Prevention of chronic back pain Poole Hospital NHS Foundation Trust

The Poole Hospital NHS Foundation Trust team wanted to design a new care pathway for patients experiencing acute back pain. Under the existing care pathway, the median time from the first onset of pain until an appointment at a specialist pain clinic was 12 years. 

The new care pathway was designed to:

• reduce the incidence of chronic pain by providing multidisciplinary support at a much earlier stage
• empower patients to make positive health care choices and manage their condition
• achieve cost savings through reductions in medical consultations, prescription costs, interventions and investigations.

Patients with acute back pain lasting three months were referred to the local physiotherapy service for an individual assessment with a physiotherapist, psychologist and occupational therapist, before starting a pain management programme which included:

• a detailed bio-psychosocial assessment
• work retention support
• a web-based tool for patients to log pain levels and activity scores
• access to self-management services such as peer support and coaching, backed up by telephone and online support.

Who was involved

The project involved pain specialists and physiotherapy services across Dorset, along with a broad network of partner organisations including Bournemouth University, GP surgeries and voluntary groups. 

Outcomes

Thirty-two patients completed the programme. Clinical outcomes included:

• reduced reliance on medication
• improved mental health, self-reliance and confidence
• return to work through improved use of pacing, relaxation and enhanced physical fitness.

Patient feedback indicated that the programme was rated very highly and that the content was extremely relevant.

Challenges

The team found that weekly attendance at a pain management programme can be difficult for people during the acute phase as they may still be employed and not be able to attend during working hours.