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Pain Medicine at Hillingdon Hospital- An Overview

Pain Medicine at Hillingdon Hospital- An Overview. Jeremy Weinbren January 2010. Questions for this evening. Who? Why? When? What?. Menu. Jeremy Weinbren Who we are and what we do Damien Smith What you can do instead Simon Dupont What the patient can be helped to do. Questions.

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Pain Medicine at Hillingdon Hospital- An Overview

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  1. Pain Medicine at Hillingdon Hospital- An Overview Jeremy Weinbren January 2010

  2. Questions for this evening... • Who? • Why? • When? • What?

  3. Menu • Jeremy Weinbren • Who we are and what we do • Damien Smith • What you can do instead • Simon Dupont • What the patient can be helped to do. • Questions

  4. Pain Medicine at Hillingdon • Two Consultants (6-8 sessions) • Damien Smith & Jeremy Weinbren

  5. Pain Medicine at Hillingdon • Two Consultants (6-8 sessions) • Two Pain Specialist Nurses (1.7 WTE) • Eva Santiago & Sam Foo

  6. Pain Medicine at Hillingdon • Two Consultants (6-8 sessions) • Two Pain Specialist Nurses (1.7 WTE) • One Associate Specialist (1.5 sessions) • Pathma Rajah

  7. Pain Medicine at Hillingdon • Two Consultants (6-8 sessions) • Two Pain Specialist Nurses (1.7 WTE) • One Associate Specialist (1.5 sessions) • Two Acupuncturist Physiotherapists (3 sessions) • One TENS Clinic Physiotherapist (2 sessions) • One Administrator (Betty Parkes) • One Secretary

  8. Pain Medicine at Hillingdon • Two Consultants (6-8 sessions) • Two Pain Specialist Nurses (1.7 WTE) • One Associate Specialist (1.5 sessions) • Two Acupuncturist Physiotherapists (3 sessions) • One TENS Clinic Physiotherapist (2 sessions) • One Administrator • One Secretary • One Advanced Pain Trainee – a 15-month training post.

  9. Pain Medicine at Hillingdon

  10. Referrals • Patients with musculo-skeletal pain • Patients with neuropathic pain • Patients with specific pain syndromes • Patients needing medication advice • Cancer Pain patients • Patients for Interventional Pain Procedures

  11. Chronic Pain Incidence 30% Lifetime Prevalence 80% Socioeconomic Costs £20 billion per year

  12. Referral Pathways

  13. New Referrals

  14. Referral Pathways

  15. New Referrals

  16. Referrals to Spinal Surgeons (SDC)

  17. New Referrals

  18. Referral Pathways

  19. Onwards from Spinal Diagnostic :

  20. Epidural Injections (Pain Medicine)

  21. Epidural Injections (Orthopaedic)

  22. Epidural Steroid Injections

  23. Long term relief with Epidural Steroids

  24. Facet Joint Injections

  25. Increased Pain on: MUSCLE DISC FACET

  26. Increased Pain on Lateral Flexion: FACET MUSCLE DISC

  27. Increased Pain on Rotation: MUSCLE FACET DISC

  28. Facet Joint Syndrome • Back pain radiating down a segmental nerve root • May follow an injury or lifting • Worse on extension or lateral flexion • Paravertebral tenderness • May be associated with disc disease – (mixed signs)

  29. Drug-based Invasive Others

  30. Invasive Non-drug Treatments

  31. Pain Medicine Follow-ups

  32. Pain Medicine at Hillingdon

  33. New Referrals

  34. Clinical Guideline 88

  35. So now you know..

  36. The Future ? • More Consultants? • Easier Access for GPs and Patients? • Fewer patients? • Community based sessions? • More integration across the local health economy.

  37. Questions ? Jeremy.weinbren@thh.nhs.uk 01895 279237

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