Our thinking, processes and tools reflect
best practice pain management

Our Thinking

We understand that everyone’s situation is different, and therefore designing appropriate management requires thoughtful and personalised assessment by clinicians with experience and expertise in chronic pain and rehabilitation.

You, the patient, play an integral role in your rehabilitation & treatment, contributing to your assessment, treatment goals & plan, and adoption of self-management strategies.

We follow a sociopsychobiomedical approach to complex pain, which is to understand and treat the pain and underlying conditions in the context of the individual’s psychology and social situation.

We aim to work well as a team, both internally within the Australis Specialist Pain Clinic, and with clinicians throughout the community and hospital services.

In order to offer a management plan that best suits the individual, we maintain a broad toolbox, including medications, interventions, biofeedback, education, group programs, physical therapy, and psychological therapy.

Our Treatment Stages

  • 1) Referral

    All referrals require a referral letter from a case manager or clinician (other specialist, GP, allied health clinician). These are triaged by a Specialist. It is important that all relevant medical information is available for the triage. If accepted, then a recommendation is made to the funder for an initial assessment. The appointment is only able to be booked after approval is received.

  • 2) Initial assessment

    A tertiary pain service begins with a Comprehensive Pain Assessment,  either by a Specialist Pain Medicine Physician alone, or by a multidisciplinary team. These assessments involve review of medical documents, a 1-2 hour patient assessment, contact with other care providers if required, patient education and a report.


    We have two Specialist Pain Medicine Physicians at Australis Medical. Dr Chris Rumball, who is also a Specialist in Occupational & Environmental Medicine, and Dr Karen Joseph, who is also a Specialist Gynaecologist. Both are available to assess and manage patients with complex pain and rehabilitation needs.


    From this assessment comes a recommendation for a treatment program. This program is only able to commence after funding approval is received.

  • 3) Management program

    Management programs will typically involve multiple team members working together

    (Interdisciplinary Pain Management Program), and usually run over 2-6 months.


    This program may be complemented with a Group Program where appropriate.


    On occasions it may be appropriate for only a single clinician to be involved (Single Speciality Pain Management Program)

  • 4) Post-program followup

    We  follow up with our patients about 3 months after program completion to review progress

Our Toolbox

Explanation and Education

This is critical to our pain management. We take the time to listen carefully to the history, review medical records, examine using pain-oriented sensory testing techniques, develop a formulation, explain the likely pain mechanisms, and then work out a management plan in collaboration with the patient

Imaging and Investigations

A key part of managing complex pain conditions is establishing as far as possible mechanisms of pain and the conditions causing these. We may arrange imaging, ranging from X-rays and ultrasounds through to MRI, and other investigations such as neurophysiology studies to clarify diagnoses

Pain Medication

Medication can help manage some types of pain and can be particularly useful to support rehabilitation programs. However it is important that patients are only taking medications that they know to be useful to improve function. Working through trials of medications in a methodical manner can be time-consuming, but a valuable exercise

IV Infusions

We offer pamidronate infusions where indicated for Complex Regional Pain Syndrome. These are most beneficial when done early in the course of the disease, and we will work with your case manager to facilitate these as promptly as possible

Nerve Blocks and Joint Injections

These may be used as part of our assessments to diagnose sources of pain, or as part of our programs to temporarily provide relief to support rehabilitation.  We will often refer to our partners for these procedures.

Radiofrequency Ablation

This technique is used to treat joint pain and nerve pain where nerve blocks have identified a specific source of pain related to a facet joint. This is performed in collaboration with interventional radiologists.

Biofeedback

Utilising desktop and mobile phone based software, this is a powerful tool for teaching techniques to manage the autonomic nervous system, which in turn can assist with management of pain

Group Pain Management Programs

Group programs such as Springboard can be a valuable component of pain management. Working with Dr Bronwyn Lennox Thompson, this program addresses issues such as sleep, pacing, goal setting, and pain education. Above all it provides interaction with others who may be facing similar challenges

Exercise and Function

Increasing exercise and function is both a goal of rehabilitation, as well as a key tool as appropriate exercise can provide pain relief, and improve mood and sleep

Self-Management

Learning techniques for self-managing pain may reduce the need for medications, and assist in maintaining activities such as hobbies and work in the face of ongoing pain. Our pain clinicians are experts in this area

Bibliotherapy

We have a wide library of books for lending for inspiration and education. We encourage our patients to take the opportunity to utilise this library while they are with our rehabilitation program

Sleep

Getting adequate sleep is a key factor for making progress in pain management and rehabilitation. We offer a nurse-lead program in sleep hygiene that utilises an online cognitive behavioural course to improve sleep quality