Pain Management Programme

You have been given this leaflet because your consultant and nurse think the Addenbrooke’s pain management programme may help you cope with your pain. This leaflet aims to give you enough information to help you decide whether you are interested in taking part. Our mission for patients participating in the pain management programme:

To empower patients to gain confidence, change their perspective on pain for the better and improve their participation in life.

Who is the programme for?

The programme is for those who have chronic pain which is pain lasting more than six months. To take part you will already have been under the care of the pain clinic. You will have been reviewed by a consultant and also have various appointments with the clinic nurses.

The programme is recommended because there is no cure for chronic pain. It sets out to give people the knowledge and tools for their own long-term management of pain.

Many on the programme say pain has taken over their lives. The programme is designed to help people get their lives back; to help people achieve their goals, get fit, lift their mood and see improvements in their relationships. If you want to achieve these things, then the pain management programme may be for you.

What does the programme involve?

The programme is held on Mondays to Thursdays for three weeks – a total of 12 days – in groups of around eight people. Although it is an outpatient programme some people qualify for accommodation during the programme.

Each group is reviewed after one month, six months and a year. You are expected to attend all sessions of the programme and reviews. If you cannot attend one of your group’s review days, you will be offered a review with a different group.

The programme involves a big commitment from you. We also suggest you avoid making significant plans for the Fridays or weekends during the programme, so you can make the most of the programme.

Who runs the programme?

Psychologists lead a team of nurses, physiotherapists and occupational therapists. We do not see pain as just a physical problem. We believe it involves your thoughts, your mood, your activities and your relationships, amongst other things. That is why a range of different staff are involved to help build coping strategies in different areas of your life.

The psychology ideas we use are called cognitive behaviour therapy. This helps people think differently about their problems and evolve ways to cope with them. The end result is often an improvement in mood.

The responsibilities of the clinical team on the programme include:

• To provide evidence-based approaches for self-management of chronic pain
• To treat you with respect and kindness
• To ensure a supportive environment for you to try out new skills

The responsibilities of the participants on the programme include:

• To be open minded
• To commit to attend all sessions
• To participate in the activities and discussions
• You have a responsibility to try out the strategies and skills in your everyday life.

What would I do on a programme?

A typical day on the programme could involve:

09.00 Review of action plan for home practice (whole team session)

09.45 Goal setting (occupational therapy session)

10.30 Break

10.45 Work and leisure (occupational therapy session)

11.30 Break

11.45 Effective communication (psychology session)

12.30 Lunch

13.30 Gym (physiotherapy session)

14.30 Hydrotherapy (physiotherapy session)

15.30 Relaxation (nurse session)

A basic lunch is provided. Sessions take place at several locations around the hospital site. You may be expected to move between these locations to attend these sessions. For some of these journeys, use of a courtesy bus will be available.

The programme includes a friends and family day in week two. This can be very helpful and help them understand more about chronic pain, review how they can support your pain management strategies and address any questions they may have.

What happens next?

You will be assessed by a physiotherapist, clinical psychologist and occupational therapist. This will last about an hour and a half.

You will be asked questions about your pain problem, physical functioning, psychological coping and your day to day activities. If you are offered a place on the programme the possibility of accommodation will be discussed with you. Alternatively, the team may suggest a different plan, like a referral to another service. If you are not interested in taking part in the programme, please inform the clinic team.

You will continue to be offered group reviews until the programme’s one-year review when you will be discharged because you will have been taught to manage your pain for yourself, with support from your GP.

Benefits

Participants on previous programmes have described the following benefits:

- “I feel like I’ve got the old me back”

- “I finally understand what’s going on with my pain”

- “I’m doing more of what I want to do”

- “I know the right kind of exercise”

- “I’m thinking in a more balanced way”

- “I can do the day to day things I need to do around the house”

- “I’ve got a plan for the months ahead”

Risks

There are no known long term risks to using pain management strategies. Taking part in the programme may lead to increased pain in the short term. This is a normal process as your body gets used to more exercise and the routine of the programme. Sitting in chairs for some of the programme can cause temporary discomfort. You may also feel upset on the programme at times, as some of the things we talk about may be emotionally challenging. You will be supported by the team in dealing with these difficulties.

Most participants say these problems are short lived and get better over the course of the programme. If you do experience more pain or distress during the programme, it is important that you tell us. Then we can work together to help you cope.

Alternatives

Alternatives to the pain management programme may include individual clinical psychology, physiotherapy or occupational therapy sessions through pain clinic. If you would like to consider this, please discuss it with the pain clinic team.

Privacy & Dignity

We are committed to treating all patients with privacy and dignity. The confidential nature of the group sessions is discussed at the start of the programme. Conversations with staff are confidential unless it is thought that there is a risk to your own or another person’s safety. The department of pain medicine is compliant with Trust policies for patient confidentiality. If you have any concerns at any stage, please speak to a member of staff in pain clinic or to your GP.

Further information contact details:

Should you require further information please contact the Pain Management Programme Administrator, Department of Pain Medicine, Box 215, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0QQ. Telephone number 01223 216993.