Woodland Hospital Pain Clinic Improving Quality of Life
Wednesday 21 March 2018
The Pain Clinic at Woodland Hospital, offers holistic pain management services which enables to improve the quality of life along with functional rehabilitation and better mobility in patients suffering from Chronic and acute pain. The aim is a comprehensive self-management plan to enable patients to take control and manage their own pain flexibly at home.
Pain affects large proportions of the populations and almost 50-84% of the people experience it at some point in their lives. Chronic low back pain is relatively more common in women as compare to men. Worldwide low back pain is the leading cause of long-term disability and leads to loss of nearly 4.1 million working days a year. Nearly one third of the people still have clinically significant symptoms, almost a year after the onset of their first sciatica.
Any pain lasting for more than 3 months is said to be chronic pain with multifactorial causes. Our specialist areas include spinal back pain with or without sciatica, neck, disc pain, joints, muscles and soft tissue pain and pain from previous nerve damage, fibromyalgia, sports injuries and post-operative pain.
There is variety of treatment options available and recommended for treating pain. Primarily a biospsychosocial model of pain management is the primordial way of managing one’s own pain with a comprehensive multimodal multidisciplinary and holistic approach in a specialist environment. This includes a variety of self-management and supportive strategies, which can be discussed with the pain consultant and a carefully planned individually tailored program chalked out in accordance with patient’s underlying issues and needs.
National Institute for Health and Care Excellence (NICE) recommends treatment guidance based on latest research, clinical evidence based and scientific data. Of recent the NICE guidance for management of low back pain and sciatica was published late last year. In them, there are recommendations for physiotherapy, self-help, medications and special x-ray guided interventions as suitable to certain subsets of patients.
NICE recommends the specific use of ‘radiofrequency denervation’ treatment for spinal pain, in which small nerves to the painful spinal facet joints can be coagulated and anaesthetised to relieve pain. In certain other conditions, steroid injections around the spine may also be considered useful to help with the rehabilitation process.
Besides injection and functional rehabilitation a complete holistic approach is recommended for pain management. This includes several other complementary therapies and supportive psychological techniques such as Cognitive and Behavioral Therapy (CBT).
As a part of my comprehensive pain assessment of the pain patients, I routinely use paper based psychometric tests pre-consulation for assessing the patient’s psychological and functional parameters of quality of life. My private consultations last for upto 40 minutes in line with the Faculty of Pain medicine and include a paper based test, history and examination and patient education session as routine. The patient is the center point of my pain management plans, which are made in discussion partnership with them.
Other self- help and educational materials are also available, which can be discussed during the Pain consultation to make a personalised management plan. A well-structured bullet point plan is then communicated to the patient and their GP.
Dr. Deepak Malik, DFPMRCA, EDRA, MRCA, FCARCSI, DIP ANAES, MBBS Pain Specialist
Pain Clinic, Woodland Hospital