Information for Clinicians
Our Services
Medical Consultation
At present all patients are seen first by a pain management consultant. In a 30 minute appointment we will formulate a targeted management plan.
This may include:
alteration of medications
pain management education
referral on for pain management programme assessment
referral on to another speciality
interventional procedures
specialist nurse follow up
Interventional Procedures
Interventions are not utilised as pain management solutions in isolation. We use them in combination with pain management techniques.
Procedures undertaken include:
medial branch radio frequency ablation - used in the management of facetogenic back pain
nerve root blocks - used in the management of lower limb neuropathic pain
peripheral nerve blocks e.g. supra scapular
axial steroid injections for specific back pain diagnoses
Pain Management Programme
Stockport Pain Managements Services run, at present, 3 pain management programmes a year. Each consists of 9 weeks of 3 hours per week. Pain Management Programmes have a strong evidence base to support their use.
Patients will be referred in by the pain consultant before being assessed for suitability. Exclusion criteria may include:
Inability to attend the days of the course
Mental health conditions
Language barriers
Inability to partake in the physical element of the PMP
Awaiting other investigations
We also have an online Pain Management Programme (ePMP) which is 10 weeks long with 5 modules.
Those who are unable to attend either a PMP and ePMP may be offered some one to one appointments to cover pain management strategies.
Chronic Pain Specialist Nurse
Our specialist pain nurses perform a variety of tasks including:
pain management education
pain management programmes
medication reviews
telephone reviews
TENS education
electroacupuncture
qutenza - used to treat discrete regions of neuropathic pain
Disease Specific Information
Back Pain
Fibromyalgia
Knee Pain
Foot Pain
Shoulder Pain
Neck Pain
Osteoarthritis
Shingles
Neuropathic pain
Back Pain
Stratification
The STarT Back tool is a simple to use tool that stratifies back pain into low, medium and high risk. Click on the image above to access the online scoring tool.
For further details on it’s use can be found here. Matched treatment recommendations can be found here .
The majority of low and medium risk patients should be managed in the community. High risk and a proportion of medium risk patients may benefit from specialist, multidisciplinary care at Stockport Pain Management Services.
Guidance
The NICE guidelines for low bak pain and sciatica were recently updated and can be found here .
The use of epidural injections for non-specific low back with or without sciatica is no longer recommended or funded by Stockport CCG
Patient Information
This patient information leaflet contains useful background teaching plus strengthening exercises.
Videos
This video demonstrates how to perform the relevant exercises.
Fibromyalgia / Chronic Widespread Pain
The key to managing fibromyalgia is encouraging patient autonomy. Through education regarding the condition and it’s management patients must learn to put together a package of self-management tools including:
graded exercise
CBT
relaxation techniques
medications
simple techniques such as hot water bottles
At Stockport Pain Management Services we are happy to see patients with fibromyalgia to aid in the reinforcement of these principles and for consideration of a pain management programme.
We do not recommend repeat referrals as the key is patient self-management in the community.
This leaflet from Fibromyalgia UK is a little outdated but outlines management approaches well.
This article gives a good overview of the pathophysiology and management of functional pain syndromes including fibromyalgia.
Knee Pain
Patient information leaflet
This video supports the exercises recommended in the patient leaflet.
Foot Pain
Patient information leaflet.
This video supports the exercises recommended in the patient leaflet.
Shoulder Pain
Patient information leaflet
Neck Pain
Patient information leaflet
Osteoarthritis
Patient information leaflet
Shingles / Post Herpetic Neuralgia
Management
NICE guidance
Patient Information Leaflet
Dealing with Pain
Neuropathic Pain
Diagnostic Tool
The Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) is a simple diagnostic tool to identify neuropathic pain.
Neuropathic pain is commonly associated with high levels of distress. We recommend referral to Stockport Pain Management Services for all cases of suspected neuropathic pain.
The NICE guidelines for pharmacological management of neuropathic pain can be found here .