Pain Information
Pain Questionnaires
Are you in pain and need help? Fill out one of the following pain questionnaires:
Pain Problems
Pain Treatments in General
"Doctor, when will my pain ever go away?"
Unfortunately I hear this question more often than I care to remember. The problem is - Once you have suffered from chronic pain (i.e. pain that lasts more than an arbitrary number of three or six months) it is rather unlikely that there is anything I or anyone else can do to make it "all go away" in a flash.
It is indeed very rare that I can perform "miracles" (for example patients with nerve entrapment within a scar where one or two scar infiltrations may lead to a complete recovery). In reality it is time to celebrate when pain is reduced by 30 % and your sleep and function has improved accordingly.
Once pain has become long-standing the huge majority of pain physicians will be honest to you and direct you into helping yourself to reduce the pain to a manageable level (well, we have some tricks up the sleeve after all) and teaching you how to live with the pain (i.e. the pain does no longer control you but rather you are in control of the pain).
Those health care professionals promising you a quick cure after 20 years of back pain, leg pain, arm pain, neck pain , headache, etc. - well, I guess I could be forgiven for recommending you to spend the money they would charge you rather on yourself / your wife / partner / significant other / family / dog / charitable organisation of your choice / ....
How can we as a Pain Team be of help to you?
Firstly, there is no one single magic bullet. Modern Pain Medicine emphasizes a bio-psycho-social-spiritual-cultural approach to assessment and treatment of pain.
More often than not persistent pain will change you. Whoever you were prior to the onset of pain, it is likely that you will have changed. Your sleep is often atrocious, your mood is going down big-time, you cry for no reason, your appetite has gone, the slightest sound your kids make drives you nuts, you can't even do the simplest tasks such as putting on socks or doing up your bra, all in all you feel like a wreck. Worst of all, often enough the people around you can't see how much you suffer because there is no torn off limb or a big knife sticking out of your back (although it exactly feels like that for you).
This is exactly the point where a Pain Team comes in.
Assessment
Firstly, you will undergo a proper assessment which may take anything between one hour (Complex Pain Assessment - by the nature of chronic pain the very basic minimum) and six hours (Pain Panel Assessment of one hour each by a Pain Physician, Physiotherapist, Psychologist, Psychiatrist, Pain Nurse and Rehabilitation Physician).
In fact, a number of patients are initially annoyed about the Pain Questionnaire they are asked to fill out but with hindsight the vast majority of patients admit that this is the first time that someone has spend some time actually trying to figure out what is going on. During the interview it is sometimes necessary to spend significant time overcoming hurdles of communication such as anger, lack of rapport and trust, misinformation, etc.
Management Goals
- Functional Restoration
- Pain management
- Psychological treatment
Multidisciplinary Pain Management - a bio-psycho-social model
- Biological
- Medication
- Physical Therapies : Occupational Therapy / Physical Therapy / TENS / Hydrotherapy / etc.
- Interventional Pain Medicine
Psychological
- Goal Setting
- Relaxation
- Diversion
- Coping strategies
- Pacing
- Identify triggers
- Encourage active compared with passive management strategies
Social
- Dealing with relationships to family, friends, others
- Guidance with regards to finances
- Direction in terms of community , social support and contacts
Based upon the issues raised in the assessment some or all of the following interventions may play a role in your case: