Pain Management

Persistent Pain Management Services are intended to provide consultative services on a time limited basis.

The Persistent Pain Service encourages active patient participation in this process.

What we do

• Provide multidisciplinary assessment and management for pain conditions via group and individual programs. This means patients may see many clinicians throughout their journey including doctors, psychologists, physiotherapists, nurses, and psychiatrists.
• Develop active self-management skills and strategies via identifying goals and working towards these.
• Identify the contributors to pain including how to live with pain, medical concerns, coping styles, physical activity/exercise, and mental health.
• Provide pain interventions within a multidisciplinary paradigm.

What we don't do

• We do not offer a fix for pain, nor focus primarily on pain cure to improving quality of life.
• We do not authorise opioid prescriptions or Medicinal Cannabinoids. However, following medical assessment, the pain specialist may recommend changes to patients medication regime to their GP.
• We do not see patients for pain interventions only. While procedures may be a part of the management plan, we do not see patients just for procedural interventions.
• We do not provide long-term care. Engagement at the clinic is designed to be on a time- limited basis, working on specific goals and developing skills in self-management skills before discharge.
• We are unable to see paediatric patients.
• We do not complete NDIS or DSP applications.
• We do not offer team care arrangements.

Our services

We offer a variety of group and individual appointments with members of our multidisciplinary team. During the journey with our service, we can provide patients with more information so that they can make informed choices and optimize their care. These programs and consultations benefit the patient to improve their function and quality of life despite the presence of pain.

• Multi-Disciplinary Assessments
• Inter disciplinary Assessments
• Individual Appointments
• Interventional Pain Procedures
• Rethink Pain (Group Program)
• Activity and Pain (Group Program)

Appointment with the Persistent Pain Service does not necessarily mean or guarantee an appointment with a Specialist Pain Medicine Physician.

We also offer telehealth appointments to patients where appropriate.

Information to be included in the referral

Information that MUST be provided

• Patient goals - expectations from referral to PPS.  
  (Please ensure patient has agreed to referral and GP has been advised of referral).
• Pain history: onset, location, nature of pain and duration
• Psychological status and cognitive function
• Psychiatric history (including active/ unstable mental health issues)
• Details of previous pain management including the course of treatment(s) and outcome of treatment(s) if any
• Comprehensive past medical history
  • History of alcohol, recreational or injectable drugs, or prescription medicine misuse
• Current and complete medication history (including non-prescription medicines, complementary and alternative therapies).

Provide if available

• Details of functional impairment
• If the person has symptoms of, or have been diagnosed with, post-traumatic stress disorder (PTSD Details of any current behaviours that may impact on the persons ability to participate in a chronic pain management program (e.g. behaviours of concern, level of alcohol intake, cognition issues, reliance on a carer, mental health issues)
• If the person has been identified as having high-risk circumstances (multiple provider episodes, high-risk drug combinations, or opioid dose threshold)
• Results of previous investigations (e.g. nerve conduction studies, HbA1c, aetiology of peripheral neuropathy)
• If the person has previously completed a chronic pain management program and if so the provider of the program
• If a medication review or assessment is required
• If the person is part of a vulnerable population.
• Patient Literacy Issues.

Referral is NOT appropriate and will NOT be accepted for

• Patients that are not currently ready to engage with the biopsychosocial model of care.
• Patients currently undertaking another chronic pain management program or under care of a private pain specialist.
• Patients that have already completed a multidisciplinary, comprehensive chronic pain management program or service for the same identifiable cause of pain where their clinical symptoms, or their readiness to undertake a chronic pain management program, remains unchanged.
• Patients who ONLY want an intervention such as an injection or nerve block.
• Patients who want ONLY medications (or authority for medications).
• Patients who are not willing to engage in a multi-disciplinary approach to pain management.
• Patients who want NDIS documentations to support disability applications.

Complete eReferral or fax referrals to 6173 0457

Patient Pathway

The PPS pathway for seeing patients include:

1. Questionnaire
2. Information session:  This outlines our model of care which is based around a cognitive and behaviour change pathway aimed at developing strategies to manage pain.
3. Assessment
   1. Multidisciplinary Assessment, or
   2. Interdisciplinary Assessment, or
   3. Single Clinician Assessment
4. Outcome/Plan (Episode of Care)
5. Treatment complete - back to GP

To progress through the PPS clinic and program, patients whose referral is accepted will have to complete an in-depth questionnaire.

The Questionnaire is essential for helping the service tailor the best approach to the patient's needs. Patients may seek assistance from their family or friends. Where patients have difficulty completing the questionnaire, the PPS nurses (phone 6166 7871) or their GP or other health professional may aid in completing the form.

If the form is not completed, the service cannot progress with triaging the patient appropriately and the patient will be discharged from the service and the referrer will be informed.

After returning the questionnaire, most patients are invited to our Introduction session, which provides information about our Biopsychosocial model of care, the multidisciplinary treatment approach and basics of modern pain science and rehabilitation approaches.

Patients then decide if they wish to continue with the service. Those who choose to continue are triaged again with the additional information we have obtained, and most are offered a Multi-Disciplinary Assessment (MDA) or Inter-disciplinary (IDA) and a management plan.

Appointment with the Persistent Pain Service does not necessarily mean or guarantee an appointment with a doctor/ pain specialist.

Subsequent treatment may take place at the PPS or be referred out to community therapists. The PPS offers both individual and group-based therapies with medical and allied health clinicians.

Appointments are based on clinical priority.

Urgent (Category 1)

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will try to see these patients within four weeks, or sooner if clinically indicated.

Semi-urgent (Category 2)

We will try to see these patients within 12 weeks.

Routine (Category 3)

Next available appointment.

PPS Pain ECHO

PPS Pain ECHO is a virtual peer-group learning model for primary health care providers, including general practitioners, nurses, allied health professionals and community health workers.

The PPS Pain ECHO provides an opportunity to discuss your patient cases (de-identified), get practical ideas from the other attendees - a multidisciplinary PPS team and other Primary Health participants (GPs, psychologist, physiotherapists etc) “ and contribute your experience. The aim is learning through case-based discussion (there is also a short theory section).

The PPS Pain ECHO meetings are held online every fourth Thursday, 8:30 am to 9:30 am. One case is discussed per session. Registration gives you access to all sessions “ attend as many or as few as you like. Sessions are free.

• Click here to register your interest in attending the PPS Pain ECHO videoconference/case discussions
• Case Presentation Template - De-identify your patient

For more information about the ECHO model itself:

• Project ECHO Website
• Video summary of ECHO model
• A Clinician describing the benefits to herself and her practice
• Pain Clinical Reasoning Guide

Other files

• Persistent Pain Service Referral Patient Questionnaire