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Pain management

Chronic pain is a pain that lasts for longer than 3 to 6 months. It is very common and affects just under 28 million adults in the UK. In about 10%, this pain is moderately to severely disabling. The most common types of pain are back pain, headache and joint pain.

Chronic pain can have a significant impact upon a person’s life including their physical activity, relationships and mood. Pain is complicated and research suggests that the best approach is to try and manage the difficulties it causes, instead of just trying to change the pain on its own.

The role of the Chronic Pain Service is to provide evidence-based services for patients who have persistent pain which is resistant to standard treatments such as physiotherapy. Our goal is to help provide symptom management, to reduce pain sensations and help you to take an active role in managing your pain enabling you to live an active life.

Inpatient pain service

The inpatient pain team at the Princess Royal University Hospital (PRUH) sees and advises patients with acute and chronic pain conditions who are in hospital This includes acute postoperative pain, back pain, pancreatitis, abdominal pain, rib fractures and neuropathic pain. Our pain specialist nurses are available Monday to Friday, from 8am to 4pm. There are also pain consultant ward rounds on Mondays, Wednesdays and Fridays.

Outpatient chronic pain service

We provide an outpatient service for people who live with chronic pain with clinics at Beckenham Beacon, Orpington Hospital and Queen Mary’s Hospital, Sidcup. Our day case interventional pain procedures are done in the Alan Cumming Day Surgery Unit at the PRUH.

The outpatient chronic pain team assess and advises patients with chronic (long-term) conditions such as back pain, joint pain such as hip, knee and shoulder, abdominal pain, chronic post-surgical pain, pelvic pain and neuropathic pain.

Chronic pain clinic

The chronic pain clinic services include:

  • education on how to manage pain and signposting to helpful information sources
  • advice about pain relief medication (analgesia) and new medication strategies
  • simple injections in clinic such as trigger point injections
  • acupuncture
  • TENS clinics for those patients who need guidance about using a TENS machine
  • investigations such as blood tests, X rays and scans where required
  • onward referral, where appropriate, to other services such as spinal surgery or a pain management programme
  • day case interventional pain procedures including:

      • • epidurals

      • facet joint injections and medial branch blocks

      • nerve root injections

      • genicular nerve blocks

      • joint injections

      • lumbar plexus blocks

      • suprascapular nerve block

      • pulsed or continuous radiofrequency

      • capsaicin 8% patch

      • other nerve blocks

    How to be referred to the Chronic Pain Service

    Referrals to our service are commonly made through your GP or by self-referral through the Vita Health Group, who provide community physiotherapy for musculoskeletal problems.

    We also receive referrals from hospital speciality services such as orthopaedics, rheumatology, gynaecology and surgery.

    What to expect when you have been referred

    When we have received the referral, you will receive a letter inviting you to attend a chronic pain outpatient clinic where you will be seen by one of the consultants. The first appointment generally lasts about 30 minutes. We will assess your pain, taking a detailed history and perform a physical examination. We will suggest a treatment plan.

    Key Clinical Staff

     Name                                              Role

     Dr Maissara Al Rikabi  Pain Consultant
     Durga Dahal  Pain Specialist Nurse
     Dr Marouf Dhar  Pain Consultant
     Marina Duque Rodrigues  Pain Specialist Nurse
     Dr Kumar Pathmanathan  Pain Consultant
     Dr Carolyne Timberlake  Pain Consultant

    Contact

    Admissions officer, tel: 01689 864366

    Pain admissions, email: kch-tr.pruhpainadmissions@nhs.net

    Pain service secretary, tel:  01689 866007

    Pain service, email: kch-tr.pruhpainservice@nhs.net

    For GPs and other health professionals

    To refer to our outpatient chronic pain clinics please use NHS e-Referral only.

    Useful websites

    National websites

    Live well with pain is run by an alliance of healthcare professionals working in pain management and people with lived experience of pain.

    Versus Arthritis UK is a community providing support for people with arthritis across the UK.

    The NHS website has information on ways to manage chronic pain.

    Local websites

    Bromley Well provides free health and wellbeing services for people living in the London Borough of Bromley, including information on:

    The Bromley Common Practice surgery website features information on how to: