Pain Management

  • Integrated pain service treating patients with chronic and acute pain

  • Address: Maidstone Hospital and Tunbridge Wells Hospital,

What we do

We provide an integrated pain service, covering acute and chronic pain. We also see patients with severe cancer pain and have strong links with the Palliative Care team as well as the Heart of Kent Hospice and Hospice in the Weald.

We aim to provide high quality pain control as well as improvement in patient function and wellbeing.

We treat inpatients and outpatients at Maidstone and Tunbridge Wells hospitals, and see over 3000 patients in clinic per year with complex pain issues as well as inpatients and interventional cases.

The most common condition seen in clinic is lower back pain, with or without sciatica. Other frequent referrals are for neck pain (cervicalgia), nerve pain (neuropathic pain), complex regional pain syndrome and abdominal or pelvic pain.

Get in touch

  • Clinical Nurse Lead and Ward Manager: 01622 220321
  • Dr Kevin Fai (Lead Consultant): 01622 220320
  • Dr Richard Griffiths: 01622 220320

Inpatients

Our team of specialist pain nurses review and offer specialist advice to patients with pain issues who need additional support.

We see patients with acute pain, cancer pain, and chronic pain issues as well as pain after surgery.

The team sees all post-operative patients need specialist pain control such as:

  • Patient controlled analgesia (PCA) - an intra-venous pump you can control to give small doses of pain-killing drugs. This avoids delays in drug administration and gives you the ability to control your own pain.
  • Epidurals - tubes inserted into the epidural space in theatre to provide pain relief during and after surgery. Drugs are given to reduce the sensation of pain.
  • Nerve catheters - tubes inserted along the path of a nerve to reduce pain in a limb (arm or leg) using local anaesthetic.

As well as daily nurse cover, we also provide regular consultant ward rounds at Maidstone and Tunbridge Wells hospitals. These are to help with more complex patients who often have pre-existing pain issues.

The team also works closely with colleagues in Pharmacy and with medical and nursing colleagues to ensure the techniques we use to manage acute pain are effective and appropriate for each patient.

Outpatients

We treat and support patients who have experienced pain for three months or more and ARE based in the Chronic Pain Unit (Hutchinson Suite), level 1, at Maidstone Hospital.

To be seen by our service, your GP will have to refer you to the central MSK (musculoskeletal) service who direct the referral to the community pain team or to us.

If your referral is directed to us, you will receive a clinic appointment to have a telephone consultation with one of our doctors.

Our outpatient clinics are at Maidstone and Tunbridge Wells hospitals, and at Sevenoaks Community Hospital. All procedures are carried out at Maidstone Hospital.

We help people with a range of chronic pain problems, especially spinal pain, to improve pain control and quality of life. We assess patients clinically, but may request tests such as MRI and nerve conduction studies to work out the cause of the pain.

We use a holistic approach to pain control, as one method does not work for everyone.

This could include:

  • Conservative management - lifestyle advice, pacing, physiotherapy, hydrotherapy and medication optimisation
  • Interventional treatments - injections can relieve pain and spasm and break the cycle of pain and immobility. We offer a wide range of interventional approaches including facet joint injections, sacroiliac joint injections, epidurals, nerve root blocks and plexus blocks
  • Surgical referral - where necessary we will advise you if surgical referral would be useful
  • Psychological treatments - there is evidence linking good psychological health and pain control. Often talking therapies can reduce anxiety and depressive symptoms and improve coping strategies. We can provide advice and where necessary refer you for psychological input.

Interventional treatments are done in the Chronic Pain Unit at Maidstone Hospital. They are carried out as day cases with local anaesthetic. Procedures are done under X-ray or ultrasound guidance.

The key to managing chronic pain is physical rehabilitation. This will be regular stretching to reduce stiffness, and pacing all physical activities.

The aim is to help you to function better which aids your healing process and slows any degenerative process. An injection helps us see if we can temporarily reduce the intensity of the pain to enable better rehabilitation.

Specialist services

We run number of specialised pain services and procedures to help treat a range of conditions.

Complex regional pain syndrome (CRPS)

We offer a specialist service for patients with Complex Regional Pain Syndrome (CRPS). This is a debilitating condition with intractable arm or leg pain that is often difficult to diagnose and treat.

We provide rapid assessment of early cases (onset of less than six months) and use functional restoration physiotherapy often combined with nerve blocks to allow manipulation without pain.

We also provide neuropathic pain medication advice and palmidronate infusions. This can improve pain and even more importantly improve the ability to use the limb more normally.

Genicular procedures for knee pain

Knee pain due to osteoarthritis is a common problem. For some patients joint replacement surgery is not an option or has been unsuccessful. As well as management with physiotherapy and medications, genicular procedures can alter the nerve supply to the knee to reduce the sensation of pain.

We do a test block using an injection of local anaesthetic to the nerves supplying the knee under X-ray guidance. If this is helpful, we often perform a radiofrequency denervation using electricity to alter the nerve function for a longer period of time. This can reduce knee pain and improve function.

Interventional cancer pain management

Patients with advanced cancer often experience significant pain. In most cases this can be treated successfully with pain killers but in 10-15% of cases people with advanced cancer still experience significant pain despite medical management.

As a regional cancer pain centre, we work closely with local palliative care teams and hospices as well as the oncologists. For some patients, specialist intervention techniques can help, such as intra-thecal neurolysis, celiac plexus blockade, stellate ganglion blockade, plexus blocks epidurals and radiofrequency denervations.

These can lead to long lasting improved pain control and function as well as reduced doses of sedating drugs resulting in an improved quality of life.