Community chronic pain

A TENS machine is a small battery-operated box, which gives out tiny electrical impulses through the skin through self-adhesive pads in the area you have pain. A specialist nurse will explain how to use the device and where to position the pads. You are able to borrow the TENS for 4-6 weeks. If it is helpful, you will be able to buy your own device. A separate information leaflet is available.

A course of acupuncture may be recommended and is available by one of our highly trained practitioners. Acupuncture has been practiced in China and other Asian countries for thousands of years. Acupuncture practitioners stimulate specific points on the body by inserting very fine sterile needles. The needles are left in the site for 10-30 minutes and are sometimes stimulated manually or by using an electro-acupuncture device. The number of needles used varies from person to person and may differ each time you have treatment. It can give pain relief:

1. By slowing down pain signals to the brain via the spinal cord and peripheral nervous system

2. Encouraging the body to produce its own pain relief substances called endorphins and serotonin.

Different combinations of points are used to treat different conditions.

Relatively few complications have been reported from the use of acupuncture. The following may occur:

• Slight bruising and or bleeding around the needle site

• Feeling light headed

• Feeling sleepy

During treatment you may experience a sharp pricking sensation when the needles are inserted, which will pass.

You may also experience a dull heavy feeling in the area being treated. These sensations are normal.

It is important you tell your nurse and acupuncture practitioner about any changes in your health at each appointment, to give them a full picture. This will help ensure coordinated and safe care.

Alexander Technique may be recommended. Back pain is a highly prevalent condition in the UK with many adults suffering at some point in their lives, some of whom experience recurrent problems. It can also be highly disabling, cause significant work loss and reduced quality of life for the individual. It is now well known that remaining active, rather than bed rest, is the best approach to back pain. 

The Alexander Technique is a method that works to change movement habits in our everyday activities. It is a simple and practical method for improving ease and freedom of movement, balance, support and coordination. The technique teaches the use of the appropriate amount of effort for a particular activity, which can help you manage your pain during everyday activities. It is not a series of treatments or exercises, but rather a re-education of the mind and body. 

The Alexander Technique is a method which helps a person discover a new balance in the body by releasing unnecessary tension. It can be applied to sitting, lying down, standing, walking, lifting, and other daily activities.

Your comprehensive pain assessment may indicate that Tai Chi could be an effective way of helping you to manage your pain.

In the fourteen year that our Tai Chi Practitioners have been teaching Tai Chi for chronic pain in the NHS they have found it to be very successful in helping to manage chronic illness. It has enabled many sufferers to reduce their medication while increasing their mobility and comfort. They have found that it also is effective at returning the confidence that is so often lost when suffering from chronic pain.

Tai Chi is a series of gentle flowing movements, which balance and strengthen the body thus improving energy levels and increasing comfortable range of motion. While it is a martial art, the vast majority of practitioners use it for maintaining health and in rehabilitation. Our Tai Chi is an adaptation of traditional Tai Chi specifically for people with chronic pain.

In practice Tai Chi is about becoming aware of one’s limits and working within them. Its benefits come about through the deep relaxation of the nervous system and the release of energy blockages rather than through any kind of force.

Consequently it is much safer and gentler than other more forceful methods and so can be taken up by virtually anyone.

The service is now running at various sites throughout east Kent: Ashford, Canterbury, Deal, Dymchurch, Folkestone, Sheerness, Sittingbourne, Whitstable and Broadstairs.

Our Counselling Psychologists are part of the specialist team. They try and help you cope better with your pain. Some people find it more difficult to cope with their pain due to their past experiences, current emotional state, loss of work, friends or family. Often patients become caught up in a vicious circle where their pain causes them to feel depressed, angry and frustrated. These emotions have an impact on how pain is felt.

Psychological support can help improve painful symptoms. Pain management courses may be offered as well as individual sessions. 

Our specialist physiotherapist uses extensive knowledge of pain and the latest science to advise and support on pain management. She is also on hand to work with all the members of the team to help create a bespoke treatment programmes for you, to target the pain mechanisms and influencing factors: physical, psychological and social. This may include graded exercise and relaxation programmes, advice and education within a pain management course, acupuncture treatment and specialist assessment.

A Pain Education Session is a one off group based session that will introduce you to chronic pain management. We will help you to understand your pain and how we can help you manage your pain through our chronic pain service.

The session consists of up to 30 people and you are welcome to bring a partner/carer along with you.

The group is informal and friendly, yet in a professional setting. We encourage questions, comments and feedback throughout the sessions but it is not group therapy, and people can just listen if they wish. Nobody will be put on the spot.

The session will last for 3 hours will be run by a multi-disciplinary team, which includes a psychologist, a clinical nurse specialist and a physiotherapist. During the session, we explore the differences between acute and chronic pain, medication myths, a self-management perspective and the psychological factors associated living with pain.

We try to ensure we have a room that is big enough for people to get up and move about throughout the session. There are two timetabled breaks during each session and we encourage people to move about as much as is required for their individual needs. We do no expect people to sit for the duration of the session.

You will be given a booklet containing handouts from the sessions and further reading, for your information.

When you have completed the session the next step of your care pathway will be activated. Each persons care pathway may be different and will be individualised to their needs.

A Pain Management Course (PMC) is a group-based self management approach for people living with chronic pain.

The group consists of up to 16 people and are welcome to bring a partner/carer along with you.

The group is informal and friendly, yet in a professional setting. We encourage questions, comments and feedback throughout the sessions but it is not group therapy, and people can just listen if they wish. Nobody will be put on the spot.

The PMC runs over four consecutive weeks and each session lasts for four hours. The sessions are run by a multi-disciplinary team, which includes a psychologist, a clinical nurse specialist and a physiotherapist. A range of techniques and strategies are discussed at the PMC to help manage your pain in a helpful and independent way.

We try to ensure we have a room that is big enough for people to get up and move about throughout the sessions. There are two timetabled breaks during each session and we encourage people to move about as much as is required for their individual needs. We do no expect people to sit for the duration of the session.

During the PMC we explore pain physiology (the science of pain), the concept of self management, relaxation and stress, pacing and activity management, acceptance (coming to terms with long term pain), pain and relationships, sleep, exercise and movement, and flare ups.

You will be given a booklet containing handouts from the sessions and further reading, for your information.

Pain is complex and often difficult to treat with medication alone. Some treatments need to directly affect the excited nerves that can be responsible for causing pain. ENM is one of those treatments.

ENM is a treatment that can stimulate an area of pain you may have with a small amount of electrical impulses, this is done through the skin to directly settle your nerves, via a battery operated device. It is not harmful or invasive and is a highly effective method to reduce nerve pain for many patients.

This therapy is particularly effective for the use of difficult to treat nerve pain often called neuropathic pain. Some examples of this type of pain include Complex Regional Pain Syndrome, pain from amputations (Phantom limb pain) Facial pain, Diabetic Neuropathy, Post Herpetic Neuralgia, nerve damage related to radiotherapy and scar tissue pain. 

This treatment will be carried out your clinic appointment by a trained pain specialist.

A sticky electrode and metal probe are placed on your skin and a very small electrical current is directed at the nerve(s) through the skin, via the ENM device. At the beginning of the therapy, whilst the nerve is located you may feel a slight discomfort or pressure. However this is not a painful procedure to have done and feels like a gentle tingling sensation. The intensity of the electrical impulses are slowly changed so the tingling sensation will vary.

The treatment lasts about five minutes for each area being treated. Afterwards you should find that your pain is either reduced or gone completely for a period of time.

The pain relief can last from a few hours to days, and in some cases, for weeks. The effect of ENM grows, becoming longer lasting after several treatments.

It is non-invasive, and used by trained professionals, therefore is totally safe to use.

There are no serious risks associated with this procedure. Some minor side effects such as a burning sensation, temporary numbness and mild temporary weakness have been observed. It is possible to have increased pain for a short time afterwards which will resolve.