Pain management.

Chronic pain is a debilitating condition and something that no one should have to live with.

Chronic pain is difficult to treat with most types of treatment helping less than a third of patients. Most treatments aim to help patients self-manage their pain and improve function in a number of domains. Different treatments work for different patients.

The first stop should be a GP so you can discuss your pain in all its forms. Read Pain Concern’s leaflet on managing healthcare appointments. The GP may suggest trying some painkillers for short-term pain relief. However, painkillers are generally not considered a primary way to manage long-term pain.

If appropriate, the GP may suggest ways for you to stay active, which can help ease pain and improve your general wellbeing.

You may also be referred for complementary therapy to see if that helps with the pain.

You should be offered advice on how to better manage your pain on a day-to-day basis, such as by using self-help techniques.

Referral pathway information for chronic pain in Devon is available here. This includes information and guidance on acute and chronic pain, referral management, guidance on the use of opioids and treatment options.

Support groups

There’s lots of self-help advice available from a variety of organisations supporting people living with long-term pain, such as:

Charities specialising in specific conditions, such as arthritis or fibromyalgia, may also offer more targeted pain management advice. Some of these organisations run helplines and self-help groups, where you can talk to and meet other people with long-term pain.

If you find you’re having difficulty managing your pain, ask the GP for a referral to a specialist pain clinic. Pain clinics offer a wide range of treatments and support. They aim to support you in developing self-help skills to control and relieve your pain.

Pain-management programmes

Some people receiving treatment at a pain clinic may be offered a pain management programme (PMP).The aim of a PMP is to improve your quality of life, despite your pain, rather than reducing your pain. PMPs are usually delivered through a series of group sessions with other people with persistent pain, in a friendly environment.

There are some pain cafes available locally in Devon, but these vary across the county and localised signposting will require knowing the constituent’s location. These are local, community-led spaces where people living with chronic pain come together to share experiences, learn self-management strategies, and access holistic support without relying on high-risk opioid medications. They provide a non-judgmental, informal environment – helping reduce isolation and build confidence in managing pain.

More information on how to get NHS help for your pain is available here 10 ways to reduce pain

Medication

Medicines generally, and opioids in particular, are often not very effective for chronic pain and are usually a small part of the pain management plan. Other non-drug treatments may be used including advice about activity and increasing physical fitness, and psychological therapies such as Cognitive Behavioural Therapy (CBT) and meditation techniques such as mindfulness. 

When medicines are prescribed they should be used in combination with other treatment approaches to support improved physical, psychological and social functioning.

Opioids can have serious consequences when they are not providing sufficient benefit or being taken in a manner that was not intended. Initial prescribing of opioid medicines for pain should be considered as a trial period, with outcomes of treatment agreed with the patient.

Patients who do not gain pain relief from an agreed dose of opioid within 2-4 weeks should have that drug withdrawn as they are unlikely to gain benefit in the long term. Short-term efficacy does not guarantee long-term efficacy. There is no good evidence of dose-response with opioids beyond 120mg/day morphine or equivalent but the risk of harm increases substantially. There is no evidence for efficacy of high dose opioids in long-term pain.

Mental health and wellbeing

For mental health support in Devon, the mental health crisis service can be accessed via NHS 111 and by selecting the mental health option or get a friend, relative or loved one to do it for you. Or visit the Devon Partnership NHS Foundation Trust website for urgent help locally.

Patients can also self-refer for free NHS talking therapy through Talkworks, provided by Devon Partnership NHS Foundation Trust. Accessing support from TALKWORKS is easy as we offer a self-referral service to adults across Devon where you can contact us without needing to go through your GP first. As an NHS Talking Therapies service, all of our treatment and support is available free of charge. You can refer yourself to TALKWORKS either online through our website, or by calling 0300 555 3344 (our phone lines are open Monday to Friday from 9am – 4:45pm). A member of our team will then be in touch to arrange a time for an initial assessment appointment.

For people in Plymouth,  Plymouth Options offers a range of services to people experiencing common mental health problems. If you are 16 years and over and registered with a Plymouth GP there are a number of ways that you can access the different services that Plymouth Options provide. You can self-refer via the following:

Alternatively, you can talk to your GP or other health and social care professionals who are able to send a referral on your behalf.