Pain consultation tool | Right Decisions

The Pain consultation tool is designed to assist your understanding of where your patient may be in terms of behaviour change. It is not meant to replace usual treatment, simply to guide the timing of your interventions focused on supported self-management.

(Adapted and reproduced with kind permission from the NHS Grampian Chronic Pain Service)

Please note that the table below may need to be scrolled horizontally or vertically in order to view all information, depending on your device.

Pain consultation tool

Main theme	Level 1 Not aware it’s a Long-Term Condition (LTC)	Level 2 LTC-aware but overwhelmed	Level 3 LTC-aware but low confidence	Level 4 LTC-aware usually confident but having a setback
Description	Feels overwhelmed. Not aware of self-management. Consider trauma background, active mental health issues and problematic substance use	Knows they could be self-managing more but doesn't yet have knowledge and skills to do so	Knows roughly what they can do to influence pain, but not confident to change behaviour	Generally managing well and has good self-management behaviours, but set back due to stressors or life circumstances
Individual’s perspective	“I need something to fix it. Is there an underlying disease?”	“I'll give it a go, but I don't expect it to help”	“I want to learn to manage pain, but I need help”	“I know I can do it, but I don't know how to get past this obstacle”
Individual’s characteristic	Passive, uninformed, resistant, distracted. May be angry, defensive or distressed May still be grieving loss - or stuck	Ill-informed about factors influencing pain, costs of actions and how to intervene/change	Frustrated, discouraged, oscillates in determination and motivation	Determined but discouraged
Questions	“What’s your understanding of pain?”	“How have you tried to help manage pain? How well have these worked for you in the longer term, as well as short term?”	“What things are most useful?”	“Any triggers that might have caused this?”
Interventions Prioritise based on level	Relationship building: Listen Validate Educate Normalise Signpost	Support Team: Individual Support network Third sector Practice MDT	Pain Management Plan: Values based goal setting Support emotional wellbeing	Common issues (and solutions) Unclear goals (SMART goals) Lack support (support team) Boom/bust (pacing/activity plan) Flares (flare up plan)