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I have pain related to a medical condition (e.g. diabetes, inflammatory bowel disease, multiple sclerosis, osteoarthritis or rheumatoid arthritis). Does the Understanding Pain information apply to me?

Yes. The same principles apply for pain related to medical conditions and injuries.

What do my scans/tests have to do with my pain?

Scans and investigations show structural changes but they can't show pain. Your doctor may have ordered scans to look for a structural reason for your pain experience (e.g. a broken bone, nerve injury or cancer). Some structural problems can be treated. However, something seen on a scan is not always the reason for experiencing pain. Once you rule out a harmful structural problem, strategies aimed improving what you are able to do and how well you can participate in what you enjoy are more effective. 

Will I get injections at the St Vincent’s Hospital pain clinic?

Probably not. Injections are not done often as there is limited scientific evidence for benefit in chronic pain.

Will my medication need to be changed?

Your medications will be reviewed considering your individual circumstances. This may mean that there may be some recommended changes to what you have been taking. For the majority of patients, short term use of pain relieving medication is appropriate for acute pain, however most chronic pain will mean that medications will become less effective over time.  Any changes in medications will be made in consultation with you, your pain specialist and GP.  

Why do pain medications work less and less? 

Over time, your body gets used to pain medications like opioids. This is called tolerance. Developing tolerance to a medicine means that you then need more or higher doses to get the same effect. Increased doses most often contribute to other side effects such as nausea, constipation, itchiness, sedation, inability to concentrate and sometimes addiction. 

Why do opioids make your pain worse overtime?

Scientific studies also show that over time use of opioids can actually contribute to making your pain worse. This is a phenomenon known as opioid-induced hyperalgesia (OIH). It happens because taking opioids has made specific nerves and the brain more sensitive to pain. The appropriate approach to treating OIH is to wean slowly from a high dose of opioids to a lower dose whilst also using other alternatives to manage pain such as non-opioid medications, behavioural interventions and physical therapy. 

How to manage opioid withdrawal symptoms?

Withdrawal symptoms can occur when you decrease the amount of opioids you are using (or abruptly cease any opioid medicine) due to physical or psychological dependence. Dependence can take as little as one month to develop. When a dose is lowered (tapered), withdrawal’ symptoms may be experienced. Generally, symptoms last for 4 to 10 days and may include: sweating, nausea, abdominal pain/cramping, diarrhoea, trouble sleeping, muscle aches, fast heartbeat and anxiety. While unpleasant, these side effects are not dangerous or life threatening. Each symptom can be managed with the assistance of self-management strategies such as relaxation techniques (e.g. listening to music/meditation) and the support of your GP. 

Once the symptoms of withdrawal subside the benefits of opioid weaning and tapering can be significant and include:

  • Feeling more alert and in a better mood
  • Ability to increase activities, socialising and capacity to work
  • Being able to drive
  • Less pain
  • Lower risk of overdose or other harm
I have tried everything including physiotherapy, strong pain medication and acupuncture before. Nothing works. Is it worth coming to the pain clinic?

Yes. The specialist team at the Pain Clinic can help you move from reliance on less effective medical treatments that are aimed at shrinking pain and towards increasing and building skills that can help you manage your pain more effectively. Our aim is to help you to increase your ability to participate in things you enjoy and improve your quality of life.

Does stress affect pain?

Yes, you have probably noticed that stress may exacerbate your pain. Whether it’s from depression, insomnia, relationship or financial problems, stress affects us by its effect on the nervous system. Our muscles can become tight, particularly in certain areas of the body (e.g. back, shoulders, neck), it can affect our gut causing upset stomachs, reflux and diarrhoea. Over time, a persistently stressed nervous system causes chronic muscle tension, which becomes painful in itself. Our specialist pain psychologist will help you to understand how stress may be impacting on your experience of pain. They can assist in teaching you how to explore different ways of coping with life’s difficulties. By reducing the amount of stress in your life, you will often also reduce pain.

Why do I need to fill out a pain questionnaire before the initial consult?

The doctors need this information to see how your pain affects your life. This helps the team identify strategies most suited to your individual story that can help better manage your pain.

How long is the waiting list for the pain clinic?

The waiting time is approximately 12 weeks. Our friendly admin staff will contact you to book your appointment once we have received a copy of your referral. You will be sent a reminder SMS of your appointment date & time. If you need to change/cancel your appointment please give at least 48 hours’ notice. Pease be advised that we operate a strict discharge policy for unattended without notice or regularly cancelled appointments on two consecutive occasions. This enables us to manage our waiting times more effectively.