Pain Consultant and Specialist Nurse

The first appointment for a patient coming into the pain management service will often (but not always) be with either the consultant or the specialist nurse.  The role of these clinicians is to undertake a holistic assessment of the patient’s pain story and the impact that pain is having on that person’s life.  Other factors such as medical problems and medications will be taken in to account. 

The consultant or nurse will review relevant pain medications and make adjustments to the drug regime.  We recognise that pain medicines can have a very limited effect and frequently cause side effects which have a negative effect on quality of life.  It is not unusual for us to recommend that patients reduce some of their medicines and only continue the ones which are most effective for the individual.

More importantly, we will help patients to have a better understanding of their pain and some of the non-medication factors which can help to improve their quality of life. 

We will consider each patient as an individual and draw up an MDT management plan with them, taking into account their values and what is important to them. 

Pain can have far reaching consequences on all aspects of life including physical, psychological and social function.  Our care pathway may involve working with skilled professionals from physiotherapy, psychology, occupational therapy and pharmacy.  It may include 1:1 therapies and/or group programmes. 

The first assessment appointment helps patients to set realistic goals and expectations, and prepares them for working with the other professionals within the service.  The prime aim of work within our team is to support patients towards a better quality of life in the presence of pain, as absence of pain is seldom achievable.


Physiotherapy in Fife Pain Management Service

Physiotherapy in pain management may be different to your experience of Physiotherapy elsewhere.   Chronic pain means that the alarm system in your body has not switched off; however it is possible to dim down the pain and muscle tension that is caused as a result.  Physiotherapy explores ways to help you develop skills and lifestyle changes to calm down this alarm system.  This helps you to regain the confidence to return to doing many of the things you may have stopped doing, due to your pain experience.

The Physiotherapist will help you consider all the factors that your body might sense as threatening and may be keeping your alarm system on high alert.  Through discussion and physical assessment we will identify your fears and worries about your pain, and the Physiotherapist will help you establish and understand why your pain is persisting, and importantly, what you can do about it.  The Physiotherapist will also look at how you move and what movements and tasks you have difficulty with.  Together we can come up with a treatment plan, and set personal goals to help you improve your everyday life experience.  This often includes finding ways of making your daily tasks more manageable as well as providing you with an exercise program to help with this.

Although chronic pain is a long-term condition, Physiotherapy can help you to learn to live beside it, understand it, and move towards living well again.


Clinical Psychology

Clinical Psychologists working in pain management, have skills in a range of different talking psychological therapies which are designed to help with the emotional impact of chronic pain.  They work with people both on a one-to-one and group basis.

In pain management psychology, psychologists can teach you skills and strategies for coping with the emotional impact of being in pain.  They can also help you learn how to live with pain and improve your quality of life despite the long-term nature of your condition.

People with chronic pain say they often spend a lot of time trying to get rid of pain, in order to reduce the impact it has on their life.  Most of the time this is not very successful and you may find yourself stuck unable to move on in life because of your pain.

In pain management psychology, we take a different approach.  Instead of trying to get rid of pain, we start to tackle ways in which it has impacted on your life.  We concentrate on giving you strategies and approaches to help you get back in touch with what is important to you in life and work towards living a full and meaningful life, despite your difficulties with pain.  We can also help you to manage the emotional reaction to chronic pain, such as anxiety and depression and build your confidence which may have been lost as a result of your pain condition.

By understanding the psychological impact of pain you can better manage your pain and improve your overall quality of life.


Occupational Therapy

Occupational therapy provides practical support to empower people to facilitate recovery and overcome barriers preventing them from doing the activities (or occupations) that matter to them. This support increases people's independence and satisfaction in all aspects of life” (RCOT, 2017).  In the Chronic Pain Service, the occupational therapists work with clients individually or in groups,  to facilitate participation in meaningful activities using pain self-management strategies.  Interventions are individualised but might include the following:  participation in activities of selfcare, productivity or leisure, education on pacing activities, application of energy conservation and work simplification strategies, assessment of home or work environment, provision of adaptive equipment, relaxation and stress management.


Pain Specialist Pharmacy

Pharmacists within the service help you get the most out of your medication. We will do this by spending time with you to;

- Review your current medication - focussing specifically on your pain medication. Ensuring they are of continued benefit, safe and also cost effective for NHS Fife

- Explore your previous use of pain medications - what doses you used and what benefits or side effects you experienced

- Increase your knowledge of the types of pain and medication you take

- Discuss options with you – and agree a short term and longer term plan to maximise the benefit you feel from taking medication and reduce the risk of side effects or harm

- Arrange follow up - to assess if changes have been beneficial and advise on any monitoring required to ensure long term safety

All our pharmacists are qualified prescribers which mean we can often make adjustments to your medication at the time you see us.  We can liaise with your GP, hospital consultant, local community pharmacist or practice pharmacist to help you further. 



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