Pain Management Unit outpatient services at Central Adelaide
The Royal Adelaide Hospital (RAH) Pain Management Unit is an outpatient multidisciplinary services that provides assessment, treatment and a management plan for patients with persistent pain. The service comprises specialist pain clinicians working as an integrated team to address the physical and psycho-social factors that may impact on the persistence of pain and its consequent disability.
The Pain Management Unit provides an outpatient services for patients and an inpatient consultation service.
Services are also provided to patients referred from rural and remote areas
Priority is given to those with pain arising from malignancy.
Contact details and location
Level 6, Emergency Block
Old Royal Adelaide Hospital site
North Terrace, Adelaide SA 5000
Telephone: (08) 8222 5403
Fax: (08) 8222 5904
Pain management staff
Pain Medicine specialists all have a post graduate medical qualification in General Practice, Rehabilitation Medicine, Psychiatry or Anaesthesia and have then further specialised in Pain Medicine.
The allied health and nursing members of the team all have experience in pain management and education.
|Specialist name||Specialist position|
|Dr Penny Briscoe||Head of Unit|
|Dr Tim Semple||Deputy Head of Unit|
|Dr Robyn Campbell||Pain Medicine Specialist|
|Dr Brenda Cassidy||Pain Medicine Specialist|
|Dr Gary Clothier||Pain Medicine Specialist|
|Dr Meredith Craigie||Pain Medicine Specialist|
|Dr Anthony Davis||Pain Medicine Specialist|
|Dr Matthew Green||Pain Medicine Specialist|
|Dr Bruce Rounsefell||Pain Medicine Specialist|
|Associate Professor Roelof Van Wijk||Pain Medicine Specialist|
|Associate Professor Andrew Zacest||Pain Medicine Specialist/Neurosurgeon|
|Ms Anne Burke||Senior Clinical Psychologist|
|Ms Michelle Martin||Senior Clinical Psychologist|
|Ms Annie Hopkins||Clinical Psychologist|
|Mr Warwick Lloyd||Clinical Psychologist|
|Ms Sandra Kazubiernis||Physiotherapist|
|Ms Julie Lanzendorfer||Clinical Service Consultant|
|Ms Jane Agalidis||Senior Administrative Officer|
Services provided are:
- Outpatient clinic consultations
- Ward inpatient consultations.
Pain Management Unit outpatients
A written referral to the Pain Management Unit is required from either a general practitioner or specialist practitioner.
Due to the complexity of pain presentations and the need to engage with the general practitioners, referrals for outpatient appointments from the Emergency Department will not be accepted.
Once the Pain Management Unit has received the referral, the medical staff will prioritise the referral based on the information provided.
The Pain Management Unit takes a multi-disciplinary approach to working with the patient to help manage their condition.Treatment may include physical and psychological modalities including:-
- Tricyclic antidepressants
- Epidural steroid injections
- Facet joints injections
- Neurolytic blocks
- Radiofrequency facet denervation procedures
- Spinal cord stimulators
- Intrathecal drug delivery system implants.
- Physical exercise
- Cognitive behavioral therapy
- Acceptance and commitment therapy
- Mindfulness approaches
- Group based therapies
The Clinical Psychology service in the Pain Management Unit provides a specialist service including assessment, treatment and management planning, as well as group and individual therapy to patients and their families. The service also provides consultation to other members of staff and outside agencies in relation to psychological aspects of chronic pain and chronic pain management.
All referrals to the Pain Management Unit including those urgently requiring consultation, must be in writing and contain the maximum data to ensure timely and appropriate decision making.
When referring patients to the Pain Management Unit, it is preferred that the referrer uses the Referral Guide to Adult and Paediatric Pain Management Units.
A Patient Screening Questionnaire can also be downloaded from the Royal Adelaide Hospital home page.
Written referrals may be faxed to (08) 8222 5904
Consider referral when the patient has persistent pain** and:
- all reasonable investigations have been completed
- reasonable and accessible management in the primary care sector has been tried with insufficient success
- pain has significant impact on some aspects of life – sleep, self-care, mobility, work or school attendance, recreation, relationships and/or emotions.
Referrals are particularly encouraged when the patient has:
- exacerbations of persistent pain that resulted in an Emergency Department presentation or hospital admission
- complex psychosocial influences on pain behaviour requiring specialised assessment and care
- significant pain in the setting of current or past history of addiction or prescribed medication use that seem to be complicating current management (e.g. an escalating opioid requirement)
- difficult to control neuropathic pain
- difficult to control cancer pain.
** Persistent pain is constant, and daily for a period of 3 months or more over the previous 6 months, or where the natural history of the painful condition suggests this is likely to be the case. This includes episodic severe pain; e.g. headache which interferes with daily life.
Waiting time for an appointment
The waiting time for appointment will vary and be dependent on the demand for this service and the medical urgency of the patient’s condition.
Once referred and triaged, the patient will be sent a questionnaire which they need to fill out and return prior to an appointment being made.
Recognising the possible delay to the first appointment, patients on the waiting list will be sent an invitation to attend an Introductory Pain Information Lecture. This looks at explaining the appropriate multidisciplinary approach to Pain Management and informs patients of community services and information available to use while they are waiting. It will also outline the appropriate usage of medication.
This lecture is compulsory unless the general practitioner discusses with one of the Pain Specialists why it is not appropriate.
The Pain Management Unit does not provide second opinions for patients who have previously been managed by other Pain Management Units. These patients should be re-referred back to the original Pain Management Unit.
Should changes occur to a patient’s medical condition during the waiting time for an appointment, referrers should send updated clinical information or contact the Pain Management Unit on (08) 8222 5403 .
General Practitioners are always welcome to phone the Pain Management Unit for advice.
Pain Management Unit priorities
|Urgency category||Wait time|
|1||1 – 2 days|
|2||Likely to be seen within 6 – 8 weeks|
|3||Likely to be seen within 3 – 4 months|
|4||Likely to be seen within 24 – 36months.|
Pain Management Unit priorities are based on clinical urgency as displayed below:
(not an exhaustive list)
|Semi urgent||Acute painful conditions not responding to treatment with risk of deterioration or significant impairment of quality of life. Patients in whom it is believed a procedure may be beneficial as either a diagnostic or therapeutic modality.||Complex regional pain syndrome
Post herpetic neuralgia
Acute radicular pain.
|Intermediate||Painful condition with intermediate duration of symptoms and progression/deterioration and risk of increasing function impairment.||Neuropathic pain conditions
Phantom limb pain
|Routine||Persistent long-term pain condition where rapid progression/deterioration is unlikely, maintenance treatment has been started or review-re-assessment has become necessary.||Headaches
Non specific low back pain
Pain Management Unit clinical information sheets
The following is a list of referral material and information sheets for the Pain Management Unit outpatients:
Referral and triage process
- Referral guide to adult and paediatric pain management unit (PDF 144KB)
- Patient screening questionaire (DOC 648KB)
- Fact sheet: Adverse effects due to longterm opioids – medical staff (PDF 134KB)
- Fact sheet: Adverse effects due to longterm opioids – patients (PDF 151KB)
- Pain Management Unit Psychology Services
- Pain Unit Psychology Modules