The RNOH offers residential in-patient programmes for adults (over 18 years) with long-term chronic neuromuscular and musculoskeletal conditions. These programmes offer a mix of individual and group sessions with input from clinical health psychology, nursing, occupational therapy, physiotherapy and medical specialties including rheumatology, rehabilitation medicine and chronic pain management. Our inpatient facilities and experience allow us to offer our programmes to patients with a high level of disability.
The programmes are focused on implementing cognitive behavioural therapy based self-management strategies to enable patients to achieve their desired goals and improve their quality of life. The programmes particularly emphasise the importance of physical gains and reconditioning, improved quality of engagement in activities of daily living and living well with a chronic health condition.
The in-patient programmes at the RNOH fall broadly into two groups:
This programme is designed for patients with chronic widespread pain including that of non-specific origin. This can also include fibromyalgia. Typically there is minimal or no medical input during these admissions. PMPs move away from seeking a medical cure or reduction in pain intensity (also known as "The Medical model"), focusing instead on self-management through education sessions, tailored exercises, psychological support and practical coping and problem-solving strategies. It is this change in emphasis that has led to the development of the PMP as a separate entity. PMP’s encompass a cognitive behavioural therapy (CBT) approach, whereby patients are supported in making cognitive and lifestyle changes in order to incorporate the self-management principles inherent in the programme into their daily lives and to take these principles forward after discharge. Therefore the primary aim of PMPs is not to reduce pain intensity but to enable patients to control the negative effects of pain on their lives. PMPs have consistently been shown to improve quality of life and reduce pain-related disability.
This programme fulfils the criteria for Combined Physical and Psychological (CPP) treatment programmes as recommended by the NICE 2009 guidelines on low back pain, as well as meeting recommendations described within the Map Of Medicine guidelines for chronic pain sufferers.
These programmes are designed for patients with conditions that may change over time, for example, Ankylosing Spondylitis, Joint Hypermobility Syndrome/Ehlers-Danlos Syndrome, or Rheumatoid Arthritis. We have specific expertise in working with patients with post-polio syndrome. We also offer a programme specifically for patients with Complex Regional Pain Syndrome. Admissions are usually for three weeks and have a strong emphasis on self-management again using a CBT approach. These programmes focus on incorporating physical, functional and self-management strategies together with ongoing medical management specific to the condition and person.
Following an admission, patients are offered two multidisciplinary team-led follow-ups at three months and 1-year post-discharge from the programmes as a way to monitor progress and to help patients consolidate the skills learned and achieve their goals.
Please note that there are certain subgroups of patients with chronic pain that we are at present unable to accommodate on to our programmes. These include severely disabled patients with progressive neurological diseases/disorders, including multiple sclerosis or patients with spinal cord injury. Please refer to the Spinal Cord Injury Centre
Patients may be placed on a PMP, CRPS or Rehabilitation programme after being seen at the pain, rehabilitation or rheumatology clinic here at RNOH. We accept referrals from GP practices as well as from consultants and clinicians at the RNOH and other secondary care centres. All referrals are triaged by one of the Consultant Medical team.
Referrals for Rehabilitation Medicine (excluding spinal injuries rehabilitation) may be sent to:
rnoh.
Telephone: (020) 3947 0044
Referrals for the Pain Management Programme may be sent to:
Dr Roxaneh Zarnegar, Consultant in Anaesthesia and Pain Management
Secretary telephone: (020) 3947 0043
Referrals for rehabilitation in patients with Rheumatological and Hypermobility disorders may be sent to:
Dr Helen Cohen, Consultant Rheumatologist
Secretary telephone: (020) 3947 0044
Dr Gayatri Mittal, Consultant Rheumatologist
Secretary telephone: (020) 3947 0044
Referrals for rehabilitation in patients with Complex Regional Pain Syndrome (CRPS) may be sent to:
Dr Helen Cohen, Consultant Rheumatologist
Secretary telephone: (020) 3947 0044
Dr Roxaneh Zarnegar, Consultant in Anaesthesia and Pain Management
Secretary telephone: 0203 947 0043