Pain Management

Pain Management

Chronic pain influences individuals in different spheres of life. When a person experiences pain, it affects their physical being, thought patterns as well as their emotions. Behaviour and cognitive responses such as fear, anxiety and perceptions about the future becomes part of their pain experience.

Our practice started to embrace both individually tailored and group approaches to assist this client group. The type of programme that best suits the individual who experiences complex pain, are determined by a baseline consultation comprising an interview and functional assessment. Thereafter, the best pain management approach is recommended to the individual taking the persons specific challenges and psychosocial risk factors into consideration.

Any enquiries relating to our pain management services can be made with Ms Mariet Smal (physiotherapist) by sending an email to

The subsequent interventions prescribed may include one or more of the following:

Pain Neuroscience education.

This includes an educational strategy based on the work of Adriaan Louw to assist the client to understand the mechanisms of pain. Both research and our personal experience shows the benefit that this approach has as the first step to assist a client to help manage their pain and are often overlooked in other medical approaches.

Individually tailored face to face pain management sessions focussing on strategies to assist with challenges in daily life and specific goal setting. These sessions follows an activity driven and cognitive behavioural approach to the management of pain with the primary aim to improve quality of life and function and assist with return to work (where and if applicable). Various pain management strategies are introduced and tailored to the individuals needs in this process.

Progressive Goal Attainment Programme:

This programme is a uniquely evidenced based programme, which are usually administered over a ten week period (involving one to one sessions) with the client. The primary aim is to assist the client to resume previous interests (where and if possible), provide strategies to implement adjustments by pre-determined specific goals and bridge the gap to resume working or stay at work (if possible).

Interdisciplinary pain management programme:

This seven week programme follows a cognitive behavioral and activity driven and goal orientated approach with the aim to address common cognitive and emotional responses to pain. Various professions are involved in the facilitation of this process namely an occupational therapist, physiotherapist, dietician, psychologist and pain specialist. Once the patient learns how to deal with these challenging thought and behavioral patterns, it better equips them to manage their pain.

Facilitation of these groups have yielded promising results and our patient feedback to date includes the following:

“I don’t want the programme to end”.
“Excellently presented”.
‘’The programme helped me to change my daily routine and activities.’’
‘’ I will definitely recommend this programme to other people with a pain condition.’’

The interdisciplinary group programme are facilitated once each term and a prior baseline assessment is required (in advance) to determine the suitability of the patient to attend the programme. Should a patient benefit from further services (eg. physiotherapy, psychotherapy, consultation with a pain specialist or other services) an onwards referral will be made.

Any enquiries relating to our pain management services can be made with Ms Mariet Smal (physiotherapist) by sending an email to


Overview of Seven week programme


Interview and Baseline Functional Assessment

Week 1

Introduction, Pain Education

Week 2

Goal setting, Activity Pacing, Exercise

Week 3

Thought Processes, Cognitive Re-structuring

Week 4

Stress Management, Sleep Hygiene, Breathing and Relaxation

Week 5

Nutrition and Inflammation Management

Week 6

Information sharing:  Medication, Flare Up and Relapse Management

Week 7

The way forward and final evaluation

Types of conditions treated

(although not exclusive to these conditions)

– Pain duration of longer than 3 months
– Fibromyalgia
– Complex Regional pain syndrome
– Chronic back pain
– Failed Back Surgery
– Headaches
– Whiplash injuries
– Chronic Fatigue Syndrome
– Carpal Tunnel Syndrome

Intervention strategies may include:
Graded exercises
Pacing techniques
Strategies to assist with cognitive restructuring
Mindfulness training
Relaxation techniques
Dietary changes to manage inflammation
Stress management techqniques