Supporting Seamless Patient-Centred Pain Management Across SingHealth

ABOUT THE SINGHEALTH DUKE-NUS PAIN CENTRE

The SingHealth Duke-NUS Pain Centre brings together multidisciplinary expertise across SingHealth to deliver coordinated, consistent and compassionate care for patients living with pain.

The SingHealth Duke-NUS Pain Centre (SDPC) was established in April 2024 and works to coordinate the pain centres within SingHealth to address the complex challenges of pain management.

As a multidisciplinary and multisite centre, SDPC integrates specialists from:

• Pain Medicine
• Palliative Medicine
• Spine Surgery
• Rehabilitation Medicine
• Physiotherapy
• Psychology

INTEGRATED MULTIDISCIPLINARY CARE

As pain often involves multiple systems and requires the combined expertise of several specialties, SDPC brings these disciplines together to improve access, consistency and quality of care for patients living with pain. By aligning clinical services and standardising care pathways across institutions, SDPC supports seamless, patient-centred pain management.

We also collaborate closely with primary care and community partners ensuring continuity of care from initial assessment through to long-term management.

The SDPC consists of multiple pain centres across SingHealth institutions:

1. Singapore General Hospital

• Department of Pain Medicine

2. Sengkang General Hospital

• Department of Pain Management

3. Changi General Hospital

• Chronic Pain Clinic

4. KK Women’s and Children’s Hospital

• Children’s Pain Management Clinic
• Women’s Pain Centre

How To Access Our Services

While the SDPC coordinates collaboration between these clinics, patients receive their care directly at the individual hospital centres listed above.

Through strategic integration of clinical services and resources and close collaborations with our primary care and community partners, our centres work to harmonise care pathways and standardise treatment guidelines across the cluster, improving overall patient outcomes.

WHAT IS PAIN MANAGEMENT?

Pain is a common symptom experienced by people of all ages but can also be a disease in itself when it becomes chronic. Pain conditions can significantly impact quality of life and often require coordinated care across various specialties to ease this pain.

Why Pain Management Matters

Pain management aims to reduce pain during recuperation and thereafter. Good pain relief is important as it decreases suffering, helps with quick recovery and, most importantly, helps the patient return to their usual activities.

Our centres offer a range of therapies and work collaboratively with patients to create a treatment program and deliver care tailored to their specific needs. We aim to help the patient achieve adequate quality of life in the presence of pain by:

i. Lessening the pain
ii. Fostering a better understanding of the pain
iii. Assisting the patient to live life despite the pain

Pain management is not just the optimisation of medications and interventions. We also focus on pain education, therapy and empowerment through self-management.

WHEN SHOULD PATIENTS BE REFERRED?

Primary care physicians can consider referral to ourpain management services if:

• The pain has lasted > 3 months
• The pain interferes with daily life – affecting sleep, work, exercise or relationships
• Multiple treatments have been tried without adequate relief
• Pain affects mood or mental health – causing anxiety, depression or frustration
• The patient is concerned about medication dependence or experiencing side effects from pain medications
• Help is needed to manage pain after surgery oran injury that is not healing as expected
• Pain is getting worse or spreading to other areas
• The patient is unsure what is causing the pain and needs a comprehensive assessment

Referral should not be delayed until the pain becomes unbearable. Early intervention often leads to better outcomes and can prevent pain from becoming more complex and difficult to treat.

What Patients Can Expect After Referral

The initial consultation is comprehensive and focuses on understanding the patient’s unique pain experience.

Pain Assessment

• Detailed discussion about the pain history, including when it started, what makes it better or worse and how it affects daily life
• Review of previous treatments tried and their effectiveness
• Review of coping strategies while in pain
• Assessment of how pain impacts sleep, mood, work/school, social activities and relationships and vice versa
• Physical examination focused on the patient’s pain condition

Medical History Review

• Current and past medical conditions including mental health conditions
• Previous surgeries or injuries
• Complete medication review including over-the counter drugs and supplements
• Previous treatments and management including TCM/herbal/other non-medical treatments
• Review of any scans, X-rays or test results the patient may have had

Treatment Planning

• Discussion and counselling about treatment goals and expectations
• Explanation of diagnosis and pain condition in clear, understandable terms
• Overview of available treatment options suitable for the patient’s condition
• Development of a personalised treatment plan
• Setting realistic timelines and milestones

Common Pain Conditions We Treat

Our clinics provide care for various chronic pain conditions, including:

• Chronic low back, thoracic and neck pain
• Herniated discs
• Osteoarthritis affecting joints (hip, knee, ankle, shoulder, elbow, wrist)
• Myofascial pain
• Fibromyalgia
• Postherpetic neuralgia (shingles pain)
• Trigeminal neuralgia
• Headaches and migraines
• Orofacial pain
• Chronic postsurgical or post-traumatic pain
• Recurrent and/or Functional abdominal pain
• Complex regional pain syndrome
• Painful diabetic neuropathy
• Cancer-related pain
• And other pain diagnoses

Other than treatments with medications, physical and psychological therapies, our centres offer a comprehensive range of minimally invasive interventions for patients with chronic pain.

CLINICAL SERVICES OFFERED

Across our network of pain centres, patients with chronic pain can access a comprehensive range of treatment services. Our holistic pain management
approach includes thorough assessment, medication titration, counselling, pain education and interventional pain management where appropriate.

The goal of pain management is to relieve, reduce, or help the patient manage pain and improve overall quality of life through evidence-based treatments
tailored to individual needs.

Treatment options available across our clinics include:

• Medication Management: Optimising pain medications while minimising side effects
  
• Physical Therapy: Specialised exercises and rehabilitation programs
  
• Psychological Therapy: Cognitive behavioural therapy and coping strategies
  
• Interventional Procedures: Minimally invasive techniques for suitable patients
  
• Acupuncture

Interventional Procedures

Depending on the condition and clinic location, interventional options may include:

• Epidural steroid injections– in the lower/upperback, neck
• Nerve blocks
• Trigger point injections
• Radiofrequency ablation
• Neurostimulation including spinal cord/peripheral nerve stimulation• Intrathecal drug delivery systems
• Platelet Rich Plasma (PRP) injections in joints/soft tissues
• Botulinum toxin (BOTOX) injections

Important Note: Treatment options and available procedures vary by clinic location based on specialisation and resources. During consultation, the doctor will discuss the treatments most suitable for the patient’s condition and available at the clinic. If specialised treatments are needed, we can coordinate referrals within the SDPC network.

Referral Guidelines to Pain Centres

HOW TO REFER PATIENTS

For GP referrals, please contact the SingHealth Duke-NUS Pain Centre: