Pain Management Network
1. How do we feel pain?
2. What is acute pain and chronic pain?
3. How can I manage chronic pain?
4. Who can help me manage chronic pain?
5. How can I take responsibility for my pain?
1. Why is nutrition important when you have pain?
2. What are the benefits of physical activity?
3. What are my current levels of physical activity?
4. How can I make my goals SMART?
5. What is an upgrade plan? What is a flare-up plan?
6. What are some top tips for keeping on track?
1. How is stress and anxiety a personal experience?
2. How can feelings affect your pain?
3. How are feelings, thoughts, and actions connected?
1. Who am I?
2. Are you avoiding certain activities?
3. What are unhelpful thoughts? How can they be managed?
4. How can distraction be used to manage pain?
5. Relaxation techniques and mindfulness
6. Using techniques in everyday life
1. School can be challenging
2. Why do I need to go to school when I'm in pain?
3. What will I do when I get pain at school?
4. How will I be able to concentrate at school?
5. How do I keep up with my school work?
6. How will I get around the school?
7. Explaining my pain to teachers and friends? How will I stay connected?
1. You're not alone in coping with pain
2. What are the strengths of my family?
3. What are some challenges that a family can experience?
4. How can I communicate with my family about my pain?
5. Tips for siblings and Families
1. How can you plan for challenging situations?
2. Why is it important to have support? Where can support be found?
Complete the quick steps for each type of pain
Does the patient have
Paraplegia (normal movement and feeling in the upper limbs,
but absent or abnormal in lower limbs and trunk) or
Tetraplegia (absent or abnormal movement or feeling in the
upper and lower limbs and trunk)?
What level is the spinal cord injury?
Is the injury
Complete (unable to move and feel any part of the body below the level of injury) or
Incomplete (able to move and/or feel some parts of the body below the level of
Please specify details of the pain in the grid below. If the pain is another type of pain not listed on the grid or is unknown, please indicate in the text box below the
Burning, electric shock-like, pricking, pins and needles, sharp, shooting, hot-burning, tingling, squeezing, cold, electric, or shooting pain
More about neuropathic pain
Aching, sharp, dull, posture or movement related
More about muskuloskeletal pain
Dull, cramping, tender
More about visceral pain
Above the level of injurye.g. above T4
At the level of injury
Below the level of injurye.g. above T4
Other type of pain or unknown (e.g. irritable bowel syndrome, complex regional pain syndrome)
What is the average intensity of pain on a scale of 0 - 10 / 10?
where 0 = no pain and 10 = pain as bad as you can imagine
The following are red flag conditions
pain with recent change in sensory or motor function
Generalised systemic symptoms
Change in bladder function
Change in bowel function
Recent fall or trauma
Follow up red flag condition(s) by
More information for you
Select options to add to the Pain Management Plan
Make a plan to deprescribe ineffective medication
Refer to the Be Pain Smart Clinic
Self management resources for your patient
Indicators of risk or misuse may include:
Dose > 40mg morphine equivalent per day (Opioid Calculator Faculty of Pain Medicine, Australian and New Zealand College of Anaesthetists)
Treatment duration > 90 days
Opioid risk tool > 3 (Pain Management Network Opioid Risk Assessment Tool)
Side effects from OTC and other medications evident
Social impact of drug and alcohol misuse (AUDIT (Alcohol Use Disorders Identification Test) Saunders JB)
Refer to a chronic pain clinic: Chronic Pain Services in NSW (PDF)
Refer to a drug and alcohol service
Make a plan to deprescribe opioids
On average, how much has pain interfered with your day to day activities in the last week?
Rate yourself between 0 and 10, where 0 = no interference and 10 = extreme interference
Complete pain diary
Refer to self management resources below
Implement graded activity plan
View possible treatments (procedures and interventions)
stimulation techniques (TENS, acupuncture)
neurosurgical procedures (decompression of nerve root or spinal cord, dorsal root entry zone lesioning, drainage or detethering of syrinx)
procedural interventions (intrathecal management, spinal cord stimulation)
How much has pain interfered with your mood in the last week?
Consider a mental health plan
Refer to psychologist for cognitive behaviour therapy and relaxation
Refer to Macquarie eCentre Clinic
Find a pain clinic in the Chronic Pain Services in NSW list
How much has pain interfered with your sleep in the last week?
Provide sleep strategies
Refer to psychologist for CBT and relaxation
Review eating habits, diet and nutrition
Refer to dietitian
Consider if the person is
Maintaining normal activities despite pain (at home or work)
Using non-drug ways of self-calming (e.g. relaxation, meditation, gentle exercise)
Taking a problem-solving approach to managing their pain (not expecting doctor to sort it out alone)
Minimising alarmist thinking
Minimising avoidant behaviours
Is the patient actively engaged in self management?
Consider referral to psychologist and a mental health plan
Do you have any additional notes to add to the Pain Management Plan?
For complex pain presentations or pain which is not responding to primary care level treatment,
consider referral to tertiary pain and/or spinal services.