Pain Medicine referrals

COVID-19 and Pain Medicine referrals

In common with most other specialties, we are changing the way we work over the next few months with a revision of our criteria for referral to the pain service. All routine injection treatments and group interventions are currently suspended at NNUH in keeping with our professional guidance
(https://www.britishpainsociety.org/static/uploads/resources/files/Recommendations_fro
m_The_British_Pain_Society.pdf)


Patients with multiple comorbidities, those over 70 years and those with any degree of existing immunocompromise are undoubtedly at greater risk of severe COVID-19 disease. In this group the risks of steroid administration are clearly adverse
(https://fpm.ac.uk/sites/fpm/files/documents/2020-03/FPM-COVID-19-Steroid-Statement2020.pdf).
Routine injection treatments will not be offered to patients referred with chronic pain and this fact should be considered before referral.
Urgent referrals:
We will accept referrals (with consideration of face to face assessment where clinically appropriate) for urgent conditions including, but not exclusively:
Trigeminal neuralgia: acute onset preventing oral intake
CRPS: acute onset less than 6 month history
Cancer pain: acute exacerbation of pain in fully investigated / oncologically managed patient
Acute severe radiculopathy: less than 8 weeks duration with appropriate MRI preventing mobilisation
Other referrals:
We are aware that it is difficult to provide an exhaustive or exclusive list of conditions that definitively would or would not be assessed due to the biopsychosocial complexities of chronic pain. We will therefore continue to consider and triage referrals for telephone / virtual consultation dependent upon clinical consideration of the available treatment options in the current COVID-19 situation.