Published: April 2026. Next review: 2031.
This care pathway supports clinicians to identify, assess and manage a patient’s pain following traumatic injury.
Persistent pain after trauma is common and can significantly affect recovery, function and quality of life, if not managed effectively. This pathway aims to support clinicians to reduce the risk of acute pain progressing to chronic pain; improve education on pain self-management; and reduce ongoing opioid use in trauma patients.
The pathway outlines recommended actions based on:
- timing (predischarge, early follow-up and longer term follow-up)
- pain severity (mild, moderate or severe).
We acknowledge the importance of Country, culture and community in the wellbeing and recovery of Aboriginal people and are committed to culturally safe care. We envision care delivered to Aboriginal people will be appropriate, considerate and authentic.
Select appropriate timing point in the patient’s care journey:
Select pain severity. Use the PROMIS-29 survey to classify pain as mild, moderate or severe.
3–5 days pre-discharge from trauma service 4 weeks post-discharge from trauma service or GP follow-up 3–6 months post-discharge from trauma service or GP follow-up
Mild pain
Moderate pain
Severe pain
Principles
- Educate
- Empower and reassure
- Educate
- Empower and reassure
- Optimise self-management strategies
- Provide holistic care
- Educate
- Empower and reassure
- Optimise self-management strategies
- Provide holistic care
- Educate
- Empower and reassure
- Discuss and assess use of self-management strategies
- Plan to monitor progress
- Provide holistic care
- Communicate escalation pathways for exacerbation
Action steps
Patient information: inform all patients about their injuries and provide them with a discharge summary and suggested supporting written information.
Examples of patient information
Communicate anticipated injury pain to the patient:
- Incidence
- Intensity
- Pattern
- Duration
Liaison: liaise with the treating specialist clinicians to clarify predicted pain recovery timelines.
Holistic assessment: consider pre-existing psychosocial barriers, such as prior health issues, substance use and/or psychological health conditions.
- Consider contextual barriers to recovery, such as family support, workplace, education or financial support.
- Assess recovery expectations.
Referral: refer to acute pain service, if available, for additional support.
Analgesic dispension: document medication type, strength, recommended timeframe for use and dosage in the discharge summary.
Opioid limitation: if prescribing opioids, limit supply to a maximum of 5 days, as needed, and aim for complete opioid cessation within 2–4 weeks of discharge.
Opioid reduction plan: recommend the patient is not fit for discharge until a safe opioid reduction plan and appropriate support are established.
Discharge documentation: provide a discharge summary to patient, including the information below as a minimum.
Discharge summary
Include the following in the discharge summary, and discuss with the patient:
Anticipated injury pain
- Incidence
- Intensity
- Pattern
- Duration
Analgesics
- Indications
- Strengths
- Interactions
- Dose-reducing strategies
- Medication alternatives, such as physiotherapy, activity pacing (focusing on function), sleep hygiene and other pain self-management strategies.
Analgesic side effects
- Potential side effects
- Management
- Dispel myths
Assistance and follow-up
With the patient’s consent, include family and friends in discharge discussions to enable them to better support the patient at home.
GP review: advise the patient to book, and where possible book for them, to see their GP within 3–7 days of discharge for injury and pain review. For patients in regional or remote areas, review may occur outside this timeframe, with the follow-up plan clearly documented.
Screening: screen for red flags including infection, hardware complications or other underlying issues.
Liaison: liaise with the treating specialist clinicians to clarify predicted pain recovery and/or review timelines.
Holistic assessment: complete a holistic assessment of the patient, considering pre-existing psychosocial barriers, such as prior health issues, substance use and/or psychological health conditions.
- Consider contextual barriers to recovery, such as family support, workplace, education or financial support.
- Assess recovery expectations.
Referral to pain team: initiate internal referral to the pain team (or equivalent service), where available, to support ongoing pain management. Recommend the patient is not fit for discharge until appropriate support is established.
Support for Aboriginal people: with consent of the patient, involve Aboriginal liaison officers, Aboriginal health workers or Aboriginal health practitioners, and family members as early as possible in discharge and follow-up planning.
Holistic recovery: frame recovery within a holistic model of health and wellbeing, not just clinical symptoms. Access to clear, culturally safe and practical information supports recovery.
Contact for questions: provide reliable phone contact for questions and problems.
Case conference: consider a case conference or phone call with GP to address the opioid weaning schedule and expected recovery timelines, if possible.
Community pharmacy: communicate with the community pharmacy to support medication management, if possible.
Referral on discharge: refer patient to their GP and recommend psychological support, such as cognitive behavioural therapy and social work involvement, to assist with pain management and coping strategies.
Psychological support resources
Patient information
- Review the patient’s understanding of their injuries
- Reassure patient
- Reinforce education on the pain management plan and provide written information, as needed
Examples of patient information
Screening: screen for red flags including infection, hardware complications or other underlying issues.
Ensure the following is re-communicated to patient:
Anticipated injury pain
- Incidence
- Intensity
- Pattern
- Duration
Analgesics
- Support the safe tapering of opioids toward zero, if this has not already been initiated, and encourage the use of alternative pain self-management strategies.
- Review medication use and develop and initiate a tailored opioid de-escalation plan if opioids are prescribed.
- Medication alternatives, such as physiotherapy, activity pacing (focusing on function), sleep hygiene and other pain self-management strategies.
Analgesic side effects
- Potential side effects
- Management
- Dispel myths
Holistic assessment: complete a holistic assessment of the patient, considering pre-existing psychosocial barriers, such as prior health issues, substance use and/or psychological health conditions.
- Consider contextual barriers to recovery, such as family support, workplace, education or financial support.
- Assess recovery expectations.
Assistance and follow-up
With the patient’s consent, include family and friends in discharge discussions to enable them to better support the patient at home.
GP review: advise the patient to see their GP within 3–7 days of discharge for injury and pain review. For patients in regional or remote areas, review may occur outside this timeframe, with the follow-up plan clearly documented.
Support for Aboriginal people: with consent of the patient, involve Aboriginal liaison officers, Aboriginal health workers or Aboriginal health practitioners and family members in follow-up and ongoing care planning.
Holistic recovery: frame recovery within a holistic model of health and wellbeing, not just clinical symptoms. Access to clear, culturally safe and practical information is important to support recovery.
Referral: consider referral to the treating specialist clinician for further advice and guidance on the predicted pain recovery timeline.
Referral to pain team: initiate internal referral to the pain team (or equivalent service) where available, to support ongoing pain management.
Physiotherapy: consider referral to physiotherapy to optimise function, including return to work, education and leisure activities.
Psychological support: refer back to GP suggesting psychological support, such as cognitive behavioural therapy or social work involvement, to assist with pain management and coping strategies.
Community pharmacy: communicate with the community pharmacy to support medication management, if possible.
Case conference: consider a case conference or phone call with the GP to address all of the above.
Patient information
- Review the patient’s understanding of their injuries
- Reassure patient
- Reinforce education on the pain management plan and provide written information, as needed
Examples of patient information
Screening: screen for red flags including infection, hardware complications or other underlying issues.
Ensure the following is re-communicated to the patient:
Anticipated injury pain
- Incidence
- Intensity
- Pattern
- Duration
Analgesics
- Ensure opioids have been discontinued, initiate a tailored opioid de-escalation plan if not.
- Continue to encourage the use of alternative pain self-management strategies.
- Medication alternatives, such as physiotherapy, activity pacing (focusing on function), sleep hygiene and other pain self-management strategies.
Re-communicate anticipated injury pain to patient:
- Incidence
- Intensity
- Pattern
- Duration
Holistic assessment: complete a holistic assessment of the patient, considering pre-existing psychosocial barriers, such as prior health issues, substance use and/or psychological health conditions.
- Consider contextual barriers to recovery, such as family support, workplace, education or financial support.
- Assess recovery expectations.
Assistance and follow-up
With the patient’s consent, include family and friends in discharge discussions to enable them to better support the patient at home.
Support for Aboriginal people: with consent of the patient, involve Aboriginal liaison officers, Aboriginal health workers or Aboriginal health practitioners and family members in follow-up and ongoing care planning.
Holistic recovery: frame recovery within a holistic model of health and wellbeing, not just clinical symptoms. Access to clear, culturally safe and practical information is important to support recovery.
Referral: consider referral to the treating specialist clinician for further advice and guidance on the predicted pain recovery timeline.
Referral to pain team: initiate internal referral to the pain team (or equivalent service) where available, to support ongoing pain management.
Referral to pain team: refer to a chronic pain service for comprehensive multidisciplinary management.
Physiotherapy: consider referral to physiotherapy to optimise function, including return to work, education and leisure activities
Psychological support: refer back to GP suggesting psychological support, such as cognitive behavioural therapy or social work involvement, to assist with pain management and coping strategies.
Community pharmacy: communicate with the community pharmacy to support medication management, if possible.
Case conference: consider a case conference or phone call with the GP to address all of the above.
Review progress: review and promote patient’s functional status and progress towards recovery goals.
Optimise function: collaboratively encourage optimisation of function, including return to work, education and leisure activities.
Follow-up: plan follow-up appointments to ensure ongoing support and assessment.
On this page
Examples of patient information
Information for People about Pain Self-management
Information to support people to develop skills and knowledge to self-manage their pain, in partnership with healthcare providers.
Source: Agency for Clinical Innovation
Information for Patients about Managing Acute Pain
Pain management fact sheets for patients on a range of topics.
Source: NPS MedicineWise
Our Mob: Resources for Aboriginal People About Pain
Fact sheets, patient stories and videos about pain to share with Aboriginal patients.
Source: Agency for Clinical Innovation
Pacing and Goal Setting
Advice and tips on how you can approach musculoskeletal pain through goals and pacing.
Source: painHealth
Pain Management for People in the Emergency Department
A fact sheet for people who have presented to the emergency department and need pain management.
Source: Agency for Clinical Innovation
Patient Information about Prescription Opioids
Source: Your Room, a joint initiative between by NSW Health and St Vincent's Alcohol and Drug Information Service
Your Mind after Injury: A Patient Guide
A fact sheet for patients about the different reactions and emotions you might experience after injury, and where and when to get support.
Source: Agency for Clinical Innovation
Resources to support opioid management
How to De-prescribe and Wean Opioids in General Practice
A guide for clinicians on de-prescribing opioids.
Source: Agency for Clinical Innovation
Quick Steps Through Opioid Management
Online tool outlining a balanced approach to safer opioid prescription as part of multimodal pain management.
Source: Agency for Clinical Innovation
Principles for Safe Prescribing of Opioids
A framework for the safe and effective use of opioid analgesics, aimed at improving patient outcomes and minimising risks associated with their use.
Source: Clinical Excellence Commission
Psychological support
Beyond Blue
Mental health information and support.
Headspace
Mental health support for young people.
Pain Education and Management Pathways App
The app is designed to give people living with chronic pain, free access to structured, evidence-based education.
Source: PainAustralia
Pain Course
An eight-week online psychological program designed to help people living with chronic pain, manage their pain and its impacts.
Source: MindSpot
This Way Up
Online mental health treatment programs.