Pain Management Program - Before You Arrive

First-time patients

If have been referred by your doctor to the St. Joseph's Pain Management Program and are awaiting your first appointment, it's important to know the following:

  • Both you and the referring doctor will receive notice of your appointments.
  • You will be given TWO (2) appointments:
    • First Appointment: The Pain 101 Session. This is an education session that is hosted by our interprofessional team. It provides new patients with information on various treatment options and chronic disease management strategies available to you as a new patient within the Pain Management Program. This appointment is approximately two hours in length and family and friends are welcome to attend.
    • Second Appointment: Your first one-on-one appointment with the physician from the Pain Management Program. This appointment can be approximately one to two hours in length. 
  • Once you receive notice of your appointments for the Pain 101 session and one-on-one appointment with one of our Pain Management physicians, it is very important that you confirm these appointments one week in advance. Please read how to confirm your physician appointment
  • For your first one-on-one physician appointment, be sure to review what to bring and what to expect.  

How to get here

Directions
To find your way to the outpatient Chronic Pain Management Program, detailed turn by turn directions from each main entrance at St. Joseph's  Hospital is available. These are printable for your convenience.

Parking
Paid parking is available in the Grosvenor Street garage (across from the main entrance) and in our Cheapside street parking garage. Metered parking is available on some side streets near the hospital.
  
Map
For your first visit, a site map of St. Joseph's Hospital may be helpful to you

Confirming your physician appointment

The doctor who referred you to the Pain Management Program will receive notification of your appointments. A letter will also be mailed directly to you to inform you of your appointments.  You must confirm the appointment at the Pain Management Program one week in advance. Confirmation of your appointment can be left at 519-646-6019 ext.2 at any time of day. Due to the high number of referrals to this clinic and long wait times, confirmation of your appointment is important.

Your first appointment

  • Please allow two hours for your first appointment.
  • Please bring the following with you to your appointment:
    • Your health card and all WSIB information if applicable.
    • An accurate list of all the medications you are currently using. An updated list of your medications from your pharmacist would be preferred. 
    • A driver as treatment may be provided and you may not be able to drive yourself home.

Follow up visits: 
Please remember to book your follow-up appointment before leaving your initial visit.

Patient attendance policy

To ensure timely and effective patient care, we try to keep appointments on schedule. If you are more than 15 minutes late, your appointment may be rescheduled as the delay may affect the care of others. This decision will be made at the discretion of your treating therapist.

Please be advised that you may be discharged from therapy if:

  • You fail to attend two (2) scheduled appointments without giving appropriate notice. We appreciate at least 24 hours’ notice of a cancellation unless a sudden illness or emergency occurs.
  • You have repeated cancellations that affect the effectiveness of your treatment.
  • You fail to contact the Pain Management Program to rebook your therapy session within 8 weeks of your last visit.
  • You have confirmed participation in one of our treatment groups and fail to attend without appropriate notification. You will not be offered a spot in any future groups.

This policy is necessary to ensure you receive maximum benefits from your therapy and to improve access to care for those awaiting our services. Thank you for your understanding and adherence to our patient attendance policy.

Download the Patient Attendance Policy for Physiotherapy, Occupational Therapy, Psychology and Social Work for your responsibility to arrive on time or provide appropriate notice if cancelling an appointment.

Frequently Asked Questions

Why is the wait time for a Pain Management Clinic appointment so long?

We understand how frustrating the wait can be, especially when you are in pain.   Our goal is to minimize our wait-times, and ensure access to our services as quickly as possible despite the program demands being very high. Wait times can vary depending on the services you require. If you need to cancel or change your appointment, please provide 72-hours notice so that your appointment time can be given to someone else. 

I thought I was referred to see a doctor.  Why should I be working with allied health professionals?

Managing chronic pain is a complicated and challenging task.  Pain medications and medical interventions alone often don’t provide optimal pain relief. Many things affect your pain and reduce the effectiveness of medical treatments, such as stress, emotional distress, activity levels, smoking etc.  As a result, you may need a multi-faceted approach from one or more of our team members to address all of the areas of your life that may be impacting your pain. This may include learning new coping strategies and incorporating lifestyle changes into your daily life. 

My Pain Management Clinic doctor has referred me to a psychologist. Does this mean he/she thinks my pain is in my head?

Often we think of pain as strictly a medical condition.  However, many psychological issues increase pain severity and limit the effectiveness of pain medications and other medical treatments.  In order for you to regain optimal function and engagement in meaningful activities it is important to understand all of the factors that impact your pain condition including frustration, irritability, grief, anxiety and / or depression.  Our social worker and psychologists are available to help our patients who are struggling with mental health and other issues that can accompany living with pain to help improve your self-management and coping strategies and improve quality of life. 

Will my pain go away with treatment?

Chronic Pain (pain present for longer than 6 months) cannot be cured, but it can be managed. Self-management is one of the most important treatments for your chronic pain. Self-management in combination with medical management will offer you the best opportunity to manage your pain and regain your quality of life. 

Will the pain specialist or my family physician/nurse practitioner be the pain medication prescriber?

Generally, the family physician/nurse practitioner will be the pain medication prescriber. 
As you may already know, it is standard practice to ask patients to sign an opioid contract/agreement stating they will only receive opioids from one prescriber. At the St. Joseph’s Hospital Pain Management Program, we want to help you follow any opioid contracts you may have signed with your family physician/nurse practitioner. 

While the pain specialist or the pain clinic pharmacist may make recommendations to start, stop, or change medications, it is the family physician/nurse practitioner who will carry out the prescribing of these medication recommendations. We follow this prescribing strategy because it makes it less likely for communication mix-ups or medication safety issues (e.g., drug-interactions) to be missed if there is just one prescriber looking after your medications. Lastly, many of our pain specialists only work in the pain clinic once a week because they also work in other areas of the hospital (e.g., the operating room or other outpatient clinics). As a result, it is much harder to get prescription requests addressed in a timely fashion through the pain clinic than it would be through a family physician/nurse practitioner’s office.

With that said, there are a few instances where the pain specialist may temporarily prescribe pain medications, such as:

  • When the pain specialist provides a prescription for a pain medication at a low dose with instructions to slowly increase the dose and follow-up with the family physician/nurse practitioner within a specific timeframe for re-assessment and the next prescription.  In such a situation, the pain specialist will provide advice to the primary care provider about next medication steps when they see you in follow-up. This step-wise prescribing care strategy is undertaken so that everyone’s time can be optimized and the follow-up visit with the primary care provider can be as productive as possible.  
  • When an opioid rotation or wean is to be undertaken and it is considered by the pain clinic specialist to be too complex/logistically tedious that it requires more supports than the primary care provider’s office has in place. 
     
What should I do if I have leftover medications that are no longer being used?

Please return all medications that are no longer being used to your local community pharmacy for proper disposal.  This is especially true for opioid medications because significant harm can result if someone (such as a child or teenager) or the family pet gets into these medications.

Why do I need a driver to come with me to certain appointments?

Sometimes the treatment offered will be a nerve block, or an intravenous infusion. These treatments may temporarily impair your ability to drive, either by causing sedation or by blocking sensation to a limb for several hours.