Barbara Walker Centre for Pain Management
Referrals - Fax: 03 9231 4660 or Email: BWCPM@svha.org.au
Please see “For Referrers” below regarding Statewide Referral Criteria for Chronic Pain Services
Welcome to Barbara Walker Centre for Pain Management (BWCPM), St Vincent’s Hospital Melbourne.
As part of St Vincent’s Health Australia, we subscribe to the values of Compassion, Justice, Integrity and Excellence, and endeavour to apply these values to all of the clinic’s activities. We are a public facility so there is no cost involved in accessing our services; however you will need a valid Medicare card.
We are located at St Vincent’s Hospital Melbourne (Fitzroy), in the Daly Wing, level 1. You can find us by entering the Daly Wing, walking down to the left of the Red Clinic and taking the lift there to level one.
We take an interdisciplinary approach to the pain care – this means we have a staff consisting of doctors, psychologists, nurses and physiotherapists. People coming to the clinic will likely see one or many different types of providers during their care.
What we do:
- Provide interdisciplinary rehabilitation for pain conditions via group and individual programs. This means you may see many clinicians throughout your journey including doctors, psychologists, physiotherapists, nurses, and psychiatrists.
- Develop your active self-management skills via identifying your goals and working towards these, using evidence-based strategies and coping skills.
- Identify the contributors to your pain including how you think and behave with your pain, medical concerns, coping styles, physical activity/exercise, and mental health.
- Provide more of a ‘coaching’ role as health providers, empowering you to make decisions about your own health. All the benefit you receive from this clinic will be completely due to your own hard work.
What we don’t do:
- We do not offer a ‘fix’, nor focus primarily on pain relief as a means to improving quality of life.
- We do not prescribe medication – following medical assessment, the pain specialist may recommend changes to your medication regime to your GP, but generally do not prescribe scripts.
- We do not provide long-term care. Engagement at the clinic is designed to be for short term programs, working on specific goals and developing to skills in self-management, before discharge.
What you can do:
- Think about your goals and expectations of pain management – they provide guidance to the direction we can take at the clinic, and whether we are the right people to see right now.
- Learn more about pain itself – understanding the complex nature of pain can be helpful in developing the skills to manage it within your life.
- Start to think about lifestyle factors that may affect your pain – you can talk to your GP or current health providers about assistance here. Medication, smoking, physical activity and stress may be good places to start.
Statewide Referral Criteria (SRC)
BWCPM is a Publicly-funded Health Independence Program (HIP) service, and operates under the State-wide Referral Criteria for Specialist Clinics. Please check https://src.health.vic.gov.au/specialities (under Chronic Pain) for more details. The general criteria are presented here.
We accept referrals for persistent or chronic pain:
- that requires complex medication management
- neuropathic pain
- in cancer survivors
- post-surgical or post-traumatic pain
- primary pain
- secondary headache or orofacial pain
- secondary musculoskeletal pain
- visceral pain
AND meeting the referral criteria as outlined below:
- persistent or chronic pain (> 3 months duration) with symptoms that impact on daily activities including impact on work, study, school or carer role
- adequate trial of treatment in previous 12 months (exercise and analgesia)
- at risk of functional or psychological deterioration, or medication dependence
- willing to explore living well with pain and is willing to learn to self-manage ongoing pain.
We will also accept referrals for acute pain conditions (such as complex neuropathic pain, or acute complex regional pain syndrome/CRPS) where early specialist management is critical. Please ensure your referral contains as much relevant information as able to enable us to triage these cases with the highest priority.
Information to be included in the referral:
Information that must be provided:
- Pain history: onset, location, nature of pain and duration
- Psychological status and cognitive function
- If the person has symptoms of, or have been diagnosed with, post-traumatic stress disorder (PTSD)
- Details of previous pain management including the course of treatment(s) and outcome of treatment(s)
- Comprehensive past medical historyHistory of alcohol, recreational or injectable drugs, or prescription medicine misuse
- Current and complete medication history (including non-prescription medicines, herbs and supplements).
Provide if available:
- Details of functional impairment
- Psychiatric history
- Details of any current behaviours that may impact on the person’s ability to participate in a chronic pain management program (e.g. behaviours of concern, level of alcohol intake, cognition issues, reliance on a carer, mental health issues)
- If the person has been identified as having high-risk circumstances (multiple provider episodes, high-risk drug combinations, or opioid dose threshold) through SafeScript
- Results of previous investigations (e.g. nerve conduction studies, HbA1c, aetiology of peripheral neuropathy)
- If the person has previously completed a chronic pain management program and if so the provider of the program
- If a medication review or assessment is required
- If the person is part of a vulnerable population.
Referral to a public hospital health independence program service is not appropriate for:
- Patients that are currently not willing to explore living well with pain and not willing to learn to self-manage ongoing pain
- Patients currently undertaking another chronic pain management program
- Patients that have already completed a multidisciplinary, comprehensive chronic pain management program or service for the same identifiable cause of pain where their clinical symptoms, or their readiness to undertake a chronic pain management program, remains unchanged
- Patients who only want an intervention such as an injection or dry needling.
As per Department of Health Victoria SRC Guidelines, Referrals may be rejected if our service is inappropriate for the patient, or if limited information is given in the referral. We will provide the reason in return correspondence. If you would like to discuss this further, contact the clinic.
- Do you have a referral letter template?
- What does pain management involve?
- The primary goal of pain management (as delivered at BWCPM) is to develop an individual’s capacity for Independent Self-Management. Intervention here will be directed at improving this capacity, more so than aiming to ‘fix’ the person in pain’s condition.
- How can I refer patients to BWCPM?
- Right now my patient does not meet the above criteria, but really needs to see a pain specialist?
- Does BWCPM participate in Medicinal Cannabis Trials/Programs/Prescribing?
Clinical Director - Dr Aston Wan
MBBCh MA GDMM MClEpid MPainMed MHeadacheMed PCertMedEd AFRACMA FFPMANZCA;
Specialist Pain Medicine Physician
Aston started working as part of the interdisciplinary team at BWCPM in 2009. He returned to BWCPM in 2020 as the Clinical Director after directing a tertiary Persistent Pain service in Brisbane for 6 years.
Clinical and Research interest: Musculoskeletal Medicine, Headache Medicine, Medical Education and Medical Leadership.
We have a video overview of our programs - click here to view.
Patients in the care of the clinic undertake a Pain Management Program (PMP). This may be individually, or group based, or often a mixture of the two.
MAPP – My Active Pain Plan. A 1 day course for people on the waiting list for assessment, MAPP aims to help people start to look at self-management strategies and begin making general change to their lives. Currently MAPP runs online using telehealth.
PEP – Pain Education Program. PEP runs for 10 hours over four weeks (2.5hours, 1 day/wk x 4) and starts to get in-depth about specific changes to activity levels, stress management, sleep habits, and other aspects of the person in pain’s life. Currently, most PEPs are being delivered online (Virtual PEP or vPEP).
Reactivate is a physical activity program to help people to become confident to start to move again. It involves eight sessions over four weeks to practice grading in activity, and/or working on specific physical/functinoal tasks.
START – Selected Targets of Activity ReTraining – START is a Three-week fulltime intensive PMP. It takes people into an in-depth understanding of how their thoughts, feelings and action shape their pain and the associated distress, disability and disempowerment. The program builds upon concpets introduced in the less-intensive programs to realise the power of independent self-management within the individual. Currently START is being run fully online (START At Home), and participants have reported great satisfaction with being able to complete the program in their own environments.
Individual programs involve one on one sessions with the pain physiotherapist, clinical psychologist, nursing staff, and/or doctors as necessary. Many participants undertake a mixture of individual and group rehab.
- The role of a psychologist in pain management may be initially unclear. The psychologist works closely with the rest of the team to build an understanding of various impacts of pain (i.e., work, relationships, sleep, mood, hobbies). Commonly, when in pain over time, we become distressed and experience much disability. As pain continues we may experience low mood, anxiety or even anger.
- Psychology aims to:
- Understand how pain impacts daily life
- Explore how pain impacts sleep
- Discuss mood symptoms and anxiety
- Assess how activity levels have changed and
- Clarify what steps you are taking to cope with pain
- The psychologist may work with people on treating and reducing emotional distress (eg. depression, anxiety or anger) and develop strategies to help manage pain (e.g., pacing activities, goal setting and relaxation strategies).
- A pain physiotherapist’s role is very different to one you might see in the community. Within BWCPM, the physio will talk to you about how pain has affected all the things to do with movement: activity, function, socialising, relationships, community involvement, and exercise. They will also look at how you think and feel about your body, with the end goal of building the trust you have in your body.
- This may include:
- Goal setting and making a plan to integrate physical activity into life
- Developing problem solving skills to reduce the impacts of flare ups
- Identify avoided activities and Encourage the return of these activities in a gradual sense
- Education about persisting pain and how we can make ourselves feel safe and trust our bodies
- Specific exercises where needed.
- Physiotherapy at BWCPM does not involve:
- Regular sessions focused on delivering passive modalities such as massage, manual therapy, and electrotherapy.
- Pain Medicine Specialist
Tel: 9231 4681
Fax: 9231 4660
HealthPathways Melbourne is an online portal designed to be used by general practice at the point of care to guide best practice assessment, management and referral of common clinical conditions.
This is a public outpatient service. All patients need to be referred to us by a GP. Please see your GP if you believe you would benefit from a referral to this clinic. Many doctors have private consulting suites as well as working in the public hospital system. This is entirely separate from St Vincent’s and our staff do not have any information about the private consulting practices of doctors.