Pain Management
In House
 |
Cancer Pain - talk to Richard Dillon (McMillan Nurse) or Ram |
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Consider Acupunture with Ashraf |
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Consider TENS machine |
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If considering Gabapentin, send to Ashraf first |
GPwSI
| Name | Location | Tel | Referral Criteria | How to refer |
| Dr. Ashraf Khan | Ashcroft Surgery |
►will try and achieve pain control with oral medication ►all do acupuncture ►will do injections where indicated but no spinal injections
Referral Criteria: Exclusion Criteria: needle phobia, anticoag Rx, bleeding disorders, structural heart probs |
referral forms should be sent directly
to the dr to whom you are referring patients will only have a limited number of weekly treatment sessions (max 6) lasting 20 mins each more details for acupuncture at the bottom |
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| Dr Colin Passant | Windhill Green | |||
| Dr. Alison Roberts | Idle MC |
Specialised Outreach Clinics
| Name | Location | Tel | Referral Criteria | How to refer |
|
Dr Frances Cole Chronic Pain Management Clinic |
Horton Park Chronic Pain Management |
01274 771 999 ask for Lynne Milner |
►mainly for somatic pain (physical pain secondary to emotional distress) ie pain of benign origin and is intractable (present most of the time with varying intensity) ►multidisciplinary apprach (physio + CBT) ►pain>6m ►age 18-70 ►speak English ►no psychotic illness/major depression/demetia/personality disorder ►had investigations to ensure diagnosis is of chronic non-malignant pain |
●use chronic pain rehab program. referral forms
●include investigations done so far: |
| Pain Clinic Liaison Nurse |
Margaret Marsden BRI |
Consultants
| Name | Location | Tel | Referral Criteria | How to refer |
| Pain Clinic | BRI and St Lukes Prof Richardson (lead) but loads of anaesthetists involved)
|
►specified back problems for example needing epidurals ►where referring to orhopaedics for pains eg back, neck, etc would be a waste of time |
●Letter, to "Dear Team" ●all investigations must be complete prior to referral ie not awaiting MRI scans etc |
Notes
Acupuncture Clinics:
Suitable conditions
Muscle pains: neck, low back, lower limbs etc
Tennis/Golfer's elbow
Recurrent tension headache
Painful intractable irritable bowel sundrome
OA
Neck Pain
Sciatic
Migraine
Period Pains
Contraindication to Acupuncture
|
| Children under age 12 |
| Pregnancy |
| Valvular heart disease (relative CI) |
| Patients on Warfarin/other anti-coagulants |
| Patients on oral steroids |
| Needle phobia |
Possible side effects of Acupuncture
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| Occasional temporary worsening of pain |
| Slight bleeding after withdrawal of needle |
| Altered mood - euphoria/drowsiness |
| Damage to underlying structures e.g. pneumothorax (very rare, avoidable with caution) |
N.B. Patient must not drive after first session, as they may become drowsy.
Length of treatment
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| Altogether 6 - 8 sessions. Arranged once weekly in consequence. |
| First session - 30-40 minutes |
| Subsequent sessions - 20-30 minutes |
| If, after fourth session, there has been no relief, usually stop treatment. |