Persistent pain services — Otago and Southland

The Persistent pain service is an outpatient service that helps with the management of long-term pain conditions.

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Contact us

You can contact the Persistent pain service by:

Where to find us

The Persistent pain service is located in the Fraser Building at Dunedin Hospital.

Street address

464 Cumberland Street
Dunedin

Postal address

Persistent pain services
Private Bag 1921
Dunedin 9054
New Zealand

Services we provide

The aim of the Persistent pain management service is help regain independent management of your pain condition and to enable you to have a more fulfilling life. This is done with other services to help manage complex pain problems by:

  • prescribing and adjust medications
  • providing education about the nature of the problem
  • providing rehabilitation to improve quality of life and performance of daily activities.

The team is innovative and keen to explore international advances in pain medicine and pain management. This means new approaches will be tried or offered from time-to-time.

Persistent pain is classified as pain that has lasted more than 3 months and can affect all ages.

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A pain doctor in a multidisciplinary persistent pain service plays a central role in the comprehensive management of chronic or persistent pain. They bring medical expertise to diagnose, treat, and manage pain conditions that often have complex, multifactorial causes. Their responsibilities include:

  • assessment and diagnosis — determine the underlying causes of persistent pain
  • medical management — develop pain management plans with other areas of expertise, which may include physical reactivation and lifestyle changes, psychological support, medications such as analgesics, anti-inflammatory drugs, antidepressants, or anticonvulsants
  • interventional procedures — targeted interventions such as nerve blocks, inject Botox, or arrange medication infusions
  • coordination with other specialists — this makes sure we take a holistic approach to your treatment
  • patient education and self-management — education about the condition, understanding the complex nature of persistent pain and the role of therapies and lifestyle changes, and guidance in self-management strategies, which are crucial for long-term relief.
  • monitoring and outcome evaluation — regularly monitor progress, adjusting treatment plans based on response and emerging needs.

By combining medical expertise with a collaborative, interdisciplinary approach, pain doctors help patients achieve better pain control, improve functionality, and enhance quality of life in the face of persistent pain.

We try and avoid long-term opiates for pain management as evidence shows a worse outcome in persistent pain patients.

Pain physiotherapy considers the relationship between physical, emotional, and social factors in understanding and treating pain. Physiotherapists make full assessments and treatment plans with you and aim to improve:

  • activity tolerance
  • confidence
  • function
  • quality of life.

You can expect to learn strategies which enable you to self-manage your pain.

Core physiotherapy techniques include:

  • assessment and diagnosis of musculoskeletal conditions
  • goal setting
  • pain neuroscience education with a focus on reassurance and education about the thoughts and feelings that may be associated with your pain experience
  • structured and tailored exercise prescription
  • graded exposure therapy
  • sleep education
  • adjunct physiotherapy techniques as required
  • mobility aid prescription and education
  • movement pattern re-education
  • manual therapy or acupuncture where appropriate
  • TENS (Transcutaneous Electrical Nerve Stimulation)
  • mindfulness and breathing exercises
  • graded motor imagery (desensitisation and mirror therapy).

The Patient education programme (PEP) is for people who find persistent pain interferes with their ability to lead a normal life. It is a 6-week programme developed to help you decide what is important to you, and to support you to take the next best steps towards being yourself again.

Group sessions happen once a week between 9:30am and 2:30pm.

Each group is limited to 10 people. Although delivered as a group programme, people will have individual treatment plans and clear goals they are working to acheive.

A typical session includes education, discussion and feedback, and exercise

Topics include:

  • understanding pain
  • managing activity
  • value identification
  • sleep
  • goal setting
  • and more.

Participants are encouraged to contribute to the discussion. Each session includes mindfulness practice.

Using a group approach helps you talk to others in your situation

Persistent pain can be a socially isolating experience with whānau, friends and even treating medical teams not understanding how difficult it can be. In the group you will be able to meet other people in the same situation as you, who understand what you are going through. Group programmes also give people the opportunity to share information and learn from one another.

The programme aims to help people:

  • with pain lasting more than 3 months
  • with no further medical or surgical investigations or treatments planned
  • that do not need urgent psychiatric treatment
  • with no drug or alcohol problem
  • with ongoing interference of activities of daily living due to pain.

How the PEP can help you

PEP may help if pain is interfering with your attempts to maintain normal daily activities or work. You may feel you are managing quite well, but other ideas and strategies may help to continue your improvement. PEP may help you regain control over your life and achieve your goals despite having pain.

iSelf help in an online group programme for people who find persistent pain interferes with their ability to lead a normal life. It is a 12-week programme developed to help you decide what is important to you, and to support you to take the next best steps towards being yourself again.

Sessions are Monday and Wednesday every week, between 1:30pm and 2:30pm.

  • Mondays are with a peer support facilitator who has a lived experience of persistent pain.
  • Wednesdays are with clinicians from the persistent pain service.

Although delivered as a group programme, people will have individual treatment plans and clear goals they are working to acheive.

A typical session includes education, discussion and feedback, and exercise

Topics include:

  • understanding pain
  • managing activity
  • value identification
  • sleep
  • goal setting
  • and more.

Participants are encouraged to contribute to the discussion. Each session starts with a review and reflection on previous content. Participants also have access to online resources.

Using a group approach helps you talk to others in your situation

Persistent pain can be a socially isolating experience with whānau, friends and even treating medical teams not understanding how difficult it can be. In the group you will be able to meet other people in the same situation as you, who understand what you are going through. Group programmes also give people the opportunity to share information and learn from one another.

The programme aims to help people:

  • with pain lasting more than 3 months
  • with no further medical or surgical investigations or treatments planned
  • that do not need urgent psychiatric treatment
  • with no drug or alcohol problem
  • with ongoing interference of activities of daily living due to pain.

How iSelf help can help you

iSelf help may help if pain is interfering with your attempts to maintain normal daily activities or work. You may feel you are managing quite well, but other ideas and strategies may help to continue your improvement. PEP may help you regain control over your life and achieve your goals despite having pain.

iSelf help is targeted to those who cannot travel to Dunedin or take significant time off work during the day to attend the in-person group.

A group exercise class runs on Friday mornings from 9am to 10am.

All participants have an individualised programme that is designed by the physiotherapy team and is tailored to their specific needs and abilities. The supportive environment encourages motivation and accountability, making it easier to maintain a regular routine.

Exercising with others can reduce the feelings of isolation that persistent pain can cause through sharing your journey, challenges, and successes. The group setting also allows for the exchange of tips and coping strategies, as members support each other. This blend of personal and collective experiences can boost motivation, improve adherence to exercise routines, and create a positive atmosphere that enhances overall wellbeing.

Numerous studies suggest mindfulness is a key pain coping skill.

This 8-week course is for patients who have a basic understanding of mindfulness but would like to better understand how to use it to support their pain management. Members can expect to learn through in-session discussion and practice, and daily home practice.

One of the most difficult parts of coping with chronic pain is its impact on relationships. Being in a group with others who understand the lived experience of having chronic pain can be very useful.

In this ongoing weekly ongoing group, members will be invited to engage with each other in a manner that focuses on interpersonal process. This means the group leaders help members use their interactions with each other to learn more about themselves and their interpersonal patterns.

Patients often report benefits from the group that extend to their everyday lives and personal relationships.

Referral information

Your main healthcare provider can refer you to our services.

You will be sent a questionnaire to complete when we get the referral. As well as contact details, the questionnaires give us information about:

  • how long you have had pain
  • how it started
  • baseline information of how it has affected your lifestyle and wellbeing.

We will email you the referral if your email address is included in the referral. We will post it to you otherwise. We can only accept your referral once you have returned the questionnaire, and email is the quickest way for this to be done.