Persistent Pain Management

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    Adult persistent pain

    • Patients with acute pain (and no provisional diagnosis)
    • Patients with acute pain and new neurological symptoms e.g. Cauda Equina Syndrome (CES)
    • Patients requiring acute mental health services
    • Concerns pertinent to any medical/surgical condition which raise the possibility of serious underlying disease (malignancy or infection) should be reviewed by the appropriate specialty either via emergency department or high priority outpatient appointment

    Paediatric persistent pain

    • Concerns pertinent to any medical/surgical condition which raise the possibility of harm occurring to the body due to serious underlying disease (e.g. inflammatory condition, infection or malignancy) should be reviewed by the appropriate specialty either via emergency department or high priority outpatient appointment

  • Adult Persistent Pain Management Service

    PPMS's are for patients with complex persistent pain who require a multidisciplinary approach for the management of their pain. PPMS expect patients to take an active role in learning self-management techniques and to have a general practitioner who remains central to the supervision of their care.
    Please consider if the goal of referral to a PPMS is aligned with the treatment goals of persistent pain management.  These are specifically to improve management of pain, improve function and improve quality of life overall. The approach is primarily a rehabilitative approach.

    PPMS are not primarily diagnostic services.

    All patients being referred to this service should:

    • have persistent pain resulting in functional impairment from physical disability and/or psychosocial issues
    • have persistent pain that has been thoroughly investigated; and
    • have referrals accompanied by all relevant investigations and specialist reports
    • all patients being referred to this service should be able to provide valid consent or have a substitute decision maker who can do so on their behalf if needed.

    Patients who may not benefit include those:

    • accepted under an insurance claim e.g., Workcover/having treatment in the private system
    • for whom litigation may be a barrier to rehabilitation
    • where there is a clear statement by a PPMS that there are no further or new therapeutic options

    Paediatric Persistent Pain Management Service

    PPMS are for complex persistent pain patients who require a multidisciplinary approach for the management of their pain. PPMS expect patients to take an active role in their care and to have a general practitioner and/or paediatrician who remains central to the supervision of their care.
    Please consider if the goal of referral to a PPMS is aligned with the treatment goals of persistent pain management.  These are specifically to improve management of pain, improve function and improve quality of life overall.  The approach is primarily a rehabilitative approach.

    PPMS are not primarily diagnostic services.

    All patients being referred to this service should:

    • have persistent pain associated with functional impairment in physical and/or psychosocial domains
    • have persistent pain that has been appropriately investigated; and
    • have referrals accompanied by all relevant investigations and specialist reports

    Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the CPC out of scope section.

  • The following are not routinely provided in a public Persistent Pain Management service.

    • Patients who can be well managed in primary care (using appropriate guidelines where necessary)
    • Previous Queensland Health PPMS patients who have not followed management recommendations unless there are extenuating circumstances or new issues
    • Previous Queensland Health PPMS patients who have completed the pain management pathway / programs and for whom no new management approaches are available
    • Patients undergoing treatment from other pain specialist services for the same pain problem without mutual awareness / agreement of cross referral by both teams
    • Patients for whom it may be more clinically appropriate for treatment to be initiated by another specialist service
    • Patients with untreated and unstable mental health conditions where these conditions require acute management in the first instance in order to facilitate safe and sustainable pain management
    • Patients that have harmful non-therapeutic and/or recreational substance misuse without concurrent treatment by a drug and alcohol specialist
    • Indefinite referrals are not accepted

Last updated: 6 June 2024

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