Introduction to the Pain Clinic

This leaflet explains how the pain service works and aims to help you get the most out of your appointments with us.

Why have I been referred to the pain clinic?

You have been referred to the pain clinic because you have persistent (chronic) pain that you are finding difficult to manage. The pathway through the service is approximately one year and our aim is to help you manage your pain more effectively and reduce its impact on your quality of life.

Who will I see at the pain clinic?

The pain clinic is staffed by a multi-disciplinary team of specialists that includes doctors, nurses, psychologists, occupational therapists and physiotherapists who all specialise in pain management.

What will happen at my first appointment?

At your first appointment, the doctor will assess your pain and recommend a management plan. This plan will be tailored according to your needs and health condition and will involve further appointments with other specialists in the pain clinic.

To prepare for this appointment please bring with you copies of any relevant letters and a list of current medicines prescribed by your GP.

What happens next?

You will be given a follow-up appointment, with a specialist nurse (who works closely with your consultant) where you will have the opportunity to:

• clarify any questions you may have from your first consultation
• discuss your management plan

At this appointment the specialist nurse will book additional appointments with our specialist teams as detailed in your management plan.

Pain management information seminar

As part of your pain clinic pathway, you will be invited to attend our pain management information seminar or to be enrolled onto the online pain information seminar. The aim of these sessions are to help you to understand chronic pain and the impact it can have on your day to-day life. Moreover, this will introduce you to the practical strategies (things that you can do) to help minimise persistent pain and reduce / manage ‘flare-ups’.

You will receive a follow-up appointment approximately three months after attending the pain information seminar. For those of you who are enrolled into the online pain information seminar, your nurse will provide you will an open appointment for you to activate upon completion of the course. The aim of the follow up appointment is to support you with the self-management strategies and to help you individualise them to your personal needs.

What other appointments might I have?

Depending upon your doctor’s or nurse’s recommendations, you will be offered further appointments to discuss medication management and to review how you are self-managing. In addition, you may be referred to the following specialist services who are trained in the management of pain, including:

• Physiotherapy - Physiotherapists assess and treat patients who have reduced mobility and/or physical conditioning as a result of persistent pain. You may encounter the pain physiotherapists at a number of different stages during your pain management pathway.
• Occupational therapy - Persistent pain can affect peoples’ ability to participate in everyday activities such as personal care, domestic tasks, meal preparation, work and leisure activities. Occupational therapists can help you work on your personal goals and manage these with more ease. They offer advice, practical techniques, and adaptive and rehabilitation approaches that will help you manage your persistent pain more effectively.
• Psychological therapy - Persistent pain can result in physical as well as psychological (body and mind) changes. Psychological changes often contribute to distress and a reduced quality of life, which can interfere with your ability to manage your pain. Pain psychologists offer support on a one-to-one perspective, in groups, or through a programme approach, in the search for better pain management. At times they will refer you onto a more appropriate psychological support service.
• Interventional treatments (nerve blocks) - These may be offered if your doctor decides that your pain is likely to respond, and that the benefit outweighs any risk. Most procedures involve the injection of local anaesthetic and steroids to nerves, muscles or joints. The purpose of the injections is to reduce your pain for a period of time to allow you to engage in muscle strengthening exercises and restore function. You can make the most of the injections and prolong the benefit by adjusting your activities in the period after the procedure by using the self-management strategies that we will teach you during the pain information seminar / online seminar.

All standard interventional treatments are carried out as outpatient appointments at The Princess of Wales Hospital day surgery unit in Ely, unless a clinical reason is identified that would require you to have your procedure carried out at Addenbrooke’s Hospital.You will need to be accompanied by someone and have transport arranged otherwise your treatment will be cancelled.

Things to remember before an appointment

• Always bring your reading glasses, hearing aid etc. to appointments. Let us know, in advance, if you need translation services.
• Always bring a list of your current medication. Always bring your pain clinic patient folder. Please inform the doctor or nurse if you are taking, or if there are plans for you to start taking, anticoagulants (medication to thin your blood). Failure to do so may result in an injection being postponed.
• If you think you may be pregnant please inform the doctor or nurse so that unnecessary medications and X rays can be avoided for the safety of the baby.

Addenbrooke’s is a teaching hospital and we are committed to the training of medical and nursing staff. Trainee doctors and student nurses are regularly based in the clinic as part of their training programme.

We do our best to keep appointments to time and yours may be cancelled if you arrive late. After each visit a letter will be sent to your GP to keep them updated and they will be your first point of contact for any further advice.

Important note

If you are unable to attend your appointment, please contact us as soon as possible, so that we can use it for someone else.

It is hospital policy that any patient who does not attend their appointments (DNA) without informing the clinic may be discharged from the service and any further appointments with us cancelled. A letter will be sent to you and to your GP.

It is also hospital policy that if you are unable to attend an appointment (CNA), having informed us, on two consecutive occasions, you may also be discharged from the service with all further appointments with us cancelled.

Contacts/further information

Pain clinic hours 08:00 to 16:00

Telephone number: 01223 217796

Pain clinic

Box 215

Addenbrooke’s Hospital

Hills Road

Cambridge

CB2 2QQ

The pain clinic can be found in outpatients, Level 3.

There is a disabled ‘drop off/collection’ point at the main outpatient entrance, where wheelchairs are generally available if necessary.

Privacy and dignity

We are committed to treating all patients with privacy and dignity in a safe, clean and comfortable environment.