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Our Service

NPP Pain Strategies provide holistic, neuro- bio-psycho-social rehabilitation for people with persistent pain in Bromsgrove. We specialise in supporting individuals with pain related to complex, multi-physical trauma and/or those who are involved in medico legal proceedings.
We offer an evidence-based, fully integrated, multi-disciplinary service; in which assessment, formulation, intervention and evaluation are seamlessly synthesised, both within and across disciplines.

What is persistent pain?

Pain is a poorly understood, complex multi-dimensional phenomena. Developing neuro- scientific theory indicates that it is as neuro-physiological experience, resulting from the contribution of several cognitive, behavioural, emotional and physiological components (Moseley, 2003).

Pain that persists for more than six months is increasingly common amongst the general population and often occurs after polytrauma and characterises rehabilitation journeys. It can generate significant psychological distress, social and occupational disability and often significantly reduces quality of life.

The impact of persistent pain?

Persistent pain can generate clinically significant psychological distress and physical, social and occupational disability. Pain has an “unrivalled capacity” to interrupt people’s lives; interfering with their ability to live how they wish; de-railing life plans and “hoped for” futures and negatively impacting self-identity (Morley, 2008). A recent study showed that the Quality of Life reported by pain patients was equal to that reported by people experiencing advanced dementia.

A lack of understanding about persistent pain and how to manage it is common amongst the general public and medical professionals alike. It is not unusual for an individual to find themselves stuck in a negative cycle of increasing disability, dysfunction and distress, with their support systems uncertain of how to help them.

What is the most effective treatment?

Early and accurate assessment of pain management needs are essential for an effective rehabilitation process and can prevent the development of entrenched patterns of pain-related disability and distress.

Current recommendations for persistent pain interventions call for timely, multi-disciplinary, bio-psycho-social approaches, grounded in psychological frameworks that should be supported by conservative use of pharmacological and surgical treatments (RCoA, 2015). Self -management approaches underpinned by cognitive behavioural assumptions are the current gold standard, demonstrating effects on a variety of useful outcomes (Cochrane, 2013). Self-management approaches include psychosocial education, physiotherapy, graded exposure to exercise, activity management, sleep management, body awareness, mindfulness training and pain orientated cognitive behavioural therapy.

Formulation

At NPP Pain Strategies, we prioritise the quick and accurate assessment of the pertinent factors driving pain-related disability and distress. A robust psychological formulation, therefore, lies at the heart of our recommendations and is the foundation of all interventions we provide. The formulation is used to help client’s and their support systems to link the different components of the pain experience, to recognise the interactive nature of thoughts, behaviours, emotions and sensations and to develop an awareness of how each component may contribute to the development and maintenance of pain, distress and disability.

As maladaptive and unhelpful thoughts and behaviours are identified, opportunities for change are highlighted and goals are set accordingly. The formulation is regularly referred to and reviewed. Its existence ensures that all stakeholders have a shared vision for progress and that all interventions flow together, concordantly and with cumulative efficacy.

Our Mission

Our mission is to enable individuals with persistent pain to move towards their best version of recovery and to re-establish their quality of life. This may mean the restoration of function, mobility, strength, wellbeing and social connection, and the resurrection of autonomy and independence, self-identity and self-efficacy. Deliver a reliable, efficient, high quality and co-ordinated service for case managers in accordance with the most up to date evidence about what helps people with persistent pain.

Our Ethos

Living with persistent pain is distressing, and managing it effectively is challenging. As there is no known cure, pain management can feel overwhelming and hopeless for individuals and their support systems. At NPP Pain strategies, we recognise these inherent difficulties, whilst simultaneously holding the confidence and hope that people with complex long- term pain can adapt, recover and rehabilitate, to create meaningful and satisfying lives.

We aim to provide person centred, responsive and responsible input at all times. We seek to both validate and challenge our clients. Bespoke intervention plans are built around the client’s idiosyncratic strengths and limitations, values, preferences and personality, whilst also remaining grounded in the scientific evidence base on what works. Our emphasis is on early intervention, empowerment and collaboration. As a team we are interested in the goals that matter to the client. A decent night’s sleep, a more positive mood, understanding the pain, getting back into the garden and returning to exercise with confidence are all examples of achievable outcomes.

Medico Legal

We provide Medico-legal reports for solicitors, reports and Immediate Needs Assessments for case managers. Our clinicians are Consultants or Senior Grades within the NHS or within Statutory Services, are highly experienced and specialists in their field with an active current case load, keeping them abreast of current

What we do

Our adult pain management service provision draws upon a specialist body of scientific theory, clinical evidence and assumptions that differ from other types of clinical health rehabilitation (e.g. musculoskeletal physiotherapy or general health psychology). The distinction becomes particularly important when working with more complex pain presentations and where there are multiple physical and psychological co-morbidities. Securing specialist help early in an individual’s treatment pathway may help to avoid negative experiences of pain management and entrenched rehabilitation resistance further down the line.

Pain management is a complex, nuanced and multifactorial “set” of interventions. Like a jigsaw puzzle, it has many pieces. The relevant pieces required must be identified, co-ordinated and systematically put into place, to ensure the production of a complete, coherent and enduring picture. Pain management pieces can be medical, physical, occupational or psychological in nature and can be “passive” or “active”. The self -management “active” pieces, require that the individual learns new information and skills and develops adaptive pain management behaviours. Pain rehabilitation also often involves a process of grief, loss and adjustment for the individual, as they come to terms with the long- term nature of persistent pain.

At NPP Pain Strategies we are experts in guiding and supporting clients to work within and between the different interventions; scaffolding and developing client knowledge and skills in a timely and appropriate way. Working alongside our clients, we facilitate a gradual process of adjustment and learning. As the client moves though phases of recovery, and sometimes in response to unexpected changes in circumstance (see medico legal proceedings), shifts in emphasis are required (e.g. from physical to psychological). In most cases, we assess and deliver treatment components in parallel, either via joint sessions or through a synchronised and boundaried care co-ordination processes.

Complex multi-physical trauma & Medico Legal proceedings

Medico legal proceedings can be lengthy, protracted, unpredictable and difficult processes, characterised by complex legal back and forth and periods of delay and uncertainty. For the individual, they commonly involve multiple medical and legal appointments, repeated physical examinations and Invasive questioning into the personal and private aspects of their lives. As pan of the process, the validity of an individual’s testimony is openly questioned and refuted and thy must ‘prove’ disability For many, it can be a draining, confusing, overwhelming and stressful time. As pain is invisible, many people report feeling “disbelieved” regarding the level of their suffering.

In the midst of this process, a person with persistent pain from complex trauma often faces significant negative changes in their abilities, function and body. These are not of their choosing and often frightening.

Understandably, feelings of anxiety, powerlessness, anger, hopelessness and helplessness are common in this population. Many report a loss of positive self- identity. Perhaps unsurprisingly, it is common for individuals to deteriorate significantly mentally, physically and emotionally during medico legal proceedings; developing co-morbid mental, physical, relational and spiritual health problems that then act to drive the pain further- creating a vicious cycle.

At NPP Pain strategies our job is to intervene early; to accurately assess an individual’s idiosyncratic challenges, to stabilise or prevent a deteriorating pain and mood picture and support and direct the individual through the impact of the medico-legal process. Alongside this, we work alongside our clients, to begin to build resources and resilience; empowering them with strategies for understanding and managing their pain.

Contact Us

Birmingham

Stoke-on-Trent

Stourbridge

Contact Us

NPP Neuro Group
6 Lower High Street
Stourbridge
DY8 1TE

We have branches in Stourbridge, Stoke-On-Trent and Birmingham

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