Pain management services

Basildon University Hospital, Nethermayne, Basildon, Essex, SS16 5NL
Orsett Hospital, Rowley Road, Orsett

Contact

Telephone 0300 44 32823

Who the service is for

We offer a Pain Management Service to inpatients and outpatients.

For inpatients we provide state of the art analgesia for post operative pain. We also treat patients with more complex pain management needs whilst they are in Basildon Hospital.

Outpatient pain management services

Our chronic Pain Management Service offers clinics at Orsett Hospital outpatient department. 

Services

Medication
Western medical acupuncture and TENS
Psychological assessment and treatment
Pain specialist physiotherapist assessment
Procedures including precision intraspinal injections and radiofrequency nerve treatment
Cognitive and behavioural Pain Management Programme (PMP)
Advanced neuromodulation
Implanted spinal cord stimulation
Drug administration via implanted programmable pump for severe pain and spasm
Refractory angina service

Advanced Neuromodulation is a specialist service offered to people living anywhere in the country. It is suitable for people with mainly neuropathic pain that has not been improved by other treatments. Prior approval is sought by the consultant from the lcoal Clinical Commissioning Group.

Pain Management (outpatients)

The Outpatient Pain Management service is currently situated at Orsett Hospital and offers a range of multidisciplinary approaches to manage chronic pain. Our colleagues in the Inpatient Pain service are based at Basildon Hospital.

Location: Orsett Hospital, Rowley Road, Grays, Essex, RM16 3EU

Opening times: Monday – Friday, 9am – 5pm

Telephone: 0300 44 32823
Pain nurses – 0300 44 30139
Both offices have a voicemail service and we endeavour to get back to you as quickly as possible.

Out of hours

For wound queries seek advice from your GP or the NHS 111 service in the first instance.

For urgent chronic pain concerns; such as red flag symptoms including saddle numbness or paraesthesia, bowel or bladder incontinence or retention, inability to weight-bear, attend A&E.

For Spinal Cord Stimulator or Intrathecal Pump queries we do not currently have an out of hours service. For urgent matters attend A&E.

Who the service is for

The department offers its service to patients with chronic persistent pain. You can be referred to the Outpatient Pain Management service via your GP or a consultant to consultant referral.

About the service

The Outpatient Pain Management team consists of:

Consultants
Specialist nurses
Physiotherapy
Psychology
Patient pathway co-ordinators (PPC)

Services provided

The Outpatient Pain Management Team provides a variety of services for chronic pain patients including:

Neuromodulation (including Spinal Cord Stimulation)
Intrathecal Pump Services
Injection Interventions
Pain Management Programme
Medication management clinics (including opioid reduction)
Physiotherapy
Psychology (including CBT sessions)
Reprogramming clinics for Neuromodulation patients
Telephone clinics

Pain management therapies and treatment programmes

Neuromodulation (including Spinal Cord Stimulation)

Spinal Cord Stimulation (SCS) delivers small electrical fields to specific parts of the spinal cord, which changes the way pain messages are sent to, and processed by, the brain. This may reduce some forms of pain, particularly neuropathic (nerve) pain. 

The SCS system consists of a small implanted pulse generator that delivers very small amounts of electricity to a fine lead that is placed close to the linings of the spinal cord.  A small surgical procedure precisely places the lead in the epidural space.  The lead is connected to a small combined battery and pulse generator that the Consultant implants, usually under the skin of the upper buttock.  Once the stimulator has been set up, you use a handheld remote to adjust and control the stimulation programs. The majority of stimulation programs produce a pleasant tingling sensation (paraesthesia) that helps to reduce the pain signals.  Some stimulation programs do not produce a sensation that you can feel (sub-threshold) but may also reduce the pain. 

Intrathecal Pump Services

Intrathecal pumps are an implanted device that has a thin plastic tube inserted into the spinal fluid. Once it is filled with medication it bathes the nerves of the spinal cord thereby affecting spasticity or the amount and severity of pain you can feel.

Although we do not currently implant these devices we are responsible for refilling a number of patients pumps and people travel from far and wide for our service. Pump refills are scheduled on a regular basis based on your calculated refill date.  At refill appointments, the effectiveness of the treatment is assessed and the pump rate or dosage can be adjusted accordingly if required. The pump stores the information about the prescription and this is reviewed via a programming device. When the reservoir is low or empty, the Neuromodulation nurse or Pain Consultant refills the pump by inserting a needle through the skin into the port located on top of the pump reservoir.

Pain Management Programme

Living with persistent pain can be very challenging.  The physical symptoms such as pain and fatigue often go hand in hand with changes in mood and motivation which can act as barriers to taking part in enjoyable activities and activities that give a sense of achievement. 

The PMP aims to help those suffering from persistent pain to take control of their lives by focusing more on valued activities and less on the pain itself.   The emphasis is on increasing understanding of persistent pain and making lifestyle changes by working on fitness and mobility, hobbies, mood and social life.   The PMP does not involve medical treatments and its aim is to improve quality of life, not reduce pain intensity.

The PMP, which is currently held at Orsett Hospital, is run by a multi-disciplinary team including nurse specialists, physiotherapists and a psychologist. Typically there are 10 people in each group and it runs for a number of weeks and you are expected to attend all sessions to gain the best outcome.

The following provides an outline of some of what is covered on a typical PMP: 

Maintaining and/or improving general fitness, mobility, flexibility and posture.
Pacing which is the ability to balance rest and activity to reduce flare-ups of pain.
Relaxation techniques and mindfulness.
Education about improving sleep quality.
Identification of valued activities and goal setting.
Acceptance.
Enhancing psychological skills to help manage mood and unhelpful habits.
Explaining persistent pain and its effects on the body, through education
Increasing knowledge about pain medication to empower patients to reduce the use of unhelpful or inappropriate medication.

Generally, before attending a PMP, you will have tried many different unsuccessful treatments in your attempt to cure or manage your pain.  Enhancing self-management strategies to live as well as possible with pain is the overall aim.

The pain team at Mid Essex Hospitals provides specialist advice and guidance in all aspects of pain management.  It exists as a resource for health care practitioners and patients alike, and provides multidisciplinary training and education across the trust, as well as evidence-based clinical guidelines and protocols. The team consists of an integrated team of Pain Consultants, specialist nurses and therapists with a diversity of expertise plus a team of administrative and secretarial staff to underpin the service.

Clinical interventions are undertaken as part of a pain management stratagem for individuals who have been assessed as appropriate for these kinds of treatment. These range from epidural injections to radio-frequency lesioning.

Pain itself can present as a simple acute episode with known cause, which is usually easily treated with simple analgesics. Circumstances which indicate the need for the pain team to be involved in inpatient care may be: 

Uncontrolled pain, despite analgesics
Chronic or complex history of pain
Adverse effects of analgesics limiting choice of treatment
Abnormal pain symptoms or behaviour 
Co-existing conditions requiring special consideration  

Inpatients 

The team takes acute or chronic pain referrals from anywhere in the hospital, and operates a ‘prompt response’ system whereby patients are seen on the day of referral. This enables the nurse specialist to make an early assessment and to advise on pain management. There are 2 Consultant rounds a week, and where appropriate, a patient will be offered specialist intervention, such as an epidural injection, to treat the pain and expedite discharge from hospital. 

The team is responsible for the safe management of a ward-based epidural service, and works in liaison with the Trust’s surgical teams to manage critical care and post-operative pain. A daily nurse-led clinical round takes place to oversee these patients.

The Pain Service is responsible for managing the education and training needs of the clinical workforce of the hospital to optimise safe and effective practice in pain management across the hospital.

Outpatients 

Chronic pain is defined as pain which persists at least 3 months after the healing process has taken place and it becomes an illness with consequence for the family and the person suffering. It has been estimated that up to 1 in 3 people in the UK and Europe at any one time have a chronic persistent pain. 

The pain team’s role is to assess and manage chronic painful conditions in order to allow the person suffering to improve their quality of life and function despite their problems. This can be difficult to achieve by one mode of treatment alone; therefore the team offers full initial assessments by a consultant, where an individualised treatment plan is initiated: this may include advice on lifestyle, drugs, therapeutic modalities such as physiotherapy, and, in some cases, interventional treatments such as nerve blocks and epidurals. Monitoring and evaluation of progress is provided by nurse specialists in clinics run alongside the consultants’ clinics. 

An essential element of chronic pain management is recognition and expert management of the psychological effect of the disease.  Psychological-biased modalities such as cognitive behavioural strategies based in the Acceptance and Commitment Therapy model (ACT) are delivered in the out-patients setting by psychological therapists and specifically trained nurse specialists. Some patients are assessed as appropriate for a multi-disciplinary educational approach to help them live well with a pain condition. This may be in the form of a group based pain management programme, or on an individual basis. 

Inter-disciplinary involvement in the chronic pain patient’s management is essential, and close links and cross-referrals are made between the pain team and other specialities in the hospital and in the community such as GP practices, physiotherapy, neurology, orthopaedic, rheumatology and psychology and psychiatric services. 
 

Pain medication and procedures

For information on pain medication and procedures please follow the Faculty of Pain Medicine link:

www.fpm.ac.uk and click on information leaflets.

Contact details

Tel: 0300 44 30162

Email: mse.pain.service@nhs.net

Chronic pain service

In simple terms, chronic pain is pain that doesn't go away.

There are many reasons why pain can become chronic but often there is no identifiable cause and therefore no diagnosis. As time goes on the initial trigger of pain may no longer be a factor. Chronic pain typically interferes significantly with day to day activities and can cause psychological distress.

Our chronic pain service aims to help you to reduce your pain symptoms and improve your quality of life. Due to the complex nature of chronic pain, all members of our team work together using a holistic, multidisciplinary approach.

Contact us

Chronic pain service: 0300 44 30159.

Acute pain

Our acute pain service was established in Southend University Hospital NHS Foundation Trust in 1996.

The team is led by a consultant anaesthetist and we have a total of five nurses - full and part time. We have close links with surgical pharmacists and physiotherapists and we liaise with many other teams including chronic pain and critical care outreach teams.

Since the service was formed it has continued to develop and extend. We currently review many inpatients experiencing acute pain each year and we are available for surgical and medical wards throughout the hospital.

The acute pain service has daily nurse-led ward rounds plus a consultant ward round, once a week. We provide advice and guidance to ward and medical staff with regards to a patient's pain management and supervise the safety of the pain relieving techniques used. Training and education is available for all levels of staff.

As a team we are continually reviewing the service and pain management within the hospital using audit. We frequently assess whether changes are required to improve pain and aim to improve the patient experience.