What does this service provide?

Who we are

We are a large team of experienced healthcare practitioners including nurses, physiotherapists, consultant anaesthetists and psychologists who specialise in the assessment and treatment of persistent pain problems.

What we do 

Our service provides specialty services ranging from cognitive behavioural therapy-based pain management programmes, diagnostic and injection clinics, referral to state-of-the art gym facilities or hydrotherapy, medication advice and education.  


Our hydrotherapy pool is used daily from Monday to Friday providing aquatic physiotherapy services for the Musculoskeletal (MSK) department.  

All patients undergo a full physiotherapy assessment before being referred for hydrotherapy. Home exercise programs are also prescribed to compliment hydrotherapy treatments. All sessions are directed by a physiotherapist and physiotherapy assistants.

Sometimes patients will progress back to dry land treatments or continue onto the gym. Other patients may be invited to attend our open sessions to maintain and work on their progress independently for a further 12 weeks after discharge.

Patients who benefit particularly from aquatic therapy include anyone struggling to exercise effectively on land, patients who are non-weight bearing or partial-weight bearing and after surgery or trauma. The pool temperature is kept at 35o Celsius and the warmth of the water provides a comforting environment that relaxes muscles and helps reduce pain. This can be particularly beneficial for arthritis and rheumatology conditions.

Gym facilities 

As part of our physiotherapy services we are able to take patients to a newly refurbished gym at Bognor Regis War Memorial Hospital. This enables us to introduce forms of exercise to help people improve physical strength and endurance, as well as reducing apprehension and building confidence when it comes to taking part in exercise. The aim is for patients to progress onto a local leisure centre or private gym to help them take control of their own pain management.

Injection and Acupuncture clinic  

While exercise-based therapy is often the best treatment for many pain problems, sometimes this may be needed in conjunction with other treatments. Evidence shows that injections are rarely the solution on their own. Our clinicians specialise in treating pain conditions and this has enabled them to become very experienced in providing a wide range of injections that may not be seen so frequently in other clinics. The aim of this injection clinic is to provide access to injections and acupuncture for pain relief when needed to complement other treatments. These cannot be offered on an ongoing or repeated basis.

Pain Management Programme 

Our Pain Management Programme is recognised as the gold standard in management of long-term pain conditions and seeks not only to talk about pain as a problem in itself, but to explore the various impacts that pain can have on a person’s life and look at different approaches to manage this. 

The Pain Management Programme is run as a group with a combined psychology and physiotherapy-based approach, most often within a community setting such as a local leisure centre.

Theatre-based procedures  

When appropriate we can make referral for various theatre-based injection procedures. These procedures are often offered as a diagnostic procedure to determine the potential source of your symptoms and are rarely used as a standalone treatment, but as a form of pain relief that can complement other treatments or management options such as exercise.   

Most commonly referred are lumbar spine (lower back) or facet joint injections (the small joints either side of your spine) of local anaesthetic and steroid, as well as nerve root block injections.  

These are referred to on a case by case basis and are performed by one of the consultants at St Richards Hospital Day Surgical Unit. 

Medication review 

We can offer a comprehensive review of your pain medication in line with national guidelines and best practice. Although we are not a prescribing service, we can make recommendations to your GP on medications that may be effective for pain relief.  There is a lot of evidence that opiate families of medication such as Tramadol and morphine have no place in persistent non-cancer related pain and are not recommended by NHS England or NICE guidance. We often help GPs to reduce the use of these medications slowly and safely, sometimes with assistance from other services if needed.

Transcutaneous Electrical Nerve Stimulation (TENS) machine 

A TENS machine is a small portable 9-volt battery powered unit that provides electrical stimulation to the skin via a series of self-adhesive pads. Some people can find these useful in the management of their pain condition, although it is not considered a stand-alone treatment and is often used in conjunction with other exercise based and self-management strategies that you will be taught within our service.  Our service has a small number of TENs machines that can be loaned to patients to trial and will be considered where appropriate as part of your care. 

Appointment information 

We offer face to face, telephone and video appointments. The majority of our initial appointments are provided as face-to-face consultations, however, some may be via telephone. Follow-up appointments can be provided in person but they are often offered as telephone appointments as many of our patients prefer this type of appointment.

Your appointment will be with one of our clinicians or a group of clinicians who are best able to help you with your condition.  

Please allow about 45 minutes for a follow up physical assessment appointment (after your telephone assessment) or one hour for a new patient appointment (this may be longer or shorter depending on your clinical need). During the consultation you will be able to discuss your history and symptoms and the clinician will assess your condition. 

You will get a chance to talk about different options for treatment and receive information that will help you manage your condition. The clinician will explain any treatments available, including risks and benefits. 

At the end of your appointment, it may be a good idea to write down the most important things discussed at your appointment. 

The following are some suggestions: 

  • what is your understanding of your condition?  
  • what has caused your symptoms? 
  • what management options are available? 
  • what are the pros and cons of each option?
  • what can you do to look after yourself? 

You will be able to discuss with the clinician what will happen next, which may be one or a combination of the following things: 

  • you may be discharged from the service 
  • you may be sent for further tests, such as a blood test, X-ray or MRI scan 
  • you may be offered a follow-up appointment, either on the telephone or face-to-face 
  • you may be referred onward if further advice or treatment is required, and these referral processes will be discussed with you at your appointment 

Whatever happens, you will receive advice on how best to look after yourself and manage your condition. 

Face-to-face appointments

On the day of your appointment, please go to the department named in your letter and register with reception. Please follow any local instructions regarding hygiene, such as wearing face masks and direction of travel around the hospital or clinic. This information will be given to you in advance of your appointment. 

Telephone appointments

All our clinicians can provide an expert assessment and will discuss your symptoms with you over the phone or online. They will also discuss appropriate management options for your problem. They will be able to send you advice, exercises and video guidance depending on what is most appropriate for your particular condition.  If you are contacted by telephone, please note that the call may come from an unknown number.

Online appointments

Appointments can also be provided using a video platform. A video appointment is normally organised following a telephone appointment when your clinician feels that they need to assess your movement to gain a better understanding of your problem. Your clinician will email you a link to access your video appointment and will discuss with you the necessary steps for getting the most from your video appointment.

Frequently asked questions

I am booked for an injection, what do I need to know?

Steroid injections are known to be a useful treatment for pain, swelling and stiffness within a joint or the area around the joint. The joint is injected with a preparation of local anaesthetic and corticosteroid.  

The anaesthetic is intended reduce the pain initially for 30 minutes and the corticosteroid should reduce the inflammation and therefore it may take up to two weeks for the effects of the injection to start working.  

The response to the injection varies from person to person but can last from several weeks to many months. There is some research to suggest that steroid may be harmful to tendon tissue so your clinician will discuss the risks and benefits for your condition on an individual basis. 

There are some health conditions for which an injection of steroid and anaesthetic is restricted. Please let us know if any of the following apply to you before you attend the clinic for an injection and your clinician will discuss these with you:   

  • you have open wounds such as leg ulcers or cellulitis at the site of the injection 
  • you have any artificial joints present in the area to be injected 
  • you are taking any antibiotic treatment for an infection or within 48 hours of stopping 
  • you have an allergy to local anaesthetic or steroid 
  • you are taking any immunosuppressant drugs, for example for HIV or arthritis 
  • you are receiving any chemotherapy treatment for the management of cancer 
  • you are taking a blood thinner such as Warfarin 
  • you have uncontrolled Diabetes Mellitus 
  • you are pregnant or breast feeding 

What should I expect after my joint injection?  

We advise you spend 30 minutes resting quietly in the clinic waiting area and make sure you feel well before you leave. Report to reception if you feel unwell. Avoid strenuous activity for the rest of the day. The injected area may be numb for up to 24 hours and the injected site may be sore for one to two days as explained in the side effects. Do not use heat pads or any other form of heat on the injection site for two days following the injection. You may however choose to use an ice pack on the injection site for pain. 

For a weight bearing joint we recommend that you rest and gently potter at home for two days after your injection to improve the likelihood of a good response.  

You may develop a bruise at the injection site. Most people notice improvement in their pain in two weeks, however maximum improvement of your pain may take up to six weeks following your injection. If you are having a vaccination within 4 weeks of your injection, please contact your GP. 

IMPORTANT – if you develop a rash or if the injection site is red, hot, swollen, or painful, you may be developing an infection. Please contact the PACE team or your GP. If you are unable to contact either of these and continue to have concerns, please go to Accident and Emergency.

Are there any side effects from having an injection?  

Side effects of a steroid injection are rare. Your clinician will discuss the side effects with you at the time of the injection.

What are the potential side effects?  

Flare Up – affects about 1 in 10 people. Occasionally people notice a flare in their joint pain within the first 24 hours after an injection. This usually settles on its own within a couple of days. Take your usual pain killers to relieve symptoms.

Infection –  very rarely, infection might be introduced into the joint at the time of an injection (estimated as 1 in 23,000 people). If the joint or area becomes more painful and hot, red, or swollen you may be developing an infection. You should see your doctor immediately or if this is not possible, go to Accident and Emergency.

Thinning of skin – occasionally some thinning of the skin or dimpling skin colour change may occur at the injection site. This is more likely to happen if you have a higher dose of steroid.

Facial flushing – steroid injections may sometimes cause facial flushing or interfere with the menstrual cycle making them irregular temporarily. You should consult your GP if concerned, or if it persists.

Mood change – treatment with steroids may cause changes in mood – either elation or depression. This may be more common in people with a previous history of mood disturbance. If you have concerns, please discuss this with your doctor

Change in glycaemic control – People with diabetes may find that the steroid injection affects their blood sugar control and may notice a temporary blood sugar rise. It is recommended that you check your blood levels more regularly as it may take between one to three weeks for them to settle.

I need an interpreter, how can I arrange this?  

If you need an interpreter, please contact our team on 01243 623 910 and we can arrange for one to be at the appointment with you. We can also arrange for interpreters for telephone appointments.

Here are some questions that might be helpful in getting you to prepare for your appointment: 

  • what are my current symptoms? 
  • what things worry you most about your condition or your symptoms? 
  • what are the most important questions you would like to ask? 
  • what are your expectations following your appointment? 
  • how can I prepare for an appointment?  

Please bring a list of your current medicines, including prescribed and non-prescribed medicines, such as over the counter medicines and supplements. You do not need to bring your actual medicines with you.  If you have had a scan or X-Ray outside your local NHS provider, please send us your CD and contact us to arrange for these to be available at your appointment. Please bear in mind that it can take a long time to get hold of these, so the sooner you can let us know the better.   

Depending on your condition, you may need to expose relevant parts of your body, so you can be examined properly.  We can arrange a chaperone if you would like someone to be with you. This is an independent person specially trained to support patients. Please let our team know on 01243 623910 before the appointment if you would like a chaperone. 

How can I access this service?

Access to the PACE service will require a referral from a registered clinician such as your GP, nurse practitioner, rheumatologist, orthopaedic surgeon or physiotherapist.  

How can I contact this service?

Please refer to the CSIMS contact us section for telephone and contact details for all locations regarding appointments, active referral queries and any other queries.

Where to find us
Address: Centenary Wing, Bognor Regis War Memorial Hospital, Centenary Wing, Shripney Road, Bognor Regis, PO20 9PP

You can find us using the what3words address snippet below on the what3words website:

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Waiting times

Waiting times vary across the service, but we aim to see all patients within 12 weeks of your referral being received. 

Where can I find resources for this service?

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