The Manchester and Salford Pain Centre is one of the country’s leading clinics for the management of all forms of pain. We are an interdisciplinary clinical team of doctors, physiotherapists, psychologists and nurses who are expert in managing all forms of pain, ably supported by reception and administration staff. This section is for information on the chronic pain outpatient service.
Referrals are received from GPs and from within the Trust. We also encourage referral of patients with complicated pain conditions from other pain clinics for our more advanced treatment options such as intensive pain management programmes and spinal cord stimulation. We would usually expect that you have completed any outstanding investigations or treatments aimed at pain relief prior to being referred to the service.
Pain Specialist Physiotherapy
The physiotherapy team consists of six physiotherapists who specialise in the field of pain management. We are involved in both new patient assessment clinics, and in the subsequent rehabilitation appointments.
The physiotherapy team utilise a combination of exercise therapy, education and advice on strategies such as pacing and goal setting to help people with chronic pain work towards their personal rehabilitation goals. The physiotherapists work within a cognitive behavioural approach and work closely with the clinical psychology team providing multidisciplinary joint treatment sessions and pain management programmes. Overall, the pain centre physiotherapists aim to enable people with chronic pain to develop self-management strategies to improve their physical function and quality of life despite their pain.
The physiotherapy team also provide training and educational sessions for other healthcare professionals and local universities.
Pain Specialist Clinical Psychology
Clinical Psychologists are highly specialised practitioners in the assessment and treatment of psychological distress. In addition to this, a Clinical Psychologist in a Pain Centre has specialised knowledge about the impact of being diagnosed with a chronic pain condition, and the bearing that this can have upon an individual’s quality of life.
The psychologists assess the impact of chronic pain on people’s lives, particularly the effects on family life, work, social activities and mood and help people learn new coping strategies to reduce the impact of pain in these areas.
People often tell us that pain makes it much more difficult to cope with other problems so we may start off by looking at stress management techniques such as breathing and relaxation exercises. This helps people to remain calm and think clearly in stressful situations. This also works well when combined with the stretching exercises given by the physiotherapists.
We also help people to rebuild their confidence by learning to recognise and challenge any negative thoughts or unhelpful thinking styles. This helps people to feel less frustrated and more realistic about dealing with problems, more in control of their lives again.
Manchester and Salford Pain Centre has a team of five medical consultants. Pain clinics originally developed through procedures being performed by anaesthetists for cancer pain. This role has expanded to include management of chronic non-malignant pain leading to interdisciplinary team working. The consultants in the Pain Centre therefore have anaesthesia as their base speciality. We also have some GPs with a special interest in pain management working within the service.
The consultants are involved in assessing patients at point of first contact clinics independently and also alongside other members of the team. The purpose of the medical review is to exclude disease processes which may be more appropriately managed by other specialists as well as optimising medication management for pain. In addition, patients may be listed for interventional pain procedures if appropriate. We offer medical support to the pain management programmes and also conduct acute pain ward rounds.
Pain Management Programmes
Manchester and Salford Pain Centre is a national centre in the delivery of interdisciplinary Pain Management Programmes (PMPs). PMPs have been running in Salford since 1983 and are currently provided on a residential and outpatient basis as part of our comprehensive pain management service.
What is a Pain Management Programme (PMP)?
A PMP, is a group rehabilitation programme for patients who are suffering chronic pain and is led by a Clinical Psychologist, Physiotherapist and Medical Consultant, all of whom specialise in the management of chronic pain. Around 12 patients attend each programme.
Chronic pain is pain that has lasted more than six months and remains unresolved despite many different treatments and investigations and it can often affect many areas of life including work, social life, home life, mood and sleep.
Prior to attending a PMP, a patient will undergo detailed assessment from all members of the team. On the basis of assessment, the programme team will determine which programme the patient is likely to gain most benefit from. If a PMP is not thought to be suitable, the reasons for this will be fully explained and other recommendations will be made, if possible.
The Pain Management Programme service at Manchester & Salford Pain Centre complies with the current guidelines for PMPs by the British Pain Society. PMPs are advocated by the British Pain Society for the management of chronic pain.
Types of Pain Management Programme
There are currently two types of pain management programme at Manchester and Salford Pain Centre, plus other forms of group based input:
- Intensive Pain Management Programme (Monday to Friday, full days, for 3 consecutive weeks)
- Standard Programme (2 full days per week, for 4 consecutive weeks)
- Facing Forwards - An online pain management programme specifically for people with persistent facial pain.
We also run some less intensive options including the Accessing Pain Management Online (APMO) course and the Introduction to Managing Pain (IMP) course, which is available both online and face to face.
Who is suitable?
Patients attending pain management programmes can expect:
- Improvements in interpersonal relationships
- Reduced depression and anxiety
- Increased physical fitness
- Increased likelihood of work retention or readiness to return to work
- Optimised medication use
- Reduction in health care use
A patient may be suitable for a PMP if the following criteria are fulfilled:
- Chronic pain causing significant disability and / or distress.
- Over 18 years old.
- All appropriate investigations and treatments for pain have been completed.
- No planned referrals to other specialities regarding the pain problem.
- Other health problems should not be risk factors for active rehabilitation (e.g. uncontrolled angina or asthma).
- Can manage basic activities of daily living and is self-caring.
- No major substance misuse (including alcohol).
- No major psychiatric disorders of current significance.
- The patient is willing to participate in a group programme involving psychological and activity-based interventions.
Due to the nature of the programme the PMP may not be suitable for all patients. An offer of a place on the programme will be made on a case by case basis, after discussion with the patient and consideration of any reasonable adjustments. In some cases the patient may be offered individual input to work towards attending a future programme or they may be offered an individualised programme of care rather than a PMP.
Hear from our patients/videos
Hear from some of our patients who have completed the Pain Management Programme (PMP).
Before PMP - What was life like before the Pain Management Programme?
During PMP - What happened on the Pain Management Programme?
After PMP - How have things changed after the Pain Management Programme?
There is strong research evidence for the effectiveness of both outpatient and residential cognitive-behavioural PMPs as a package, compared with either no treatment or standard treatments.
Spinal Cord Stimulation
- Live well with pain - Includes the ‘Ten Footsteps’ to Living Well with Pain; an interactive online resource for people living with persistent pain. Also information on painkillers and opioid reduction advice
- Pain concern - charity for people with pain including podcast
- Flippin’ Pain™ - a public health campaign with a clear goal: To change the way we think about, talk about and treat persistent pain. Flippin’ your understanding of pain could change the lives of you and your loved ones forever.
- Retrain Pain – website with a scienced based approach to help people overcoem chronic pain. Information available in a variety of languages
- Pain Toolkit - pain self-management advice
- Tame the Beast - Useful 5 minute video to help understand pain
- Understanding pain in under 5 minutes
Patients can be referred to the centre either by their GP or any hospital specialist. A formal letter of referral should be sent to AdminCentreReferralsSCO@nca.nhs.uk outlining the patient’s history and current position. Other useful information to include would be a list of current medications and results of any investigations such as a summary of scan results and any pertinent psychosocial history.
Once we receive a referral the patient will be asked to complete and return a questionnaire about their pain. The information they provide will help us understand more about the pain they are experiencing and how it is affecting them, both physically and emotionally. These questionnaires are an important part of the assessment and are reviewed by an MDT. They help us to allocate to the most appropriate clinic and allow more time during the appointment for discussion and explanation. Please emphasise the importance of these questionnaires when you discuss the referral with your patient