189: Bridging Disciplines in Chronic Pain Care: A Case Study

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic neuropathic pain, Treatment/management

Background and Aims: Chronic pain is a complex condition, requiring multidisciplinary care that not only targets the physical component but also the emotional, psychological and social aspects. This often leads to better management and improved quality of life among chronic pain patients. Hospital Canselor Tuanku Muhriz (HCTM), UKM is one of the few public hospitals providing specialized chronic pain management under the Department of Anaesthesiology & Intensive Care, involving a team of professionals who co-manage patients with chronic pain.

Methods: The core profession at the Pain Management Clinic (PMC), HCTM is the anaesthesiologist, and the clinic runs once weekly. The clinic is also attended by the physiotherapist and occupational therapist weekly, and a psychologist monthly. Patients are referred from various medical and surgical disciplines, Patients with medical co-morbidities are discharged to primary care once pain is satisfactorily managed, for subsequent follow up of chronic pain. This case report describes the 360-degree multidisciplinary team co-management of a 71-year-old, Malay, male retiree with multiple comorbidities and chronic non-cancer pain. His wife was deceased and he lived with his youngest daughter.

Results: He presented to the PMC with neuropathic neck and shoulder pain post-tonsillectomy and radical neck dissection. Following analgesic adjustment, pain was controlled with gabapentin and tramadol. Referral to primary care ensued for cardiovascular follow-up and transfer of care. He continued exercises and self-reduced tramadol. However, recurrent visits for analgesic replenishment raised opioid dependence concerns, hence he was re-referred to the PMC for pain management. Titrated analgesics, restricted opioids, physiotherapy and interventional pain therapies constitute biological pain management with significant improvement. Continual coordination among the PMC, primary care, physiotherapist and psychologist addressed psychosocial pain contributors, facilitated coping strategies, and restored function.

Conclusions: Co-management of chronic pain patients fosters integrated, patient-centred care by combining the expertise of a multidisciplinary team. This collaborative approach enhances treatment effectiveness, supports long-term management, and ensures that individualized care plans address the complex needs of each patient. Ongoing monitoring across disciplines is essential to reflect progress, and future assessment of patient outcome may validate the benefits of co-management.

References: NA

Presenting Author: Nadia Binti Md Nor
Submitting Author: Agnes Chong Shu Sze

Senior Author: Nadia Binti Md Nor

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Wan Nur Sabrina binti Wan Manshol - Family Medicine Department, Faculty of Medicine, Primer Clinic, Universiti Kebangsaan Malaysia (UKM)
• Nadia Binti Md Nor - Department of Anaesthesiology And Intensive Care, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, UKM