Pain Medicine

Contact Information 
Patient Co-OrdinatorCatherine Paisley 01 414 3104
Phone01 414 3104
Head of Department Dr. Camillus Kevin Power

Service Hours for Pain Service: Phones are attended between 01- 414 3104.  7am-3pm or 01 – 414 3473 8am–4pm. A voicemail service is used outside these hours.

What We Do

Acute Pain Service - Tallaght Hospital

The Acute Pain Service (APS) which is based in the Department of Anaesthesia, Critical Care and Pain Medicine provides advice and clinical support on the most appropriate management of inpatients with acute pain.

The Acute Pain Team is multidisciplinary and comprises Consultant Anaesthetist, Clinical Nurse Specialist, and Clinical Pharmacist. The APS functions 24 hours a day, seven days a week. Formal multidisciplinary rounds with the Acute Pain Team and Recovery Room nursing staff takes place each morning (Monday to Friday) on all patients receiving Patient Controlled Analgesia (PCA). Out of hours service is managed by the anaesthetists on call. Patient Controlled Analgesia is a system where patients administer their own analgesia intravenously by pressing a handset which is connected to a pump. It is used for the treatment of Acute Pain in patients who fulfill the following criteria:

- Post-operative or Trauma Patients 16 years or older, alert, orientated and co-operative
- Capacity to understand the instructions
- Capacity to use the devise

Epidural analgesia was introduced to Tallaght Hospital in 2005. It is now available on all wards, ICU and PACU. The acute pain team reviews patients twice daily during the week.

The Team
Chronic Pain Service is provided by:
Dr. Camillus Power Consultant Pain Anaesthetist Director Pain Service
Dr. Anne Heffernan Consultant Pain Anaesthetist
Sheila Horan Senior Physiotherapist 
Orla Spencer Senior Clinical Psychologist
Laura O’Donnell Senior Occupational Therapist 
Deirdre Wilson Clinical CNM11
Deirdre O’Shea CNM11
Catherine O’Donoghue CNS

Advanced Pain Therapies Offered

Spinal Cord Stimulation
Peripheral Nerve Field Stimulation

Multidisciplinary Pain Clinic

In Tallaght Hospital this service is staffed by two Consultant Pain Specialists, Dr. Camillus Power and Dr. Anne Heffernan. There is also a senior Physiotherapist Sheila Horan and a senior Clinical Psychologist Orla Spencer. There is a dedicated referral route to Liaison Psychiatry and Occupational Therapy (Laura O Donnell). Referral is by means of a GP or Specialist letter to Dr. Power. The appointments service is administered by Caroline Morris (Phone 414 3473). The clinic runs on a Monday and Thursday afternoons.

Ulysses Pain Management Programme

This is a four week cognitive behavioural programme which aims to improve the quality of the lives of patients with chronic pain. The model that is used to treat chronic pain is known as the biopsychosocial model. Simply, this model aims to treat the whole person by addressing the psychological, social and physical consequences of chronic pain. The Ulysses Pain Management Programme uses this model to help address these issues.

The programme is located in the Rehabilitation area on the ground floor of Tallaght Hospital. It runs for four weeks, three days per week, from 9am to 3pm.  It is run as a group so you will get to meet other people with a chronic pain condition. Most people find this very beneficial, as they often report that having chronic pain is a very isolating experience.

Who is suitable to attend?
- Patients with pain lasting more than six months
- All investigations, procedures and surgeries have been completed
- Significant disability due to the pain
- Significant distress due to the pain
- Interference with work, leisure and sport

What happens on the course?
A typical day includes a group session run by the clinical psychologist, an exercise session (based in the gym or the hydrotherapy pool) with the physiotherapist, an education session which looks at some aspect of pain management and a session led by the occupational therapist.

The Ulysses Team
The team is made up of people from many different health disciplines. Below is an explanation of the role each team member plays in rehabilitation. 

Pain Consultant

On the programme the doctor will educate you about the known causes and treatments of chronic pain as well as a questions and answers session.

Clinical Psychologist: We have already discussed that the experience of chronic pain can sometimes affect your mood. However once poor mood and stress become established they actually begin to affect your pain levels. The clinical psychologist helps you identify unhelpful thoughts and behaviours that may be contributing to this vicious cycle effect. You are then taught skills to help you reverse this cycle and gain control over your mood and pain levels. It is important to understand that the clinical psychologist’s role is not to tell you that you are “imagining” your pain but rather to help you find a way out of what is obviously a distressing experience.

Physiotherapist: The effect of chronic pain on the body is widespread. Muscles weaken, joints stiffen up, exercise tolerance is reduced and patients often develop a fear of movement in case they exacerbate their pain. The Physiotherapist role in the Pain Programme is to structure a paced exercise programme in a safe environment to reduce these adverse effects. Also included is a session describing the structure of the spine and why an exercise programme – either in the gym or pool is so important.

Psychiatrist: People who experience chronic pain find that it can impact their lives in a variety of ways. In addition to the physical effects, there are emotional stresses and strains as a result of dealing with chronic pain every day. These emotional stresses may result in your mood becoming low or irritable and your appetite, energy and sleep being disturbed. The psychiatrist will help you understand and identify these emotional symptoms and, where necessary, offer advice and treatments to alleviate them.

Occupational Therapist: Chronic pain can affect your ability to perform everyday activities such as managing household tasks, working or enjoying leisure pursuits. You may be physically unable to perform these tasks or may avoid them for fear of making your pain worse. The Occupational Therapist’s role is to help you learn practical ways to manage your daily activities successfully and safely. This involves developing techniques such as goal setting and problem solving, pacing, work simplification and use of proper body mechanics.

You: You need to be proactive; i.e. taking the opportunity to improve your quality of life. You need to practice daily the techniques and approaches that you learn on the programme. - “Practice makes perfect”. You need to be patient and not impatient - chronic problems take time and effort to become more manageable. All members of the team have an important role to play in helping you manage your pain and increase your quality of life. However you have the biggest and most important role to play. By attending the Ulysses Cognitive-Behavioural Programme you are already displaying a responsible commitment to improving your quality of life and aiding your rehabilitation. While you are on the programme, active participation, will guarantee the best results possible. By the end of the programme, rather than react to your pain in a helpless way, you will learned the skills to respond to your pain in a controlled and proactive fashion.

What happens after the programme?
Although the programme lasts for four weeks we like to meet with you after the programme ends. These “follow up sessions” are scheduled at two months and six months. They provide a great chance to meet up with the other group members and report on the progress you have made. It also provides a useful means of support and advice for when things are not going quite so well. This difficult time is what we call a “setback” and it is something that can be expected to happen from time to time. What is important is that when this happens you use the programme and the skills you have learnt to get you back on track.

How to be referred for assessment?
You need to be referred to the Pain Service through your consultant or GP to: Dr. Camillus K. Power or Dr. Philip Hu at the Pain Service in Tallaght Hospital. 

Pain Exercise Class

This is suitable for patients who do not require a full cognitive behavioural pain management programme but who are not exercising and have a certain fear of movement. The pain exercise programme aims to:

    -   Increase flexibility and strength
    -   Reduce any fear of movement
    -   Teach a daily stretching and strengthening programme

The exercise programme runs twice a week (1-hour) for four weeks. It is based in the Physiotherapy Department on the Ground Floor of the Hospital. A half hour educational session is also included once a week.

The programme - is group based 4-5 patients per programme. Patients are assessed pre and post programme using functional tests and questionnaires. Referrals to the exercise class are via the Pain Clinic.