know so they can direct you accordingly.