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.
Hydrotherapy
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.
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.
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