Pain Management Unit
The Pain Management Unit (PMU) is a multidisciplinary unit where patients suffering long-term or persistent pain can be assessed, diagnosed and treated. The aim of the unit is to aid and support patients in the long-term management of their pain.
Most patients referred to the PMU will undergo a multidisciplinary assessment involving one or more of the following:
- Consultation with a pain medicine specialist
- Consultation with a psychologist with a special interest in pain
- Consultation with a psychiatrist with a special interest in pain
- A detailed musculoskeletal examination by a physiotherapist with a special interest in pain
Following these consultations a treatment plan will be formulated and communicated to the patient and the referrer. This individualised pain management program may be delivered individually, or via group based intervention, or often via a mixture of the two.
Individual programs involve one on one sessions with a physiotherapist, a psychologist, nursing staff, and/or doctors as necessary.
- Medications: rationalisation of current medication or trials of new medications
- Pain specialist intervention techniques, including:
- Medial Branch Blocks (MBB)
- Radiofrequency Denervation (RFD)
- Sympathetic blocks
- Implantable medication delivery systems
- Lignocaine infusion
- Nerve root sleeve injection
- Intra-articular corticosteroid injections
Persistent pain affects our quality of life. Although two people may have the same pain condition, their experience of living with pain can be very different so a broad whole-person treatment approach is important. Psychologists specialising in pain management assist by offering a comprehensive assessment, pain neuroscience education and practical strategies for managing pain and supporting lifestyle change.
Psychology often involves looking at how our thoughts and emotions are influencing our pain. One psychological intervention that is often used to do this is Cognitive Behavioural Therapy (CBT). CBT can help people achieve their goals, despite their pain. CBT helps people understand their internal responses to pain and develop self-management strategies for pain, such as mindfulness and relaxation. CBT can also be used to help people improve their sleep. Strategies are targeted individually, according to the psychologist’s assessment.
Pain specialised psychologists use a trauma-informed approach to pain care. Treatment may involve diagnostic clarification, learning about the mind-body connection, managing stress and trauma responses, as well as developing practical strategies for managing pain.
PMU physiotherapists will look at how pain has affected movement, more specifically a person’s activity, function, social activities, relationships, community involvement, and exercise.
Treatment may include:
- Goal setting and making a plan to integrate physical activity into life
- Developing problem solving skills to reduce the impacts of flare ups
- Identify avoided activities and encourage the return of these activities in a gradual sense through strategies such as pacing
- Education about persisting pain and how to learn to move confidently again
- Specific graded exercises where needed
Physiotherapy at the PMU does not involve:
- Regular sessions focused on delivering passive modalities such as massage, manual therapy, dry needling and electrotherapy.
The PMU offers a range of groups for our patients depending on their needs.
Map & Compass: Introductory educational program designed to provide patients with knowledge which will help
PACERS: Physiotherapy led program over five weeks, incorporating individually prescribed exercise and pain education.
Pain Neuroscience Education: This group explains the neuroscience of chronic pain conditions and how people can harness strategies to help them learn to cope better with pain.
Sleep Management Group: The Sleep Management Group uses a CBT approach, this is the most effective treatment currently available to improve sleep. The majority of people completing this program substantially improve their sleep and many people no longer need sleeping tablets.
iRest Yoga Nidra: Integrative Restoration (iRest) or iRest Yoga Nidra is a modern, trauma-informed, secular adaptation of the ancient meditative practice of Yoga Nidra. Yoga Nidra is often referred to as “yogic sleep” or a structured rest practice; it is a practical way of training the mind and body to rest.
The PMU is a publically funded service, and operates in the State-Wide Referral Criteria for Specialist Clinics. Please check https://src.health.vic.gov.au/specialities (under Chronic Pain) for more details. The general criteria for an appropriate referral are listed below:
We accept referrals for persistent or chronic pain:
- That requires complex medication management
- neuropathic pain
- in cancer survivors
- post-surgical or post-traumatic pain
- primary pain
- secondary headache or orofacial pain
- secondary musculoskeletal pain
- visceral pain
AND meeting the referral criteria as outlined below:
- persistent or chronic pain (> 3 months duration) with symptoms that impact on daily activities including impact on work, study, school or carer role
- adequate trial of treatment in previous 12 months (exercise and analgesia)
- at risk of functional or psychological deterioration, or medication dependence
- Willing to explore living well with pain and is willing to learn to self-manage ongoing pain.
We will also accept referrals for acute pain conditions (such as complex neuropathic pain, or acute complex regional pain syndrome/CRPS) where early specialist management is critical. Please ensure your referral contains as much relevant information as able to enable us to triage these cases with the highest priority.
Referral to the Pain Management Unit is not appropriate for:
- Patients that are currently not willing to explore living well with pain and not willing to learn to self-manage ongoing pain
- Patients currently undertaking another chronic pain management program
- Patients that have already completed a multidisciplinary, comprehensive chronic pain management program or service for the same identifiable cause of pain where their clinical symptoms, or their readiness to undertake a chronic pain management program, remains unchanged
- Patients who only want an intervention such as an injection or dry needling.
As per Department of Health Victoria SRC Guidelines, Referrals may be rejected if our service is inappropriate for the patient, or if limited information is given in the referral. We will provide the reason in return correspondence. If you would like to discuss this further, please contact the clinic.
Last Modified: Thursday, 04 August 2022
Address: 73 - 79 Little Ryrie St, Geelong
Phone Numbers: GP hotline: If you wish to discuss the triage of your patient or require additional information about your patient's referral, please ring the GP hotline on 03 4215 1398 (for doctors only).
Fax: 03 4215 1383