Pain

Caring for patients who have ongoing, chronic or acute pain.

The Pain Service at Royal Cornwall Hospitals helps patients manage pain. We work with patients who have ongoing, chronic or acute pain.

Our team is led by six consultants who share a specialist interest in pain problems, together with pain nurses, acupuncturists and a pain management team of physiotherapists and psychologists. We also work closely with the Palliative Care team to support terminally ill patients both in the hospice and the community.

Although the Pain Service works as an integrated unit, different elements of our service are located in different areas. The majority of our services take place at the Royal Cornwall Hospital in Treliske, but we also see and treat patients at St Austell, St Michael’s and West Cornwall Hospitals. The Pain Team also teaches across the Royal Cornwall Hospitals and other hospitals in Cornwall, as well as carries out audits and setting standards.

Day Surgery for Pain

Pain day surgery, where we carry out therapeutic and diagnostic invasive procedures and injections, is mainly performed in the X­-Ray Department at the Royal Cornwall Hospital in Treliske, Truro.

We also carry out a number of procedures at St Michael’s Hospital in Hayle, including local infiltrations, regional blocks, epidurals, specific nerve blocks under x­ray control, cryotherapy, spinal cord stimulation for a variety of conditions (CRPS, neuropathies, Failed Back Surgery Syndrome) and insertion of intrathecal infusions and more permanent computerised pumps.

Inpatient Care

The Pain Service doesn’t have specific inpatient beds, instead any pain patient who needs inpatient assessment or treatment will normally be admitted into surgical or medical short stay beds after we have arranged this with the relevant surgeon or physician.

The pain nursing team supervises patients daily. On their rounds, they will look after both pain patients and patients being treated by other services who are in pain. Consultants carry out twice­-weekly rounds for specific problems, and also guide other medical staff in helping them manage their patients’ pain.

Pain Outpatients

At the main Pain Clinic, based in the Tower Block at Royal Cornwall Hospital, we assess, diagnose and sometimes treat outpatients at a range of different clinics, led by our consultants, nurses and physiotherapists. We also carry out bio-psycho­social behavioural assessments, run courses and follow­ up with patients at the clinic.

We also hold clinics for pain patients at St Austell Hospital and West Cornwall Hospital. At St Austell Hospital, there is a consultant clinic on Wednesday mornings from 8.30am to 12.30pm.

At West Cornwall Hospital, we run a Wednesday morning Consultant Clinic (8.30am to 12.30pm), an Extended Scope Physiotherapist assessment clinic (9am to ­12.30pm) and a Nurse Acupuncture and review clinic (9am to 4.30pm). To attend any of these clinics you will need to be referred by your GP.

Pain Management

The pain management unit helps patients who have specific chronic pain problems. We’ll provide assessment with both a physiotherapist and a psychologist, and suggest a management plan with a cognitive behavioural approach.

Pain management programmes

A pain management programme helps patients to self-manage their pain problems. It teaches patients how to reverse many of the negative changes that affect their life and that of their family. It shows patients how to acquire the necessary skills and knowledge to reduce disability, become more physically active, and improve quality of life.

In broad terms, a programme includes:

  • Learning how to exercise in a way that is best for people with chronic pain. This means building up fitness and activity levels on a very gentle and gradual basis so that you can do a little every day without suffering for it later.
  • Learning how to pace activities so that you stop doing too much on a good day but almost nothing on a bad day.
  • Learning the skills of relaxation to reduce physical and emotional tension and help with flare-ups and sleep problems.
  • Learning about how chronic pain differs from acute pain and developing an understanding of how the body works, particularly in the context of a ‘chronic pain syndrome’.
  • Looking at how thoughts and feelings affect the way you deal with a long-term pain problem and learning how to modify unhelpful thoughts in order to change the ways you deal with their pain problem.
  • Learning how to plan out and set short-term and long-term goals on a step by step basis in order to improve many aspects of day-to-day life.
  • Learning how to deal with temporary set-backs and use pain management principles in the years ahead.

Pain Management contacts

Phone

01872 252160 or 01872 252792 (open 9am to 4pm Monday to Friday)

Psychology Consultant

Dr Tim Salzman

Specialist Physiotherapist in Pain Management

Barbara Sharp

Referrals to the Pain Service

We accept referrals from GPs via Choose and Book. Apart from some specific exclusions (detailed below) we will consider the referral of any patient with significant, persistent pain to the Pain Relief Clinic.

Referral Guidelines

The following conditions will be considered as urgent priority:

  • Uncontrolled cancer pain
  • Severe Neuropathic Pain Syndromes such as Radicular pain (incl. true sciatica and due to osteoporotic collapse), Neuralgias (Trigeminal, Post-herpetic, Diabetic neuropathy), Phantom Limb Pain and Complex Regional Pain Syndrome

The Pain Clinic will also review and advise on patients with complex medication, when a multi-disciplinary approach is required, or escalating strong analgesic needs (e.g. opioids such as morphine for severe pain), where treatable pathology has been excluded and reasonable attempts at pain control have been unsuccessful.

We don’t accept referrals for:

  • Headaches – please refer to neurology*
  • Polyarthropathy, Suspected Connective Tissue Disorder and Fibromyalgia – please refer to Rheumatology*
  • Any problem where treatable pathology has been inadequately assessed and excluded (e.g. abdominal or pelvic pain) – Refer for appropriate specialist opinion*
  • Acupuncture Only requests – If required as a specific therapy, this should be requested and supplied in the Community
  • Patients that have previously attended the pain clinic for for the same condition, and have been discharged because there are no more available therapeutic options – These patients are unlikely to benefit greatly from re-referral but can be discussed at a joint pain case conference to ensure all reasonable options have been explored

*The Pain Clinic will assess these patients if felt appropriate by the specialist consultant to whom the patient was originally referred.