Who may not benefit

Patients  with very long standing pain (eg 5+yrs)

Patients who have attended a pain clinic before

Most of the Pain Services in New Zealand run fairly standardised treatment pathways.  They all follow an integrated Biopsychosocial model, identifying the importance of reconciling medications, interventions with activity optimisation and psychological support.  If this has been undertaken before we find that there is little additional value in repeating the entire process. In some cases however it is possible to update a specific process (e.g. psychology or physiotehrapy only)

Patients with active and poorly managed psychiatric or psychological disease

Individuals with uncontrolled significant psychological disorders tend to be unable to access fully the integrated approach to pain management, especially the cognitive based strategies.  We tend to recommend a stabilisation of this component prior to a formal Pain Service Assessment.

People with substance abuse disorders

Active alcohol, prescribed drug or recreational drug misuse makes an meaningful improvement almost impossible

Those people with significant cognitive disabilities.