We specialise in the assessment, investigation and management of pain in patients with acute, chronic and cancer pain. 

We work as multidisciplinary team consisting of consultants in Pain Medicine, clinical nurse specialists, specialist pain physiotherapists, and a clinical psychologist.

We are committed to helping our patients to reduce the impact of pain where possible, safely, compassionately, and collaboratively, and to improving quality of life for everyone who consults the pain medicine team.

This may involve the use specialist techniques and medicines to ease pain. Also, we teach strategies to help people manage and live well with their pain condition.

Our service delivers pain management care as part of an outpatient service at Broadgreen Hospital.

What is acute and chronic pain?

  • Pain is the term used to describe an unpleasant sensation in the body
  • Pain that has been felt for less than three months, for example after injury or operation is called ‘acute pain’. This pain usually recovers over time.
  • Pain that lasts longer than three months is known as ‘chronic pain’. Pain can occur following an injury, operation or disease which lasts beyond the expected healing time. For some people, chronic pain can develop despite no pathology showing up in examinations or investigations. Chronic pain can be very difficult to manage. 

Pain physiotherapy

Many patients with persistent pain will require advice and guidance on physical activity or exercise. Physiotherapists who specialise in the field of pain management can help you to develop the skills needed to manage your condition, increase activity levels, and improve your quality of life.

The physiotherapy team will assess you and utilise a patient-centred approach to agree a treatment plan. Sessions are designed to help patients self-manage their pain by utilising a combination of education and advice on strategies such as pacing of exercise and daily tasks and goal setting to support patients to work towards their personal rehabilitation goals, whilst targeting the thoughts and emotions related to the movements that contribute to the pain and reduced function. 

The physiotherapists work closely with the clinical psychology team providing multidisciplinary joint treatment sessions to support a biopsychosocial approach. We offer appointments on a one-to-one basis and in joint clinics with the specialist pain psychologist.

Additionally, we can signpost you to appropriate local community centres to continue your exercise and physical activities as well as useful online resources to explore at home. We offer individualised online exercise programmes via a system called Physitrack which you can access at home and allows us to monitor and progress your programme.

Overall, the physiotherapy teams focus is to help patients understand pain while developing strategies to improve their physical function and quality of life despite their pain.

Pain psychology

Living with a long-term health condition, such as chronic pain, can be very difficult for people to cope with. It can be hard to know what to do, and you may feel low in mood or worried about what is going to happen to you in the future.

The clinical psychology service within the pain clinic can allow you to talk through some of those worries or difficult feelings and can help you to find ways of managing the pain so that you can live your life in the way that you would like to, despite the pain.

Clinical psychologists are trained in working with people in a variety of ways and can help you to understand the impact that your chronic pain has on you, including on your mental health. You will be asked to fill in some questionnaires when you attend your first appointment, so please bring along your reading glasses if you need them. At your first appointment, you will decide with the clinical psychologist whether you would like to attend further sessions and if so, how many and for how long.

Pain interventions

We have a dedicated theatre suite next to the pain medicine outpatient department in which interventional pain management procedures are performed. 

If you have planned procedure, this can happen in either a morning or an afternoon session. There will be other patients, so there will be a period waiting after you arrive.  To ensure your safety there will also be a period of monitoring following the procedure in dedicated recovery areas in the pain medicine department.

It is important that you tell us if you have any new health issues, or any new medications have been started since your last appointment with our team.  It is also vital we know if you are taking any blood thinning medicines such as warfarin, clopidogrel, ticagrelor, prasugrel, dabigatran, rivaroxaban, or fondaparinux.

You cannot drive home yourself from hospital after having a pain procedure, so please arrange for somebody to collect you.

Pain education programme

This a group programme for people who would like more information on how to manage their pain. It has input from consultants in pain medicine, clinical psychologists, and physiotherapists.

On the programme, we discuss a variety of things such as medication management, exercise, and thoughts and feelings about pain, as well as strategies to manage the things that people find most difficult about living with chronic pain. 

TENS

We run an outpatient clinic specialised in the use of a TENS machine in the management of pain. You can only be referred to this specialised clinic by a health professional working in this pain medicine department.

During the outpatient TENS clinic appointment, you will be shown how to use the TENS machine, where to place it and what settings to use. If appropriate, we can loan you a TENS machine for you to try at home. You will need to return this loaned machine back to us at your follow-up clinic appointment. TENS machines are available to buy from stores and online.

Acupuncture

We offer an outpatient clinic specialising in the use of acupuncture in the management of chronic pain. You can only be referred to this specialised clinic by a health professional working in this pain medicine department.

Palliative care

We work with the Palliative Care team to manage pain associated with cancer, in both the inpatient and hospice setting. We provide an outpatient clinic services at the Marie Curie Hospice, Woolton and St John Hospice, Wirral.  

Liverpool Refractory Angina Centre (LRAC)

The Pain Medicine service from Liverpool University Hospitals works collaboratively with Cardiology from Liverpool Heart and Chest Hospital to deliver this national multidisciplinary service. This service specialises in helping patients who have persistent angina and chest pain despite having had treatment with medication, stents, and coronary artery bypass surgery.

Specialist facial pain clinic

We work with our colleagues in the Ear, Nose and Throat department to deliver a service helping people manage facial pain.

Specialist alkaptonuria pain clinic

We work with the National Alkaptonuria Centre at Broadgreen Hospital to deliver a specialised service to help patients manage pain associated with Alkaptonuria.

Specialist clinic for pain associated with pancreatic disorders

We work closely with the pancreatic surgical team to deliver a specialised clinic for managing pain associated with pancreatic disorders, such as chronic pancreatitis. 

Specialist clinic for early Complex Regional Pain Syndrome

We work closely with Therapies, and Orthopaedics and Trauma to deliver a service to help patients manage the symptoms in the early stages of Complex Regional Pain Syndrome. We also work with colleagues at the Walton Centre for the management of established Complex Regional Pain Syndrome. 

Specialist medication infusion therapy for refractory pain

We deliver a specialist service to help manage pain resistant to conventional treatments.

Opioid medicines are useful for treating acute pain and usually only need to be given for a short period. The dose of opioid should be reduced as healing occurs.

There is little evidence that opioid medicines are helpful for Chronic Pain.

Only a small proportion of people may obtain good pain relief with opioids in the long-term if the dose can be kept low and especially if their use is intermittent (however it is often difficult to identify if the medication will help long term at the point of starting the medication).

The risk of harm and side effects from opioids increase as the dose increases above the recommended upper dose limit.

If you are prescribed opioid medication and your pain remains severe despite this treatment, it means that they are not working and should discuss with your GP or Pain Medicine Consultant to consider reducing and stopping the medication.

Click here to read more on opioid medication from the Faculty of Pain Medicine 

Click here to read the ten opioid safety messages

What happens at your outpatient clinic appointment?

Your first clinic appointment in our department will involve meeting a member of our clinical team to assist with the assessment of your pain. 

After your initial assessment, we will discuss options with you. For some people, we may make recommendations that can be carried out by your GP or another service closer to home. We may also refer you for other treatments within our service to help support you. For some of our patients, we may suggest a follow up appointment to review your progress.

If after your assessment, input from another speciality team is required, we can refer you.

What should you bring to your outpatient appointment?

Please bring a list of all your medications. Generic appointment letters as used across departments may request a urine sample however this is not required for the Pain Medicine Unit.

What should I do if my pain is deteriorating?

If you are waiting for your first outpatient appointment with the Liverpool University Hospitals Outpatient Pain Service, please speak to your GP who can assess your health needs and offer advice on the most appropriate treatment pathway. They can also contact us and alert us to any changes in your situation.

If you are an existing patient, please contact the Pain Service secretary.

More information

If you have had pain for longer than three months, please discuss options with your GP. 

Your GP will be able to offer you some initial support and resources.

If you and your GP feel that you need specialist pain management, they can refer you to you to our service. We have links with other services within the Trust who may also make this referral for you as part of your treatment plan.

We appreciate that you may have waited for a long time before being offered a referral to the Outpatient Pain Service, and that you may still have a wait before you can attend for your assessment.

The following websites offer information about Chronic Pain and its treatments, as well as some general advice about living with your pain condition that you might find helpful.