We are a therapy-led service which works with people who have pain that has persisted beyond the expected healing times or occurred in the absence of treatable pathology and impacted on their lives. The service aims to help people improve their quality of their life and to live well alongside persisting pain.

 The service provision includes:

• Introductory Session- an initial face to face or virtual group appointment offered to the majority of patients. Following this session, patients can opt in or out for a face to face, individual MDT assessment
• MDT face to face assessment supported by a clinical/counselling psychologist/CBT therapist/OT and a physiotherapist.
• Biomedical clinic- run by Pain Consultants with the support of specialist pain physiotherapists and psychologists.
• Individual input with one or a combination of clinicians including: pain physiotherapists, occupational therapists, pain nurses, pharmacist and pain psychologists
• Group programmes including a 10-week Pain Managment Programme (with a 1m and a 6m follow up) as well as shorter group interventions including a Sleep Group and a Movement Group

The full service pathway can be found in the downloads section.

All referrals are screened and patients can bypass the initial group introductory session if this is deemed inappropriate  i.e. non English speaking, significant difficulties within a group setting etc.

The full service pathway can be found in the downloads section.

 Link to the Homerton Service webpage: https://www.homerton.nhs.uk/locomotor-pain-service

Eligibility criteria

Inclusions

• Persistent pain that is significantly impacting on daily life and/or mood.
• Already had MSK physiotherapy assessment and treatment for the problem they have been referred with
• Patients requiring a complex medication review / on controlled medication and continue to report poorly controlled pain. If patients are on over the counter analgesia, GP to review their medication.
• Patients whose pain has been fully investigated as appropriate.
• Patients who would like to explore a holistic approach to managing their pain.

Exclusions

• Patients with urgent red flags
• Current active suicidal intent
• Patients with ongoing investigations into their pain presentation e.g. MRIs, blood tests, or people who are only interested in further investigations into their pain presentation.
• Patients with ongoing assessment/treatment in other services for same condition (e.g. awaiting orthopedic, neurosurgery, or rheumatology review, or under another pain service).
• Those who need a review of their response to an intervention, e.g. if they have just started a new medication or exercise programme with physiotherapy.
• Significant drug and alcohol misuse (including prescription medication) e.g. clear cognitive impact, unable to attend appointments etc. Please discuss this with the pain team on a case-by-case basis via the Pain Service Advice and Guidance request.
• Patients who are not open to learning more about self-management and how it may be helpful to them in living better with pain. 
• Patients experiencing psychological distress not related to pain, i.e. those with significant trauma history, bereavement, or difficult social situations etc. Please consider referring to other mental health specialties.

See downloads for full service eligibility criteria.

How to refer

The following clinicians can refer to this service: GPs