Chronic pain management service

Chronic pain is defined as pain persisting beyond the normal healing process. It is sometimes defined as pain lasting for more than 3 months.

Unlike acute pain, which improves as healing progresses, chronic pain causes the individual to experience physiological and psychological symptoms, which can lead to significant and prolonged disability.

The Chronic Pain Management Service offers a wide range of medical and non-medical interventions for people living with chronic pain. We are an interdisciplinary team with expertise in management and treatment of chronic pain. 

Our goal is to improve pain control, support adaptive changes to improve daily function, productivity and overall quality of life. The multidisciplinary team includes consultants in pain medicine, clinical psychologists, physiotherapists, a pain specialist nurse, an acupuncturist, an Alexander technique teacher and office support staff.

We accept referrals for patients:

  • Who are over 18
  • Have been in pain for more than 3 months
  • Have failed to respond to standard pain relief treatments
  • Have severe and intractable pain and need help managing this

Please refer to appropriate specialist if the patient is requesting a diagnosis for their condition.

All NHS GP referrals must be submitted using the NHS e-Referral Service (e-RS). Referrals sent by email or post from NHS GPs will not be processed.

We accept referrals from GPs in:

Kingston

Richmond

Roehampton

Putney

East Elmbridge

Merton

Wandsworth

Sutton

  • Acute trauma
  • Signs of cauda equina syndrome
  • Suspected malignancy, such as significant unexpected weight loss, unremitting night pain or features suggestive of malignancy on systems review
  • Severe mental illness
  • Unmanaged suicide risk
  • Symptoms or signs of inflammatory joint disease or connective tissue disease
  • Symptoms or signs of cardio-respiratory disease
  • Widespread or progressive neurological symptoms
  • Sepsis, infection or early complication from a pain service procedure requiring immediate hospital attention

Urgent Referral to Pain Clinic

The following conditions require time sensitive interventions within a narrow time window:

  • Suspected Complex Regional Pain Syndrome within 6 months of onset – Please start management at time of referral
  • Complication from a Pain Service procedure excluding conditions that require acute admission

Routine Referral to Pain Clinic

The pain service is designed to help with the management of severe, intractable pain. Patients should have tried appropriate analgesia to improve their function, and received physiotherapy, prior to referral. Routine referrals include the following:

  • Complex Regional Pain Syndrome over 6 months of onset
  • Chronic Post Surgical Pain Syndromes
  • Cervical and thoracic pain with red flags and alternative pathologies excluded that do not need spinal surgical review
  • Chronic abdominal, groin and pelvic pain with no alternative pathology found and all specialised medical and surgical options exhausted.
  • Neuropathic pain syndromes and disorders where all usual Primary Care management has been exhausted
  • Chronic pain syndromes where all usual Primary Care management has been exhausted
  • Complex medication or escalating strong analgesic needs, with red flags excluded, all medical and surgical options exhausted, no new pathology and Primary Care measures have been undertaken

Referrals for Pain Management therapy should be made to Pain Clinic, the consultant will triage depending on individual need into the appropriate parts of the service.

The secondary care pain management programme is designed to help people learn to live with and around their pain. It is not a cure. It is designed for severe, intractable chronic pain, to help patients with persistent pain live better and happier lives.

Supporting Information

For professionals:

Faculty Of Pain Medicine Opioids Aware Opioids Aware | Faculty of Pain Medicine (fpm.ac.uk)

Faculty Of Pain Medicine Dose equivalents and changing opioids | Faculty of Pain Medicine (fpm.ac.uk)

Opioids: risk of dependence and addiction - GOV.UK (www.gov.uk)

Guidance for healthcare professionals on drug driving (publishing.service.gov.uk)

Tapering and stopping | Faculty of Pain Medicine (fpm.ac.uk)


For patients:

Pain Management Programme – https://youtu.be/dW_AHGg37TM

Live Well With Pain Home - Live Well with Pain

A Guide to Pain Management in different Languages - Pain Management Self Management

The British Pain Society website has some useful information if you would like to find out more: https://www.britishpainsociety.org/people-with-pain/

Useful patient information leaflets on pain medications, interventions, driving and pain Patient information leaflets | Faculty of Pain Medicine (fpm.ac.uk)

Useful patient information leaflet on taking opioids for pain FPM-OA-taking-opioids.pdf