The management of complex chronic pain often requires the skills of several pain specialists working together to provide a comprehensive assessment and treatment plan. At the time of initial assessment a referral may be made to other clinicians within the multidisciplinary team.

Identification of appropriate pharmacological agents for possible short or long-term maintenance. Trials of oral medication may require sequential clinic visits to monitor clinical effects, side effects and serum (blood) concentrations of the drug being trialled.

Provision of a range of interventional treatments with full theatre, X-ray and recovery room facilities. Procedures include nerve blocks, joint injections, medication infusions, externalised and implanted intrathecal pumps and Spinal Cord Stimulators.

The core focus of physiotherapy through TARPS is on assessing and managing activity intolerance, to improve patient function and self-efficacy. Musculoskeletal assessment and use of our Physical Capacity Evaluation (PCE) testing provides a baseline measure of function and a means of monitoring progress. The PCE involves a battery of physical performance tests that are quick, simple, use minimal specialised equipment and are meaningful to the patient and therapist. Virtually all physiotherapy intervention is active, usually involving simple graded activity using a cognitive behavioural model. We do specific exposure therapy relevant to the patient, and use new technologies such as the use of virtual reality to optimise activity.

There is the opportunity either individually or in small groups to explore and refine a range of coping strategies and techniques shown to be useful for persons coping with persistent pain. The general aim of these sessions is to improve participation in daily activities and enhance quality of life. The TARPS Team has extensive expertise in this area and regularly reviews its processes in the light of world trends and developments. Typical of the problems addressed are mood difficulties associated with or related to persistent pain e.g. depression, anxiety and Post Traumatic Stress Disorder (PTSD). Specific cognitive and behavioural methods reviewed include: Skills training e.g. relaxation, mindfulness meditation, hypnosis for pain control, cognitive restructuring Activity management Stress management Work skill exploration.

The Pain Management Programme is a structured 3-week course (Monday to Friday - 8.15am to 3.00pm) for patients with chronic non-malignant pain. It has been designed to help when standard medical or surgical treatment may have provided little, or minimal relief from pain. Following the Programme, the group members are invited to attend three follow-ups at 1, 6, and 12 months. Further review will be offered on an as-needed basis. The Pain Management Programme consists of three main parts: EDUCATION - topics from a variety of speakers on understanding chronic pain, lifestyle and personal development skills, goal setting, relapse management, guidance for return to work and sharing information on how family and other relationships are affected by pain. RELAXATION - the opportunity to try a variety of relaxation and mindfulness meditation techniques. These techniques enable participants to become more aware of their muscle tension and factors that intensify the pain. Relaxation may have an effect on reducing pain, managing anxiety and improving sleep. ACTIVATION - a graduated exercise programme designed to improve general fitness and increase activity levels. Ultimately the goal is to facilitate and enable resumption of normal or more nearly normal life activities.

For patients who have completed their initial assessment at TARPS, there is an open invitation to attend a drop-in group relaxation class on Wednesday 12:00 - 12:50. No appointment is necessary. Note - this is also offered as a virtual group option via Zoom.