Existing Patient Log-in
Paula Banbury

Clinical Lead - Specialist pain nurse

I have worked in pain services for over 20 years and strive to deliver excellent care for our patients. I am an advanced nurse practitioner, specialising in medication reviews and making sure that a painkiller is helpful and not causing unhelpful side effects.

Professor Roger Knaggs

Professor of Pain Medicine

A specialist pharmacist in pain management, the professor will review current medication and recommend alternative medication trials, as well as supporting the de-prescribing pathway. Our specialist pharmacist will consider alternative medication options, and we will often review our patients who have complex medications or lots of other complaints that make the mediation choices extremely limited.

Joanne Fleming

Specialist Pain Pharmacist

I am a Clinical Pharmacist and a non-medical prescriber, specialising in pain management. My role involves medication reviews and recommendations, managing complex medication regimes and those with multiple health issues, and supporting deprescribing. As a military veteran an additional role I undertake is as an Armed Forces Network Service Champion, guiding serving and veteran patients to access further help and support.

Tasnima Uddin

Specialist Pain Pharmacist

I am a clinical pharmacist with experience in a range of specialities having worked in general hospital. I have extensive experience in medicines information, with time spent in forensic mental health. I have now focussed my experience on the management of complex chronic pain and enjoy helping people find a way forward in their lives.

Catherine Woods

Specialist Pain Nurse

I have worked in pain management  for many years and really enjoy working with patients to improve their quality of life, which can involve optimising painkillers or changing regimes.

Your first appointment

Your first appointment

The first appointment with our team is usually a 40minute telephone consultation, although face to face appointments are available. In these cases, you are welcome to come on your own or bring a friend, family member or carer. Although the emphasis will be on your medications, we will still talk about how pain is affecting your life — things like your sleep, mood, hobbies, family, relationships, work, fitness, and general health.

We may also direct you to other members of our team who can offer additional help and support in the management of persistent pain such as Pain Rehabilitation, Advanced Practice Physiotherapists or Wellbeing team.

Depending on your personal needs, we may look to introduce pain medication, change or stop medications. This will be based on your medical history, all current medicines and drug allergies. Often new medications need some monitoring, such as blood pressure checks or blood tests. This monitoring is done by your GP practice whom we have a close relationship with.

Not all medications are suitable for everyone— especially if you have other health conditions or take certain other medications. That’s why we carefully check everything before starting a new treatment.

Types of Medication

Neuropathic medications are used to treat nerve pain. This type of pain is often seen in conditions like fibromyalgia, diabetic nerve pain, multiple sclerosis, shingles, or some types of back and neck pain. These medicines were originally made to treat other problems like depression, anxiety, epilepsy, or migraines — but they also help to calm the nervous system, which can reduce nerve pain.

Opiate medication, like codeine and morphine are strong painkillers and are not recommended for chronic pain conditions like Fibromyalgia. They can be effective however for people with arthritic pain or severe pain, but can be risky if used too long or in high doses.

Non steroidal anti-inflammatory (NSAIDS), like ibuprofen or Naproxen, reduce swelling and pain. They are good for things like arthritis or muscle pain but can upset your stomach or cause other side effects if used too much. They are not recommended for older people.

There are links below to the range of medications we commonly use and our resources page has more information.

Benefits

Pain medicines can help reduce pain by about 30% for some people. They can be helpful during a pain flare-up and may make it easier to keep working, exercising, and spending time with others. Some medicines can also help you sleep better.

Side effects

All medicines can cause side effects. These might be mild or more serious.

  • Mild side effects often settle with time and don’t stop most people from continuing treatment.
  • Severe side effects may mean the medicine needs to be slowly reduced and then stopped.

If you have side effects, we will work with you to find a better option.

How effective are they?

Pain medicines don’t work the same for everyone.

  • For some people, they bring useful relief.
  • For others, they don’t help much at all.
  • Even when they do help, they usually don’t take the pain away completely — but they can make it more manageable.

 

Gabapentin for the Treatment of Pain

Oct 17, 2024

Pregabalin for the Treatment of Pain

Oct 18, 2024

Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)

Oct 17, 2024

Duloxetine for the Treatment of Pain

Oct 17, 2024

Amitriptyline for the Treatment of Pain

Oct 17, 2024

Why have I been prescribed Amitriptyline?

Nortriptyline for the Treatment of Pain

Oct 17, 2024

Cannabis and pain

Oct 17, 2024

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Medication

What if I want to stop taking pain medicines?

If you feel your pain medicine isn’t helping, is causing problems, or you’re worried about taking it long term, our medication team can support you. They will talk with you about your concerns and help plan a safe and sensible way to reduce or stop the medicine if needed. Every plan is personal and based on what’s best for your health.

It’s important not to stop taking your prescribed pain medicine suddenly without speaking to a healthcare professional. Some strong pain medicines can cause unpleasant side effects or make you feel unwell if they are stopped too quickly. Your GP, pharmacist, or our team are here to help.

Understanding your pain medicines

Oct 18, 2024

Opioids are a group of medicines that have similar effects...

Tapering your opioids: information for safer opioid management

Jul 16, 2024

Please read this leaflet for information on reducing your medications. 

Opioid Medicines and the Risk of Addiction

Oct 17, 2024

This safety leaflet is to help support you in using...

Using and looking after controlled medicines safely

Oct 18, 2024

All medicines need to be used and looked after safely,...

Testimonials

 “I was worried about having a medication review as I thought my painkillers would be stopped. I was really pleased that all of my options were explained and I was supported by the Nurse. I feel as though I understand my painkillers better now “

Patient KL

“I found it useful to understand how painkillers can be taken to help improve my activity levels and pacing “

Patient GF

“I felt so much better once I had come off a painkillers that was causing me to feel forgetful and dizzy. My pain didn’t increase and with the Pharmacist’s support I was able  to take my time and I felt supported “

Patient DP

“I had been taking the same painkillers for 12 years. I wasn’t sure if they were actually helping me. I had an appointment with a nurse who specialised in pain medications. We looked at everything I was taking and discussed a plan to reduce and stop the tablets that weren’t really helping. Once these were stopped, I tried a new tablets that seemed to suit me and my pain. I was followed up by the Pharmacist at my GP Surgery”

Patient NS
Some common questions we are asked

Frequently asked questions

The effects and benefits of medication for persistent pain varies between patients. The aim of medication is to improve function and quality of life.

Below are some common medications used for persistent pain. All medications are started on a trial basis. The type of medication recommended will depend on your pain condition.

 

  • Anti depressant – commonly used for depression, these medications can used for persistent pain conditions
  • Anti neuropathic – considered for nerve pain
  • Opioids – these are better used for short term acute pain and long term usage is not usually recommended
  • Anti inflammatory – These can be helpful for arthritic and inflammatory pain

We have information sheets on different pain killers in the links further up this page.

This can be variable dependent on various factors such as the other medication you are currently taking and your health conditions. Any concerning side effects should be discussed with your health care professional.

Our service does not recommend sleeping tablets. There may be other medication options that can benefit sleep. If this is a concern for you, please report this during your assessment. There are also non-drug strategies that can promote sleep that we can assist you with.

At the end of your assessment, your GP surgery will be informed of our recommendations. Most prescriptions are processed by the surgery. If you have not had notification from your surgery about your medications within 2 weeks, please contact them to discuss.

You may be offered a follow up appointment, alternatively reviews may be directed to your GP or surgery clinical pharmacist.

You can contact the PICS team for advice for a non-urgent response. You may be directed to your GP, pharmacist or 111 dependent on the circumstances.

Contact us

If you have a specific query or would like to find out more, please contact us

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