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Medical specialties

Pain Medicine Diploma

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An evidence-led diploma in pain medicine: how acute and persistent pain work, what medicines, psychological therapies and interventional procedures can and cannot do, and how to prescribe opioids safely, anchored on National Institute for Health and Care Excellence (NICE) guidance, the International Association for the Study of Pain (IASP) definitions and the World Health Organization's ICD-11 pain classification.

Twenty-five weekly sessions across five modules take you from mechanisms, assessment and medicines, through acute and postoperative pain, chronic pain conditions and interventional procedures, to cancer pain, special populations and running a pain service, taught live by practising specialists you can question.

Course director
To be announced
Format
25 live weekly sessions on Zoom, in 5 modules
Dates
Confirmed when enrolment opens

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CT scans of the thoracic spine showing a needle placed into the small joints beside a vertebra for a pain-relieving injection.
Image: CT-guided costotransverse joint injection by Hellerhoff via Wikimedia Commons, licensed under CC BY-SA 4.0.

Who it is for

Senior trainees, fellows and early-career specialists in anaesthesia, pain medicine, rehabilitation and neurology, and physicians, GPs and allied specialists who manage persistent pain, worldwide.

The programme

25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.

Module 1 · Sessions 1 to 5Foundations: mechanisms, assessment and medicines

  1. 1. How pain works: nociceptive, neuropathic and nociplastic pain

    • Explain the difference between nociceptive, neuropathic and nociplastic pain using clinical examples
    • Classify a patient's chronic pain using the ICD-11 categories
    • Describe the mechanisms of peripheral and central sensitisation
    • Use the current international definition of pain to explain persistent pain to a patient

  2. 2. Assessing the person in pain

    • Take a biopsychosocial pain history that identifies the drivers of disability
    • Identify red flags that need urgent investigation
    • Select validated screening and outcome measures for a pain clinic
    • Agree goals with the patient that focus on function rather than pain scores alone

  3. 3. The psychology of pain and pain management programmes

    • Recognise the psychological factors that maintain pain and disability
    • Explain the principles of cognitive behavioural therapy and acceptance and commitment therapy to patients
    • Decide which patients to refer to a pain management programme
    • Describe the components of a pain management programme that meets national guidelines

  4. 4. Non-opioid medicines and the limits of drug treatment

    • Choose non-opioid analgesics by pain mechanism and comorbidity
    • Apply NICE NG193 advice on which medicines not to start for chronic primary pain
    • Prescribe and review gabapentinoids safely, including the risk of misuse
    • Plan a medication trial with a defined review point and stopping rule

  5. 5. Opioids: prescribing, tapering and dependence

    • Decide when an opioid trial is appropriate for chronic non-cancer pain
    • Recognise opioid-induced hyperalgesia, tolerance and dependence
    • Plan a safe opioid taper with the patient using NICE NG215 principles
    • Compare UK opioid guidance with the 2022 US guideline and explain where practice differs
Module 2 · Sessions 6 to 10Acute and perioperative pain

  1. 6. Running an acute pain service

    • Design a multimodal analgesic plan for common operations using procedure-specific recommendations
    • Apply the 2024 national consensus on peri-operative pain management to ward care
    • Set up monitoring and escalation for patient-controlled and epidural analgesia
    • Audit an acute pain service against the Faculty of Pain Medicine Core Standards

  2. 7. Regional anaesthesia and catheter techniques for acute pain

    • Select a regional technique that matches the surgical site and the patient
    • Recognise and treat local anaesthetic systemic toxicity
    • Apply antithrombotic timing guidance before neuraxial and deep blocks
    • Explain the benefits and risks of a nerve block to a patient for consent

  3. 8. Opioids after surgery and persistent post-surgical pain

    • Prescribe opioids at discharge in line with national best practice guidelines
    • Identify patients at risk of persistent post-surgical pain
    • Plan follow-up that detects and treats persistent post-surgical pain early
    • Lead an opioid stewardship initiative in a surgical unit

  4. 9. Acute pain in complex patients

    • Manage acute pain in patients on long-term opioids or opioid substitution therapy
    • Adjust analgesic choice and dose for renal and hepatic impairment
    • Assess pain in people with cognitive impairment using observational tools
    • Decide when low-dose ketamine is appropriate for acute pain

  5. 10. From acute to chronic: preventing the transition

    • Identify the risk factors that predict the transition from acute to chronic pain
    • Use stratified care to match treatment intensity to risk in acute back pain
    • Manage acute sciatica in line with NICE NG59, including when not to use gabapentinoids
    • Recognise early complex regional pain syndrome after injury and refer promptly
Module 3 · Sessions 11 to 15Chronic pain conditions

  1. 11. Chronic primary pain and fibromyalgia

    • Diagnose chronic primary pain and fibromyalgia without unnecessary investigation
    • Explain the diagnosis in a way that reduces fear and repeated testing
    • Build a management plan based on NICE NG193 and European recommendations
    • Deprescribe medicines that NICE NG193 advises against

  2. 12. Chronic low back pain and radicular pain

    • Manage chronic low back pain using the NICE NG59 pathway
    • Decide when imaging changes management and when it does not
    • Select patients for spinal injection or radiofrequency denervation using NICE NG59 criteria
    • Refer for a surgical opinion at the right time

  3. 13. Neuropathic pain

    • Diagnose neuropathic pain using history, examination and screening tools
    • Choose first-line treatment in line with NICE CG173 and the 2025 international recommendations
    • Use topical capsaicin and lidocaine for localised neuropathic pain
    • Decide when to refer for specialist or neuromodulation treatment

  4. 14. Complex regional pain syndrome

    • Diagnose complex regional pain syndrome using the Budapest criteria
    • Start early rehabilitation and coordinate the multidisciplinary team
    • Apply the UK national guideline on referral and management
    • Counsel patients on prognosis and realistic expectations

  5. 15. Headache and facial pain

    • Classify headache and identify red flags using NICE CG150
    • Recognise and manage medication overuse headache
    • Treat trigeminal neuralgia in line with the European Academy of Neurology guideline
    • Decide when to refer facial pain to neurology, dental or surgical colleagues
Module 4 · Sessions 16 to 20Interventional pain medicine

  1. 16. Safe practice in interventional pain medicine

    • Select patients for interventional procedures using clinical and psychological criteria
    • Manage antithrombotic drugs around pain procedures according to bleeding risk
    • Apply radiation safety and image guidance principles
    • Obtain consent that covers rare but serious neurological complications

  2. 17. Epidural and nerve root injections

    • Explain the evidence for epidural steroid injection in radicular pain
    • Choose between interlaminar, transforaminal and caudal approaches
    • Reduce the risk of catastrophic neurological complications
    • Set realistic expectations for how long the benefit lasts

  3. 18. Facet and sacroiliac joint pain and radiofrequency denervation

    • Select patients for medial branch blocks using clinical features and NICE NG59
    • Interpret diagnostic block results, including false positives
    • Critically appraise the major randomised trials of radiofrequency denervation
    • Plan radiofrequency denervation within an exercise-based programme

  4. 19. Neuromodulation

    • Select patients for spinal cord stimulation using NICE TA159 criteria
    • Explain why current neuropathic pain recommendations do not routinely recommend spinal cord stimulation
    • Describe the role of intrathecal drug delivery in refractory pain
    • Manage device complications and follow-up with the implanting team

  5. 20. Peripheral joint and soft-tissue procedures

    • Decide when a peripheral joint or soft-tissue injection is appropriate
    • Appraise the evidence for genicular nerve radiofrequency treatment in knee pain
    • Explain what platelet-rich plasma and other biologics can and cannot offer for chronic pain
    • Avoid repeated low-value injections by setting clear review criteria
Module 5 · Sessions 21 to 25Cancer pain, special populations and the pain service

  1. 21. Cancer pain

    • Titrate strong opioids for cancer pain in line with NICE CG140
    • Manage breakthrough pain and opioid adverse effects
    • Identify patients who need radiotherapy or an interventional procedure
    • Coordinate care with oncology and palliative care teams

  2. 22. Pain in older people and people with cognitive impairment

    • Assess pain in older adults using the UK national guidelines
    • Use observational pain tools for people who cannot report their pain
    • Choose analgesia that limits falls, delirium and constipation
    • Review and deprescribe analgesics in older patients

  3. 23. Pain, substance use and cannabis-based medicines

    • Recognise problematic use of prescribed medicines in people with pain
    • Manage pain in patients with opioid use disorder together with addiction services
    • Apply NICE NG144 when patients ask for cannabis-based medicines
    • Respond to requests for escalating doses without stigmatising the patient

  4. 24. New treatments and how to judge them

    • Appraise trials of new analgesics, including placebo and nocebo effects
    • Describe the mechanism and licensed use of new non-opioid analgesics
    • Apply consensus guidance when considering ketamine infusions for chronic pain
    • Evaluate digital and self-management tools before recommending them

  5. 25. Running a pain service, with a complex case panel

    • Apply the course to complex cases in a multidisciplinary panel discussion
    • Design a pain service that meets national core standards
    • Choose outcome measures to evaluate a pain service
    • Build a personal plan for continuing development in pain medicine

What the diploma includes

  • 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
  • Practising specialists teaching live, so you can put your questions to them.
  • Weekly MCQs and a final written assessment.
  • A digital certificate carrying your final classification.

Lead or teach the Pain Medicine Diploma

We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.

Apply to teach