Roles Within the Team
The Community Pain Service is a group of clinicians and support staff that work closely with you to diagnose your pain condition, and develop a shared management plan. This is a list of people you may meet.
The role of our physiotherapists is to help people to make sense of their persistent pain. At the initial assessment they will explore with you the history of your pain as well as how it impacts on your ability to move. They will also complete a physical assessment. They support people to understand the strengths and ability of their body. Physiotherapists traditionally use exercise to facilitate a return to important activities and to maintain a fit and healthy lifestyle. Physiotherapy in pain management is different to traditional physiotherapy in that it incorporates the biopsychosocial model into the approach. This means that the physiotherapist works closely with all the pain clinicians on the team to ensure the best possible outcome for the long term. Graded exposure to movement is key to managing and reducing pain. Pain specialist physiotherapists can support you in understanding your pain, getting started with exercise and staying active for life.
Our doctor’s role is to make sure there is a good understanding of the medical issues relating to pain, to ensure we’re not missing anything worrying, and to also help guide how best to move forward with treatment. Other non-pain related medical conditions may have an impact upon rehabilitation, so we aim to understand this too. Understanding why we have pain can be important, but sometimes there is no clear diagnosis or indeed cure. Often, a few things can be playing a part in pain; this can explain why treatments can sometimes partly work. Education around pain, and pain research, is one of the interests shared by many of us in the team (and why you may be given the occasional questionnaire!)
Our nurse works with the team to support those patients who are starting new medication, and can give advice to help you gain maximum benefit from medication. She also explores aspects of your self-management and lifestyle changes. She can provide Transcutaneous Electrical Nerve Stimulation (TENS) machines for pain management and can offer acupuncture for flare up management.
Our occupational therapist explores the activities that make up daily life, for example personal care, washing, dressing, domestic tasks, work and leisure. She can work with you to develop an action plan to enable you to participate more fully in the tasks you wish to undertake. A variety of methods may be used to achieve this including pacing, goal setting, education, communication, mindful relaxation work and provision of adaptive equipment where required.
Experiencing pain can affect people not only physically but emotionally as well. Conversely, pain can also be positively affected by the psychology of the individual, their situation/personal circumstances they are in and by other treatments. Our psychologist aims to have useful conversations with people to find out what they want to be different in their lives, despite their pain, and to think with them about coping, and uncovering their strengths and resources. The hope is to help people to live as well as possible despite the pain. It works best when people are willing and ready to take an active part in making changes.
We know that medication is one of the many tools we have to help us manage our pain. Our pharmacist may see you to discuss your medication in more detail with you and in order for you to understand the role of medication in managing long term pain. This may be to discuss concerns you may have or that your GP may have, to formulate and optimise your medication plan, to explore medications that might help or to reduce and stop medications that might no longer be effective or that could be causing side effects. The pharmacists works closely with other clinicians in the team, particularly the doctor and nurses, to help manage your medication between them. The pharmacist will communicate with your GP regularly to ensure they are happy to continue with any changes we recommend and to keep them informed of the plan going forward. The pharmacist offers a range of face to face and telephone appointments at different times during the week.