Sign-posting & referrals

This lesson outlines some of the services that are often useful for patients consulting with persistent pain. You may wish to discuss cases with your GP if you are considering referrals to other services.

Guidance for referring to pain services

In some patients pain-related distress and suffering due to the wider aspects of pain may get in the way of day-to-day life and in some it may be overwhelming. In these often complex cases, an interdisciplinary pain rehabilitation approach may help the patients to move forwards. Patients benefit the most from this type of approach once they have completed all active investigations and treatments (such as scans, injections and surgery) for their pain. Similarly, it is important that the expectation of pain services is understood by patients prior to referral and you may wish to explain to patients that pain services aim to support patients to adjust to living with pain rather than reducing or controlling pain.

Guidance for referring to physiotherapy services

In some cases, patients may report problems in doing some of their normal activities of daily living because of pain, for example, reduced mobility or problems dressing. If patients are looking to address any related reduction in function, they may benefit from an assessment and treatment under physiotherapy services.

In the PROMPPT population the aim of physiotherapy may be more to improve function rather than to reduce pain. You may wish to explain this to patients before agreeing to a referral (for example “Physiotherapy may help you to become stronger which will make it easier for you to [walk/drive/work]”).  

Guidance for referring to local mental health support services

Consider a referral to your local mental health services when patients with low mood or anxiety are looking for practical support and talking therapies when there is no immediate risk.