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Persistent Pain Management


If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

Adult persistent pain

  •  Patients with acute pain and new neurological symptoms eg Cauda Equina Syndrome (CES)
  • Patients requiring acute mental health services
  • Concerns pertinent to any medical/surgical condition which raise the possibility of serious underlying disease (malignancy or infection) should be reviewed by the appropriate specialty either via emergency department or high priority outpatient appointment

Paediatric persistent pain

  • Concerns pertinent to any medical/surgical condition which raise the possibility of serious underlying disease (malignancy or infection) should be reviewed by the appropriate specialty either via emergency department or high priority outpatient appointment


Please note this is not an exhaustive list of all conditions for outpatient services and does not exclude consideration for referral unless specifically stipulated in the CPC out of scope section. 

The following are not routinely provided in a public Persistent Pain Management service.

  • Patients who can be well managed in primary care (using appropriate guidelines where necessary).
  • Previous Queensland Health Persistent Pain Management Service (PPMS) patients who have not followed management recommendations unless there are extenuating circumstances or new issues.
  • Previous Queensland Health PPMS patients who have completed the pain management pathway / programs and for whom no new management approaches are available (within previous 12 months).
  • Patients undergoing treatment from other specialist services for the same pain problem without mutual awareness / agreement of cross referral by both teams.
  • Patients with untreated and unstable mental health conditions.
  • Patients with a cognitive impairment of sufficient severity that would affect the ability to self-manage their condition unless they have a carer that is willing and able to assist with pain management recommendations.
  • Patients that have unstable, non-therapeutic drug dependence without concurrent treatment by a drug and alcohol specialist.
  • Patients consuming >100mg oral Morphine Equivalent Daily Dose (oMEDD) for longer than 3 months that are not already engaged in an appropriate primary care directed opioid deprescribing program (Patients with long term psychological opioid dependence are less likely to engage with non-pharmacological interventions. Please consider phoning your local PPMS for advice regarding medication optimisation or opioid deprescribing).
    Indefinite referrals are not accepted