Back pain management programme

The aim of the programme

The Back Pain Management Programme is for those with persistent spinal pain, whether that is in the neck or in the lower back. We also accept those with more widespread pain conditions such as fibromyalgia and rheumatoid arthritis, providing pain in the neck or back is your biggest concern. You can be referred by any healthcare professional.

The programme aims to

• reduce the disability and distress caused by your chronic pain
• increase participation in daily activities and exercise
• improve your quality of life
• help you feel more in control of your pain

There is no 'hands on' physical or passive treatment during the programme. The programme does not aim to ‘cure the pain’.

The programme

The programme is run for three consecutive weeks, Monday to Thursday (09:30 to 15:30). Either in person in the Physiotherapy Department at Addenbrookes Hospital, or online virtually. Throughout the programme you will work in a group, and will be encouraged to participate as fully as possible in order to achieve the most out of the course. You may experience increased pain during the programme due to a change in your daily routine, however, the team will be able to guide you through this.

Criteria

There are certain criteria that would mean someone may not be at the right time to commence the back pain programme, these include;

• If you cannot commit to the full schedule as mentioned earlier.
• If you are awaiting further medical investigations or tests in relation to your pain,
• If you are awaiting further invasive medical procedures be that injections or surgery in relation to your pain,
• If your greatest pain concerns are outside of the back or neck.

The pre-assessment appointment

Before being given a start date for the programme you will have a pre-assessment appointment with the team (Physiotherapist, Occupational Therapist & Clinical Psychologist) to ensure that the programme is suitable for you. Hopefully we would be happy for you to commence a programme, but we may feel that another approach is more suitable or that you are not ready for the programme at the time. Therefore you may not be accepted onto the programme, but we would discuss an alternative plan with you.

Education and discussion sessions

These occur every morning and are led by various team members (physiotherapist, occupational therapist, clinical psychologist). The sessions cover topics including:

• moving more easily with back pain
• flare-up planning
• the multiple aspects of pain
• pacing and lifestyle management
• goal setting
• problem-solving daily activities
• sleep strategies
• how our thoughts, feelings, emotions and pain can influence each other and the impact they can all have on our day-to-day life
• helping others better understand what it is like living with persistent pain and maintaining change for the future

There will also be a talk by a dietician and a pain clinic nurse. Every morning usually ends with a relaxation session prior to lunch.

Exercise and exploring movement sessions

These occur on most afternoons, this time is for you to experiment with movement and discover elements of exercise that you find most enjoyable and successful doing. You can go at your own pace and there is no pressure to do anything you don’t feel confident doing. In person programmes may involve using our gym and hydrotherapy pool, whilst for virtual programmes there will be a mix of different types of exercise involved (for example;. tai chi, yoga, pilates). Specific information about the exercise will be provided either prior to or at the beginning of the programme.

Friends and family day

There is an open day when you can bring a relative or friend. This is usually on the Monday of week three of the programme. It will give them an opportunity to discuss your goals, to gain insight into the programme, and enable them to help provide support to you in the changes you have made in your lifestyle.

After the programme

After you have finished the programme, there are group reviews with the therapy staff at one month, six month and one year intervals.

The aims of these appointments will be to review your progress towards your goals and resolve any difficulties you may have with applying pain management tools. In general, at the end of the programme patients report less fear of movement, increased physical ability, reduced distress and greater achievement of personal goals, though the extent of these changes varies for each individual.

After the last review you would then be discharged from the pain service.

If you have any further queries you can contact the staff concerned in the Physiotherapy Department on 01223 216633 or programme administrator on 01223 596476.

Resources

Example timetable

Key

• PT = Physiotherapy
• OT = Occupational therapy
• Psychology
• All
• Other