This page is a printable version of: https://www.iow.nhs.uk/our-services/planned-care-services/chronic-and-acute-pain/chronic-pain-treatments.htm
Date: 11 December 2023
During your initial assessment appointment (see Assessment Process Page) a treatment plan will have been discussed and decided upon. This page provides more information on possible treatments that the Chronic Pain Service can provide.
Not all treatments will be appropriate for everyone, this can be discussed further during you appointment.
As individuals respond differently a tailored combination needs to be found for each person, and this usually requires trying several different medications to find the most effective.
Some medicines are only beneficial for a limited period of time; these may only be needed to manage flare-ups. Other medicines are more effective for long term control but may take a little while to initially begin working.
The Pain Clinic team may advise the General Practitioner who referred you about other medications or changes to your current medications to provide some possible pain relief.
Patients need to see their GP to get the recommended medicines prescribed after the clinic letter arrives. Please make sure that you continue to take your medicines as agreed with the Pain Clinic clinician or GP, unless you have intolerable side effects.
If pain is located in a particular region and there are structural changes identified that may contribute or cause this pain, then targeted injections may help to relieve pain. These work by numbing a specific structure – such as a nerve, a joint, a muscle etc. - With local anaesthetic and reduce inflammation and irritation. Occasionally this can lead to (or RF) treatment to prolong the effect of targeted injections. However, none of these treatments will lastingly relieve or cure pain. While relief from an injection can be profound, then effect is time limited, lasting from a few weeks only to – rarely – a year.
Injections therefore need to be part of a wider treatment package.
Transcutaneous electrical nerve stimulation (TENS) is a form of external pain relief treatment for painful body regions, using mild electricity applied through the skin.
While we cannot provide TENS machines and necessary skin patches, these can be obtained in local pharmacies or ordered via online purchase. We are able to help you with how to make best use of your TENS machine, such as where to put the patches, how to operate the machine settings and when to apply it.
Senior specialised physiotherapists within the chronic pain service often see patients on an individual basis for an assessment or course of appointments. At your initial assessment a physiotherapist will work with you to help you understand your condition, agree a treatment plan, and help you to set personal goals. A specific manual treatment such as massage or soft tissue mobilisation may be appropriate. However, treatment is likely to include advice about movement, posture and finding ways of achieving your goals and managing long term pain or preparing you for group sessions such as the pain management programme.
The psychological approaches aim to improve understanding and coping with the emotions and overall impact on life that can occur when living with chronic pain. Psychological approaches used include cognitive behavioural therapy (CBT), Acceptance and commitment therapy (ACT) and mindfulness.
-CBT helps people to understand how thoughts, beliefs and attitudes can impact on our emotions and behaviour and teaches different skills to help cope with difficulties.
-ACT encourages people to re-evaluate and change their relationship with their experiences (including distress and pain). Rather than trying to get rid of unpleasant thoughts, feelings and sensations ACT encourages a willingness to allow these experiences and setting value- based goals.
-Mindfulness is a form of meditation that focuses on being in the present moment.
Psychological interventions may be offered individually on a short-term basis, or as part of small group based programmes.
Isle of Wight Pain Management Programmes (PMP)
The Isle of Wight (Group) Pain Management Programmes involves a combination of educational talks and practical sessions. The aim of pain management is to help you understand why you are experiencing pain, to reduce any worries or fears you may have about causing harm or more pain and to learn skills to help you live better alongside your pain. The programme focuses on:
-Increasing confidence in managing your pain independently.
-Improving quality of life by increasing your activity levels without increasing your pain.
-Helping you set and work towards realistic, valued and enjoyable goals.
-Helping you learn about stress reduction and learning relaxation strategies and mindfulness.
Treatment Information Leaflets
Complex Regional Pain Syndrome Leaflet
DMSO CRPS Patient Leaflet
Epidural Patient Information Leaflet
Facet or Sacro-Iliac Joint Injections Leaflet
Ketamine Infusion Leaflet
NAC for CRPS Patient Leaflet
Nerve Root Block Leaflet
Opioid Information Leaflet
Stellate Ganglion Block Leaflet