How useful are pain management clinics?

Megrose2 Member Posts: 331
edited 14. Aug 2018, 14:58 in Living with Arthritis archive
The last time I saw a rheumatologist, two years ago, he suggested that I might benefit from going to a pain management clinic. As I've said in another post I've now got OA in my hands, feet, knees, spine, painful shoulders, fibromyalgia and hip bursitis on both sides, so every day is painful. I'm sticking with the paracetamol at the mo because co-codamol makes me very constipated, even the lowest dose. On the few occasions I've taken two co-codamol I've felt totally spaced out.

I saw a GP about the rheumatologist's suggestion and she told me that they would probably want to put me on Tramadol or another opioid, which I really don't want. I'd be really interested to hear of other's experiences of pain clinics - good or bad!




  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Hello, I went to one a few years ago and found that their advice was to take stronger pain meds and employ distraction techniques. I was already doing the latter (and still do, developing new ones all the time) and the former was not an ideal 'solution' as, in my opinion, that reduced avenues for when things worsen. They also offered pain discussion groups where people in chronic pain could sit and talk about it: where's the distraction in that? :lol: I find cocos dull enough for me to get on and I counter-act the resulting constipation with fibre, roughage, water and docusate capsules from the GP (for me OTC constipation relief lacks clout). I (somewhat regretfully) have never felt spaced-out when taking them but that fits with my argument that the stronger the relief the more we are taken away from the pain rather than vice-versa. I was once given some medical cocaine before a balloon was stuffed up my right nostril and inflated. . . . happy days (or rather daze).

    It could be that things have changed over the intervening years but pain is an age-old problem, mis-understood and still very elusive to treat effectively as it, and its perception, is such an individual thing. I say that you have nothing to lose by going and hopefully something to gain. Please let us know how you get on. DD
  • crinkly1
    crinkly1 Member Posts: 156
    edited 30. Nov -1, 00:00
    I also have widespread OA and attended a local hospital Pain Management course of several days soon after the problems became intrusive - over 20 years ago now.

    As has already been said things change but I found it very helpful, especially retrospectively. I rejected some of the pain management measures as not being 'right' for me but I learnt a lot about how different drugs work, discovered previously unconsidered options to be effective and have also continued to use the knowledge gained.

    I entirely agree that when there's nothing to lose a referral to any Pain Management input is well worth a try but it needs approaching with an open mind. You don't have to follow advice but might just find something previously unknown that is helpful.
  • jennand
    jennand Member Posts: 131
    edited 30. Nov -1, 00:00
    I attended a pain management course of 1 day a week for 8 weeks, 8 years ago. It was following a lumbar disc replacement so not really RA initiated. I have mixed feelings about it. I also didn’t rate the drug therapies too much as I think we all have different problems and different tolerances and this advice was general. Also, the meditation sessions didn’t help, but I didn’t expect it anyway. I have a very active mind and find it difficult to “switch off”. ( I frequently wake up at stupid O’ clock thinking about what to cook for dinner that day). The physio sessions were ok. The group discussions bored the pants off me as it seemed everyone tried to out do others with their pain levels. One good session was the pacing regime which I try to incorporate to this day, although even that I frequently ignore, to my detriment. But I do try.
    So, all in all I’d say my course wasn’t a resounding success but I picked up a few tips.
  • Megrose2
    Megrose2 Member Posts: 331
    edited 30. Nov -1, 00:00
    Thank you very much, everyone, your replies have been really helpful. I suppose I was wondering if they offered anything more than drugs and, from what you've all said, this seems to be the case. I really liked the idea of learning how to 'pace', something I'm rubbish at. You've made me think it may be helpful after all, so I may well see my GP and discuss it again.

    I was also interested in the Docusate you mentioned, DD. I did try to take the co-codamol with Lactulose, but finished up with very painful wind - another pain!

    Thanks again, much appreciated.

  • Slosh
    Slosh Member Posts: 3,194
    edited 30. Nov -1, 00:00
    I was referred to one last year. One extra drug was added to my mix and I was referred to physio for some stretching/relaxing exercises both of which did help and the consultant talked to me about how I managed my pain and was pleased with all my strategies so I was soon discharged.
    It was very helpful, if only to know I was doing the right things.
  • GraceB
    GraceB Member Posts: 1,595
    edited 30. Nov -1, 00:00

    Years ago I went to my local pain management clinic. They loaned me a TENS machine (but back then "in the good old days as DD would say!" :lol: I only had one joint affected - my right knee). The TENS machine therefore did a good job, so much so, I brought one privately after the trial run with the loan machine.

    They also said I should use a particular painkiller as it had helped me in the past (Co-Proxamol even though that was coming out of "general use" then), and wrote to my GP to say they were to prescribe it. My GP's reaction? "It's on a red flag to us so we won't prescribe it". If I'd wanted it, I'd have had to have travelled 30 miles once a month to collect a prescription in person from the clinic which seemed barmy so I changed meds.

    I've been on Tramadol (initially the quick 50mg release tabs; now the slow release 100mg tabs) and Paracetamol for a long time now although I only take the minimum of each. I have a small supply of the 50mg tabs which I take on the days my pain escalates out of control. It keeps the edge off the OA pain for me (which is now in my left ankle, the natural remaining part of my right knee which has a partial knee replacement), my lumbar spine, my cervical spine, my left shoulder and my left knee (although that was replaced last year - not very successfully though).

    I'd say go for it myself. You have nothing to lose. Personally I don't feel that talking therapies would have helped me but I know everyone is different. What works for one person has no effect on another so it may be worth a try.

    I wish you good luck. Please let us know how you get on.

  • Megrose2
    Megrose2 Member Posts: 331
    edited 30. Nov -1, 00:00
    Thank you Slosh and Grace. It's good to know that you both found it helpful. As you said, Grace, I have nothing to lose.