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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 on 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 Chronic Pain Service provides evidence-based services for patients who have persistent pain which is resistant to standard treatments such as physiotherapy. Our goal is to help with 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. Outpatients clinics are held 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.

We 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
  •  referral to other services where needed, such as spinal surgery or a pain management programme

We also perform 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 often made by GPs or by self-referral through the Vita Health Group, who provide community physiotherapy for musculoskeletal problems.

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

What to expect when you have been referred

When we have received the referral, you will get a letter inviting you to 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 then 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

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 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.

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: