What does it mean to be ‘referred for pain management’ by the gp?

[ViaRia01]

I’m looking into this on my mother’s behalf. Over several years she has been suffering with stomach pain and gastrointestinal issues. Has been sent for various tests and referred all over the place for various consultants. All tests seem to be showing nothing wrong but pain is ongoing and severe.

GP essentially has said that there’s no further tests he can do and he’s sorry but there is nothing more he can do. He asked “would you like to be referred for pain management?” And my mum said yes.

So I had assumed this would mean taking a special/ powerful painkiller and maybe having to go through a few options before finding the best medication to relieve her pain and without too many side affects.

When the referral letter came through it was something quite different and so I’m curious to know what others would expect when referred for pain management?

thanks so much for any replies.

I would expect a referral to a specialist pain management clinic which focused on CBT, mindfulness and similar.

I’d expect a referral to a pain clinic, which offers alternative ways to manage pain, probably based on psychological methods, given there is no identified physical cause of the pain. Offering pain medication when there is no disease or condition to warrant it surely can’t be the right approach?

A gp can prescribe opioids inc patches/morphine tablets etc . Pain management here is a mix of physio, talking and meds. Ours won't prescribe anything particularly stronger until all other options have been investigated .

It usually means that they haven't found anything wrong and they are referring you for CBT/yoga/get used to it this is your life now type activities.

It’s where they gaslight you into thinking the pain is all in your imagination.

she will be offered mindfulness, various CBT apps etc.

Therapy, group or individual, focusing on improving function.
Psychology.
Physiotherapy.

Is your mum on codeine? I had awful abdominal pain for 2 years, initially diagnosed as gastritis but meds for that didn't help. I had a gastroscopy and ultrasounds that came back normal. Meanwhile I was on co-codamol for knee pain the whole time, and when I stopped taking it the abdominal pain went away immediately. There's a condition called sphincter of Oddi dysfunction that can be caused by codeine.

if She’s had all the relevant scans and tests and they’ve found nothing then yes I’d welcome the pain clinic. They’ll go down different options to try and ease your mums pain or try and mask it anyway.

That's what I was thinking too.

I agree co codamol is awful for your digestion, so if she's on that I'd look at (managed) stopping.

Pain management uses psychological techniques to help cope better with pain. I had real pain from an injury but didn't want to take opioid painkillers (see above) and was able to "manage" it quite sucessfully like this, the brain is a powerful thing.

I would assume they be look pain meds.

My mum was referred to the pain clinic too! It was for a type of pain with a cause, but the only medical treatment available was really invasive surgery with a low success rate which she didn’t want.

She had a great time, really rated it, as all the techniques for managing pain they taught helped her see it differently and integrate it as something she lives with but that doesn’t dominate her life. Don’t listen to the posters saying the gaslight you, they don’t.

A pain clinic has specialists who understand the psychological impact of chronic pain as well as the way it can affect day to day activities. They will help her review medication options as well as supporting her make positive lifestyle changes. In my experience it wasn't all about assuming pain was in the mind but focussed on ways to manage when medication alone isn't working.

I am under the pain clinic due to my fibromyalgia, my course hasn’t started yet due to staff shortages, but I have recently had an appointment with one of the physiotherapists. My understanding is that they look at the pain holistically, make sure your medication is the best combination and also look at the psychological side and do gentle exercise to help you optimise mobility. I have no concerns about accepting the course when it’s available.

I referred to a pain consultant privately as the NHS waiting list was years.. She was superb. Found the ‘point’ where the pain was coming from, booked me in for painkilling injection in her NHS clinic which was scary but was essentially an immediate fix.

I went from 8 x 30/500 cocodamol daily to not needing any. Overnight!
My pain was abdominal but she was also doing joint injections in the same clinic.

Thanks so much to everyone who has replied. It’s been really helpful.

So, yes, she was offered an online group talking therapy/ support group sort of thing. I don’t know any more details than that but mum doesn’t want to do that. For various reasons, some of which I sympathise with. It is difficult to see her chose not to at least try it, although I accept it is her decision.

I admit that I did initially see it as a sort of gaslighting/ if there’s no diagnosis then the pain must not be real. It’s good to hear positive experiences had by some. I do think that a group setting suggests there will be less tailored advice to mum and less likely to be able to identify the point of pain or to discuss optimising her medication etc.

She is not on codeine as far as I know but, I have to admit, I’m not really sure.