Reviewed on : 15 May 2020

Reviewed by : Catherine.Campbell@inhealthgroup.com

Expires : 15 May 2022

About Pain Management Solutions

Pain Management Solutions provide a community based treatment service for Persistent Pain

Patient referrals should only be made using the attached referral forms.

InHealth Pain Management Solutions

Multidisciplinary team: Physios (3), Occupational Therapist, Nurse, Well Being Practitioner (CBT) and Consultant in Pain Management

Locations:

• City Of Coventry Health Centre
• Holbrooks Heath Care
• Oasis Health Care, Cheylesmore
• Westside, Rugby

Assessment

Clinical Specialist 45 minute appointment to develop care plan with patient following which letter is sent to GP detailing outcome and copied to the patient

Adjustments can be made for patients if required including interpreting facilities, information provided in different languages, text changed for people with sight difficulties or dyslexia for example Care plans

Treatment pathways:

• Pain education/ self management – PMP 18 hour or individual session if patient unable to attend group session (anxiety in a group)
• CBT sessions (6) face to face or telephone
• Medical interventions following NICE guidelines and local Coventry CCG policy  Medication reviews, normally telephone based unless due to hearing or language difficulties we can arrange face to face

COVID-19 response:

All team members mobilised to home working – telephone based reviews

All care pathways continuing apart from medical interventions

Medical interventions – on hold, patients being held on a waiting list

Future plans – piloting of Zoom sessions for 1:1s and Pain Management Programmes

Pain Management Programmes

18 hour – 6 week programme

Current venues:

• Moat House Leisure & Neighbourhood centre Winston Ave CV2 1EA
• Benn Partnership Centre, Railway Terrace, Rugby CV21 3HR
• Quinton Park Baptist Church, Quinton Park, CV 3 5PZ

Led by 2 members of the team

Usually invite 10-15 patients

Handbook provided

Promote self management and development of strategies

Basic exercises introduced, mainly stretches and gentle strength exercises

Relaxation, mindfulness and acceptance commitment therapy (ACT) approaches introduced

Pain education

Chronic pain mechanisms

Explain difference between acute pain and chronic pain and therefore why the treatment needs to be different

Helping the patient to understand the mechanisms of chronic pain:

• Understanding pain in 5 minutes Youtube
• Why things hurt – Lorimer Moseley TED talk
• Tame the Beast – www.tamethebeast.org
• www.livewellwithpain.co.uk ‘Life after Opioids’
• www.paintoolkit.org

Help patient to recondition

CBT/ Mindfulness

Medical interventions 

Dr Yehia Kamal Consultant in Pain Management

Performed in mobile injection unit at Oasis Health Care

In line with NICE guidelines and local Coventry policy

Low back pain/ neck pain: Medial branch blocks only, currently if successful we then refer into secondary care for a Radiofrequency Denervation

Epidurals – only for acute (less than 12 weeks at point of referral) and severe sciatica

Interventions for other joints: Suprascapular nerve block, Genicular nerve block

Medication Reviews

Telephone based with an Independent Non-Medical Prescriber

Recommendation letter sent to GP

Common referral triggers:

• Current pain medication not effective – expectations of pain medication
• Causing side effects
• High doses of Opioids in excess of 120mg in 24 hours
• Patient keen to reduce pain medication and look at other ways of managing pain

Supporting patients to wean off Opioids at IPMS

Medication review triggered due to high dose, ineffective, GP has requested support and/or patient

Develop Opioid reduction plan – Faculty of Pain Medicine recommend a 10% reduction every 2 weeks

In reality there is no single right way to approach reducing Opioid medications (It is ideally done as gradually as possible, this might mean reducing your daily dose by the smallest amount possible every week or two)

Normalise withdrawal side effects and offer reassurance that they will ease

Normalise increases/ changes in symptoms but again these can settle, promotion of self management and self care.

Contact us:

Inhealth Pain Management Solutions Longfields Court Wharncliffe Business Park Middlewoods Way Barnsley S71 3GN

Tel: 0800 034 0406

Catherine.Campbell@inhealthgroup.com