Pain Management Service

The doctors in the Pain Team understand how difficult and frustrating it is to cope with long-standing pain.

It can be particularly frustrating when it seems that clinical staff think that the patient is making up or exaggerating pain. Pain cannot be measured by tests; it is subjective (what the patient feels).

The doctors in the Pain Team are experts in managing children and young people with long-standing persistent or recurrent pain.

We use medicines and sometimes other additional interventions with which other doctors are not always familiar.

However, medicines are not always the only answer for chronic pain and we work closely with other team members (nurses, occupational therapists, physiotherapists, psychologists and family therapists) to help you manage your pain.

Pain Clinic doctors will contribute to your treatment in the following ways:

• Listen closely to understand your symptoms and situation
• Examination
• Diagnosis
• Some explanation of pain mechanisms
• Explanation of your pain problem
• Prescription and review of medicines
• Liaison and letters of support to other agencies

We have learnt that living with pain is a really difficult thing and can stop you and your family from doing things that you want to do. It can also make you feel very upset, scared and worried.

The psychology team aim to help children, young people and their families in times of difficulty.

We listen to your concerns and try and understand your situation and find a helpful way forward.

We always believe that your pain is real and are here to help you to make changes for the better.

We are not medical doctors and we do not prescribe medicines or do any physical examinations. We work closely with other members of the team (doctors, physiotherapists, occupational therapists and nurses).

Families (children, parents and guardians) may see a clinical psychologist or a family therapist after Pain Clinic for lots of different reasons, including:

• Difficulties adjusting and coping with your pain
• Anxieties and fears
• Problems at school
• Physical problems made worse by worries
• Traumatic experiences
• Feeling upset all of the time
• Problems within the family resulting from pain
• No medical explanation for your pain

We are able to talk (with your consent) to other agencies that you are involved with such as school, children’s services and other medical teams.

You will be seen by either an occupational therapist or physiotherapist from the Pain Therapy team. We both work very similarly and very closely together. We will work with you and your family to explore how pain affects you and your life.

During your individual sessions you will be able to talk about the things that you find challenging in order to look for solutions that work for you. This may include looking at how your body moves, whether you need help getting back to doing everyday things like looking after yourself, how you are managing with schoolwork, your leisure activities and interests; maintaining and improving your social life; and working towards your hopes and plans.

Together with your therapist you develop practical pain management tools and ideas that will support you in living well with pain and in your journey towards recovery. Some of the areas that we can explore together in the Pain Management programme include:

• Understanding pain
• Reducing stress
• Thoughts, feelings and actions
• Setting goals
• Pacing activities
• Solving problems
• Relaxation and mindfulness
• Rehabilitation
• Sleep management

Living with chronic pain is sometimes very difficult for children and their families. Whilst most children improve with input from our team, sometimes the path is not straightforward. It is not unusual for symptoms to fluctuate and we find that many families find it invaluable to be able to contact the team for advice between appointments. Clinical Nurse Specialists provide this point of contact for our team.

Clinical Nurse Specialists are senior, experienced nurses who have usually undertaken advanced training in pain management. You will meet a nurse when you attend for your first appointment in the Pain Clinic. They find it very helpful being able to put a name to a face and we believe that families value this contact as well.

Nurse specialists are closely involved with families after the Pain Clinic. They:

• Will make sure that we have accurate details to contact you
• Provide you with contact details for the pain clinic and treatment plans
• Will be available to provide telephone advice and support
• Provide a co-ordinating role to other members of the pain team
• Supply and teach on the use of TENS machines
• Contribute to the acupuncture service alongside physiotherapy staff