Pain Management - multidisciplinary service

The Pain Management service at Royal Perth Hospital provides multidisciplinary assessment and treatment for people with persistent non-cancer and cancer pain.

The team includes clerical, nursing, physiotherapy, psychology and occupational therapy staff, along with doctors from pain medicine and psychiatry and addiction medicine to address the often complex health issues that can impact on your individual condition.

Referral process

Many conditions causing pain can be managed with the help and support of your general practitioner (GP). If your GP considers that you need specialist assistance and treatment, they can refer you to a public hospital outpatient service based on your clinical priority.

All referrals, except patients requiring immediate review (that is, within seven days), will be sent to the Central Referral Service (external link) who allocate the referral to the most appropriate hospital for each patient based on location, the specialty and the level of service required.

Services available

We offer both individual and group approaches to treatment. Firstly, after we receive your referral letter the pain doctor will triage your referral and recommend if you are suitable to attend a short pain management program.

If appropriate, you will be given an appointment to attend the one-day group Pain Education Program (PEP).

The PEP day provides up-to-date information and multidisciplinary advice about the most effective management strategies for persistent pain. When you attend you will be given a pain questionnaire to complete. This helps us to identify your concerns and forms a baseline so we can measure any improvements in your pain recovery.

We look at what happens in the nervous system when pain persists and identify strategies to reduce pain ‘wind-up’. Other topics include the use of medication and procedures; movement and exercise; pacing everyday activities; psychological approaches to pain management; and information to help you to be able to talk effectively with your GP.

Often patients gain enough ideas from the PEP day to address their chronic pain with ongoing guidance from their GP.

Individual Assessment and Treatment Sessions

Once you have completed the PEP course and you feel you need more input after the program, you can ask for individual appointments with a pain clinic nurse; our allied health professionals including physiotherapy, clinical psychology, occupational therapy; and/or a consultation with a pain medicine specialist physician to help you develop a personalised pain management plan.

Listed below are the different roles, assistance and activities of the various teams who can help work with you to address the multiple aspects of pain and lifestyle:

Clinical psychologists – can help you understand pain and its relationship between muscle tension, emotions, thoughts and behaviour. They can help with strategies to improve sleep, develop coping skills and help you to relax.

Occupational therapists – can help you adapt your environment and show you ways to make activities of daily living, such as housework and personal care, easier. They can provide information about useful aids or equipment.

Physiotherapists – can provide advice about graded exercise program, posture and ways to relieve pain as well as treatments to maintain joint and muscle movement.

Pain nurses – can help you with education sessions, fit your TENS machine (external link) and provide pain assessments. The nurses are also available by phone/email should your GP wish to contact the clinic.

Pain doctors – our doctors from pain medicine and psychiatry can help you with medical assessment and management.

Resources

Videos

Chronic Pain – Is it All in Their Head? – Dr Daniel J Clauw, Michigan Medicine, August 2017 (YouTube link)
A variety of videos to watch by Dr Daniel Clauw, who is presenting to individuals experiencing long-term pain.

Tame the Beast (external link)
Tame the beast – it’s time to rethink persistent pain by Dr Lorimer Moseley.

Understanding Pain – Live Active (YouTube link)
Understanding pain in less than 5 minutes, and what to do about it!

Download

TENS Therapy Patient Information brochure (PDF 327KB)
What is a TENS machine? A Tens machine is a small box that transmits small electrical pulses around or through the site of pain.

Useful links

There are many websites that have helpful information about pain. Listed below are some useful resources for information, support, and community and self-help programs:

Painhealth WA
Local site offering tips on self-management tools to assist in the co-management of musculoskeletal pain.

Pain Australia
A not-for-profit organisation established to improve the treatment and management of pain in Australia. Their site is a wealth of knowledge offering up to date information, book suggestions, free online courses, trials, videos and more.

University of Sydney – Pain Management Research Institute
Good information on the latest scientific research into pain. Easy to understand explanations of what pain is, who gets pain, the important difference between acute and persistent pain among many other things.

International Association for the Study of Pain (IASP)
Worldwide Pain Society. Go to the Patient Resource section this provides a list of resources to patients and also includes worldwide Pain Management Organisations and their recommendations.

The Fibromyalgia Support Network of Western Australia Inc
Provides information, education and events for people living with Fibromyalgia.

The Heart Foundation
Australia’s largest network of free walking groups – caters for all exercise tolerance levels. Type in your post code or suburb to find the nearest walking group.

Over 55 Walking Association
Well organised walking group for the over 55s every Tuesday at 10am. All the walks must be close to a bus stop or train station and have public toilet facilities. All walks are organised such that you walk as far as you like then turn around and walk back. There are no time limits or expectations on participants.

Pain Concern – UK based
UK charity site providing excellent interactive tools for pain sufferers and their families including articles, radio segments, videos, online forum and social media feeds, interviews with experts and more.

The Pain Matters magazine is aimed at people living with chronic pain. It contains news, features, comments on pain management, research into treatments, and personal experiences of living with pain.

The noi group – Neuro Orthopaedic Institute
This website is more difficult to navigate but has some excellent videos and suggestions. Try clicking on ‘noi likes’ for a list of books, videos, art ideas, debates, and much more.

Look out for articles such as Prof Lorimer Moseley and his ground breaking research into the role of the mind in persistent pain states – or click on ‘noi jam’ for a collection of articles/texts that will inform, entertain and intrigue.

Functional and dissociative neurological symptoms – A patient’s guide
This site provides a summary of many of the common, and some less common symptoms associated with persistent pain.

Click on a ‘symptom’ for explanations, tips, hints, advice and often a link to more in-depth discussion is also provided. Click on other tabs such as causes, misdiagnosis, or treatments for more useful information.

The Pain Toolkit
Excellent short videos that tell it like it is. There are drop down questions/answers which are easy to follow. Great resources page – many of the sites are from the UK- but some are Australian, and they have plenty of great ideas and information.

They have a free app for iPhone or android that you can use as a daily reminder to make the changes and keep up the good work.