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

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Presentation transcript:

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

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

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 Menu

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

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

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

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

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.

Pain Medicine at Hillingdon

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 Referrals

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

Referral Pathways GPRMCPain GPRMCSDCPain GPRMCSDCProcedure

New Referrals

Referral Pathways GPRMCPain GPRMCSDCPain GPRMCSDCProcedure

New Referrals

Referrals to Spinal Surgeons (SDC)

New Referrals

Referral Pathways GPRMCPain GPRMCSDCPain GPRMCSDCProcedure

Onwards from Spinal Diagnostic : Pain Ortho PCS/PMP Xray Physio

Epidural Injections (Pain Medicine)

Epidural Injections (Orthopaedic)

Epidural Steroid Injections

Long term relief with Epidural Steroids

Facet Joint Injections

Increased Pain on: FACET DISC MUSCLE

Increased Pain on Lateral Flexion: FACET DISC MUSCLE

Increased Pain on Rotation: FACET DISC MUSCLE

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)

Invasive Drug-based Others

Invasive Non-drug Treatments

Pain Medicine Follow-ups

Pain Medicine at Hillingdon

New Referrals

Clinical Guideline 88

So now you know..

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

Questions ?